Correlates of same-year recidivism among jail detainees: implications for Medicaid and community-based reentry policy

Introduction: High incarceration and recidivism rates in the United States constitute a major public health concern, compounded by healthcare disruption and limited community reentry resources.Theory: In preparation for implementation of California’s Section 1115 Medicaid demonstration to expand services for justice-involved individuals, we examined correlates of same-year recidivism among new entrants to the Los Angeles County Jail system in 2023.Method: Using multivariable logistic regression, we analyzed 60,739 intake encounters to assess associations between subsequent jail return and demographic characteristics, substance use, houselessness, and communicable and chronic health conditions.Results: In adjusted analyses, severe mental health impairment (aOR 2.1, 95% CI 2.0–2.3), moderate impairment (aOR 1.5, 95% CI 1.4–1.6), houselessness (aOR 1.5, 95% CI 1.4–1.5), stimulant use (aOR 1.3, 95% CI 1.2–1.4), HIV infection (aOR 1.3, 95% CI 1.1–1.5), and hepatitis C infection (aOR 1.6, 95% CI 1.5–1.8) were independently associated with same-year recidivism.Discussion: These findings highlight the intersection of behavioral health needs, housing instability, and chronic disease burden during reentry. As California and other states implement Medicaid-funded reentry initiatives, coordinated community-based healthcare and enabling services will be critical to reducing short-term reincarceration.