{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T07:12:12Z","timestamp":1778051532834,"version":"3.51.4"},"reference-count":62,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:00Z","timestamp":1771804800000},"content-version":"vor","delay-in-days":53,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Rural Health"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Incarcerated women in rural Kentucky face significant barriers to healthcare, including provider shortages, geographic isolation, and limited access to preventive services. This study examines how county health rankings and primary care provider (PCP) availability relate to women's self\u2010reported health conditions and healthcare utilization prior to incarceration (PIT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 900 incarcerated women across nine Kentucky jails were screened for opioid use disorder and enrolled as part of a larger clinical trial. County\u2010level data, including 2023 County Health Rankings and 2022 PCP\u2010to\u2010population ratios, were merged with self\u2010reported data on health conditions and service use PIT. Logistic regression models assessed associations between county\u2010level indicators and pre\u2010incarceration healthcare utilization and health status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      On average, women were 37.3 years old, 92.6% non\u2010Hispanic White, and 67.1% lived in a rural county before jail. Women from counties with better health rankings were more likely to access substance use treatment (\n                      <jats:italic>AOR<\/jats:italic>\n                      = 0.993,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.028) before incarceration. Those from counties with poorer rankings were more likely to report hepatitis C (\n                      <jats:italic>AOR<\/jats:italic>\n                      = 1.008,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.002) but less likely to report other health concerns, possibly reflecting reduced access or awareness. Fewer available PCPs were associated with higher rates of chronic conditions, such as issues with blood pressure (e.g., hypertension;\n                      <jats:italic>AOR<\/jats:italic>\n                      = 0.782,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.010).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>County\u2010level disparities in healthcare infrastructure may significantly affect the health of women involved in the criminal legal system. Strengthening provider networks, expanding telehealth, and investing in rural health systems are critical to improving access and outcomes for this vulnerable population and may reduce recidivism and adverse post\u2010release health events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jrh.70130","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T21:44:30Z","timestamp":1773006270000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["County health rankings, provider shortages, and the health of incarcerated women with opioid use disorder"],"prefix":"10.1111","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-6023-7278","authenticated-orcid":false,"given":"Meghan","family":"Urhahn","sequence":"first","affiliation":[{"name":"University of Kentucky College of Medicine  Bowling Green Kentucky USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9269-0285","authenticated-orcid":false,"given":"Martha","family":"Tillson","sequence":"additional","affiliation":[{"name":"University of Kentucky Center on Drug and Alcohol Research  Lexington Kentucky USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brianna","family":"Gagen","sequence":"additional","affiliation":[{"name":"University of Kentucky College of Medicine  Bowling Green Kentucky USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Staton","sequence":"additional","affiliation":[{"name":"University of Kentucky Center on Drug and Alcohol Research  Lexington Kentucky USA"},{"name":"Department of Behavioral Science University of Kentucky College of Medicine  Lexington Kentucky USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,23]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2015.04.001"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2019.00914"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2020.102701"},{"key":"e_1_2_9_5_1","volume-title":"Health Professional Shortage Areas (HPSA) Data","author":"Health Resources and Services Administration","year":"2023"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102458\u201013\u2010713"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475\u20106773.12663"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/19371918.2015.1021024"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/10410236.2014.936337"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.52567\/pjsr.v3i3.224"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884\u2010019\u20102433\u20101"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/jrh.12335"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877\u2010017\u20100538\u20109"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph192215065"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1037\/rmh0000109"},{"key":"e_1_2_9_16_1","doi-asserted-by":"crossref","unstructured":"HoadleyA BassSB Zisman\u2010IlaniY et\u00a0al.Combined self\u2010stigma of justice system involvement opioid use and mental health disorder. 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