2352-P: The Association between Recency of Criminal Legal Involvement and Acute Health Care Utilization among U.S. Adults with Diabetes

Introduction and Objective: Over 100 million Americans experience criminal legal involvement (CLI) in their lifetime. The prevalence of diabetes is higher among those with CLI, and CLI is associated higher rates of acute care utilization (ACU), though this relationship is not well understood. It is not known if recent compared to remote CLI has a stronger association with high ACU among adults with diabetes. Therefore, this study tested the association between never, remote, or recent CLI and ACU in a nationally representative sample of US adults with diabetes. Methods: Using data from the National Survey of Drug Use and Health (2021-2023), we included respondents with diabetes (n=10,188). The primary independent variable was CLI: no prior CLI; CLI during lifetime, but not in the past year (remote CLI); or CLI in the past 12 months (recent CLI). Our outcomes included ACU: emergency visits and hospitalizations. Negative binomial regression models controlled for relevant sociodemographic confounders. Results: Among Americans with diabetes, a weighted 4.1 million (13.9%) reported remote CLI and 0.4 million (1.4%) reported recent CLI. Among individuals with CLI in the past year, 46% were living in poverty, 32% had less than a high school education, and 10% were uninsured. There was no significant relationship between remote CLI and ED visits or hospitalizations compared to those with no prior CLI. However, in both unadjusted and adjusted models, those with past year arrest had significantly more ED visits (adjusted IRR 2.16; 95% CI 1.72, 2.71) and hospitalizations (adjusted IRR 1.80; 95% CI, 1.23, 2.65) in comparison to those with no prior CLI. Conclusion: This nationally representative study of US adults estimates that nearly half a million had diabetes and recent CLI. Recent CLI, but not remote CLI, was associated with higher rates of ED use and inpatient admissions. Researchers should prioritize interventions focused on the period immediately following an interaction with the criminal legal system in adults with diabetes. Disclosure L.C. Hawks: None. S. Nagavally: None. J.S. Williams: None. Funding National Institutes of Health/NIDDK (1K23DK132505) PI: Hawks