Featured Publications
Evaluation of Changes in US Health Insurance Coverage for Individuals With Criminal Legal Involvement in Medicaid Expansion and Nonexpansion States, 2010 to 2017
Howell BA, Hawks L, Wang EA, Winkelman TNA. Evaluation of Changes in US Health Insurance Coverage for Individuals With Criminal Legal Involvement in Medicaid Expansion and Nonexpansion States, 2010 to 2017. JAMA Health Forum 2022, 3: e220493. PMID: 35977325, PMCID: PMC8994123, DOI: 10.1001/jamahealthforum.2022.0493.Peer-Reviewed Original ResearchA prospective cohort study examining exposure to incarceration and cardiovascular disease (Justice-Involved Individuals Cardiovascular Disease Epidemiology – JUSTICE study): a protocol paper
Howell BA, Puglisi LB, Aminawung J, Domingo KB, Elumn J, Gallagher C, Horton N, Kazi DS, Krumholz HM, Lin HJ, Roy B, Wang EA. A prospective cohort study examining exposure to incarceration and cardiovascular disease (Justice-Involved Individuals Cardiovascular Disease Epidemiology – JUSTICE study): a protocol paper. BMC Public Health 2022, 22: 331. PMID: 35172807, PMCID: PMC8848673, DOI: 10.1186/s12889-022-12688-x.Peer-Reviewed Original ResearchConceptsCardiovascular risk factorsProspective cohort studyRisk factorsCardiovascular diseaseCardiovascular riskCohort studyCVD riskPsychosocial factorsCVD risk factor controlRisk factor controlClinical risk factorsTraditional risk factorsHealth care useIncarceration exposureIndex releaseCVD morbidityCVD incidenceJail/prisonCare useDiscussionOur studyLeading causeClinical measuresPsychosocial stressEpidemiology studiesProtocol paperThe Stigma of Criminal Legal Involvement and Health: a Conceptual Framework
Howell BA, Earnshaw VA, Garcia M, Taylor A, Martin K, Fox AD. The Stigma of Criminal Legal Involvement and Health: a Conceptual Framework. Journal Of Urban Health 2022, 99: 92-101. PMID: 35031942, PMCID: PMC8866593, DOI: 10.1007/s11524-021-00599-y.Peer-Reviewed Original Research
2024
Postrelease Risk of Overdose and All-Cause Death Among Persons Released From Jail or Prison: Minnesota, March 2020-December 2021.
Hill K, Bodurtha P, Winkelman T, Howell B. Postrelease Risk of Overdose and All-Cause Death Among Persons Released From Jail or Prison: Minnesota, March 2020-December 2021. American Journal Of Public Health 2024, 114: 913-922. PMID: 39024534, PMCID: PMC11306622, DOI: 10.2105/ajph.2024.307723.Peer-Reviewed Original ResearchConceptsOverdose deathsPrison exposureJailPrisonRisk of overdoseRates of overdose deathsOverdose death ratesOpioid use disorderGeneral populationDeath recordsDrug overdosePeopleStandardized mortality ratioPersonsIncarcerationUse disorderPostreleaseMortality ratioDeath rateRisk of deathRetrospective cohort studyMortality riskCohort studyMinnesotaOverdoseAccessibility of Opioid Treatment Programs Based on Conventional vs Perceived Travel Time Measures
Kim J, Lee J, Thornhill T, Dennett J, Lu H, Howell B, Grau L, Fiellin D, Heimer R, Gonsalves G. Accessibility of Opioid Treatment Programs Based on Conventional vs Perceived Travel Time Measures. JAMA Network Open 2024, 7: e240209. PMID: 38376839, PMCID: PMC10879949, DOI: 10.1001/jamanetworkopen.2024.0209.Peer-Reviewed Original ResearchConceptsTransit travel timeAccessibility metricsTravel timeTravel componentsAccessibility scoresTransportation burdenTravel burdenOut-of-vehicleComponents of travelConventional accessibility measuresSpatial regression modelsTravel time measurementsPublic transitTransit schedulesAccessibility measuresDeparture timeTravel time analysisTrip durationTravelOperating hoursTime analysisCross-sectional studyOpioid use disorderPolicy recommendationsDecision-making
2023
Receipt of opioid use disorder treatments prior to fatal overdoses and comparison to no treatment in Connecticut, 2016–17
Heimer R, Black A, Lin H, Grau L, Fiellin D, Howell B, Hawk K, D'Onofrio G, Becker W. Receipt of opioid use disorder treatments prior to fatal overdoses and comparison to no treatment in Connecticut, 2016–17. Drug And Alcohol Dependence 2023, 254: 111040. PMID: 38043226, PMCID: PMC10872282, DOI: 10.1016/j.drugalcdep.2023.111040.Peer-Reviewed Original ResearchConceptsNon-medication treatmentsRelative riskOpioid overdose deathsIncidence rateMOUD treatmentOverdose deathsOpioid use disorder treatmentResults Incidence ratesRetrospective cohort studyDifferent treatment modalitiesPopulation-level effortsUse disorder treatmentFatal opioid poisoningsCohort studyOpioid poisoningTreatment modalitiesConclusion ExposurePoisoning deathsFatal overdosesTreatment exposureDisorder treatmentDeathTreatmentMethadoneRiskHealth Insurance and Mental Health Treatment Use Among Adults With Criminal Legal Involvement After Medicaid Expansion
Howell B, Hawks L, Balasuriya L, Chang V, Wang E, Winkelman T. Health Insurance and Mental Health Treatment Use Among Adults With Criminal Legal Involvement After Medicaid Expansion. Psychiatric Services 2023, 74: 1019-1026. PMID: 37016823, PMCID: PMC10939137, DOI: 10.1176/appi.ps.20220171.Peer-Reviewed Original ResearchConceptsHealth insurance coverageMental disordersMedicaid expansionSubstance useInsurance coverageTreatment useMental health treatment useAffordable Care Act Medicaid expansionMental health treatmentSubstance use disordersFederal poverty levelUse of treatmentsLegal involvementLow health insurance coverageNSDUH respondentsUse disordersHealth treatmentDrug useMental illnessPercentage point increaseAge 18Insurance accessDisordersHealth insuranceTreatmentConcordance between controlled substance receipt and post-mortem toxicology in opioid-detected overdose deaths: A statewide analysis
Howell B, Black A, Grau L, Lin H, Greene C, Lee H, Heimer R, Hawk K, D'Onofrio G, Fiellin D, Becker W. Concordance between controlled substance receipt and post-mortem toxicology in opioid-detected overdose deaths: A statewide analysis. Drug And Alcohol Dependence 2023, 244: 109788. PMID: 36738634, PMCID: PMC9975083, DOI: 10.1016/j.drugalcdep.2023.109788.Peer-Reviewed Original ResearchConceptsPost-mortem toxicologyOverdose deathsChief Medical ExaminerBenzodiazepine prescribingBenzodiazepine prescriptionsPrimary outcomePreventable deathsOpioid overdosesOpioidsAddiction servicesBenzodiazepinesMental healthStudy periodDeathMedical examinersConcordanceStatewide analysisSubstantial numberReceiptDaysDepartmentMedicationsToxicologyFentanylPrescribing
2022
Primary Care for Veterans Experiencing Homelessness: a Narrative Review of the Homeless Patient Aligned Care Team (HPACT) Model
Tsai J, Havlik J, Howell B, Johnson E, Rosenthal D. Primary Care for Veterans Experiencing Homelessness: a Narrative Review of the Homeless Patient Aligned Care Team (HPACT) Model. Journal Of General Internal Medicine 2022, 38: 765-783. PMID: 36443628, PMCID: PMC9971390, DOI: 10.1007/s11606-022-07970-y.Peer-Reviewed Original ResearchConceptsHomeless Patient Aligned Care TeamPrimary care medical home modelsVeterans' healthOnly original research studiesNarrative reviewPatient Aligned Care TeamsCare team modelPrimary care utilizationEmergency department utilizationMedical home modelDatabases Ovid MEDLINEPositive patient experienceVeterans Experiencing HomelessnessOriginal research studiesCare utilizationOvid EmbasePrimary careCare teamOvid MEDLINEInclusion criteriaPatient experiencePeer-reviewed studiesHome modelHealthcare outcomesVA system
2021
Changes In Health Services Use After Receipt Of Medications For Opioid Use Disorder In A Statewide Correctional System
Howell BA, Martin RA, Lebeau R, Truong AQ, Wang EA, Rich JD, Clarke JG. Changes In Health Services Use After Receipt Of Medications For Opioid Use Disorder In A Statewide Correctional System. Health Affairs 2021, 40: 1304-1311. PMID: 34339247, PMCID: PMC9036835, DOI: 10.1377/hlthaff.2020.02156.Peer-Reviewed Original ResearchConceptsOpioid use disorderReceipt of medicationHealth care useHealth service useCare useService useUse disordersTotal health care costsEmergency department visitsCorrectional settingsOpioid overdose mortalityEvidence-based treatmentsHealth care costsHealth care servicesRhode Island DepartmentUnified jailDepartment visitsPharmacy claimsInpatient admissionsMedicationsOutpatient servicesOverdose mortalityCare costsCare servicesAddiction treatmentThe Transitions Clinic Network: Post Incarceration Addiction Treatment, Healthcare, and Social Support (TCN-PATHS): A hybrid type-1 effectiveness trial of enhanced primary care to improve opioid use disorder treatment outcomes following release from jail
Howell BA, Puglisi L, Clark K, Albizu-Garcia C, Ashkin E, Booth T, Brinkley-Rubinstein L, Fiellin DA, Fox AD, Maurer KF, Lin HJ, McCollister K, Murphy S, Morse DS, Shavit S, Wang K, Winkelman T, Wang EA. The Transitions Clinic Network: Post Incarceration Addiction Treatment, Healthcare, and Social Support (TCN-PATHS): A hybrid type-1 effectiveness trial of enhanced primary care to improve opioid use disorder treatment outcomes following release from jail. Journal Of Substance Use And Addiction Treatment 2021, 128: 108315. PMID: 33583610, PMCID: PMC8319218, DOI: 10.1016/j.jsat.2021.108315.Peer-Reviewed Original ResearchConceptsTransitions Clinic NetworkOpioid use disorderPrimary careTreatment cascadeClinic networkOpioid Use Disorder Treatment OutcomesMedical needData Safety Monitoring BoardStandard primary careCommunity health centersCommunity health workersPrimary care teamsSafety monitoring boardCause of deathDisorder treatment outcomesPatient's medical needsHistory of incarcerationPolicy-level barriersOUD treatmentCare teamEffectiveness trialHealth centersTreatment outcomesCommon causeOpioid overdose
2019
Mental Health Treatment Among Individuals Involved in the Criminal Justice System After Implementation of the Affordable Care Act
Howell BA, Wang EA, Winkelman TNA. Mental Health Treatment Among Individuals Involved in the Criminal Justice System After Implementation of the Affordable Care Act. Psychiatric Services 2019, 70: 765-771. PMID: 31138056, DOI: 10.1176/appi.ps.201800559.Peer-Reviewed Original ResearchConceptsMental health treatmentHealth insurance coverageCriminal justice involvementHealth treatmentAffordable Care ActInsurance coveragePast-year criminal justice involvementJustice involvementMultivariable logistic regressionCare ActSerious psychological distressGeneral populationDrug useLogistic regressionAdjusted estimatesPsychological distressTreatmentNational surveyInvolvementStudy yearsPercentage pointsIndividualsPast yearYears
2016
Incarceration History and Uncontrolled Blood Pressure in a Multi-Site Cohort
Howell BA, Long JB, Edelman EJ, McGinnis KA, Rimland D, Fiellin DA, Justice AC, Wang EA. Incarceration History and Uncontrolled Blood Pressure in a Multi-Site Cohort. Journal Of General Internal Medicine 2016, 31: 1496-1502. PMID: 27619934, PMCID: PMC5130961, DOI: 10.1007/s11606-016-3857-1.Peer-Reviewed Original ResearchConceptsVeterans Aging Cohort StudyRecent incarcerationPost-traumatic stress disorderBP controlPast historyUncontrolled blood pressureBlood pressure controlHistory of hypertensionAging Cohort StudyCardiovascular disease mortalityRisk of hypertensionPrimary care engagementHistory of incarcerationLogistic regression modelsConclusionsAmong patientsUncontrolled BPAntihypertensive medicationsCohort studyBlood pressureClinical factorsHypertension outcomesMultivariable analysisCare engagementDisease mortalityInclusion criteria