Emergency Department Visits by Incarcerated Adults for ..

24
Emergency Department Visits by Incarcerated Adults for ..


Summary

What is already known about this topic?

Incarcerated adults experience disproportionate negative health outcomes compared with the general adult population, including unintentional and violence-related injuries.

What is added by this report?

The proportion of nonfatal injury-related emergency department (ED) visits by incarcerated adults resulting from assault or self-harm was five times as high as those among nonincarcerated adults. Among incarcerated adults, men and persons aged <65 years had the highest proportions of assault-related ED visits. Falls accounted for the most ED visits among incarcerated adults aged ≥65 years. A higher proportion of ED visits by incarcerated women than incarcerated men was for overdose or poisoning.

What are the implications for public health practice?

Tailoring injury prevention efforts for incarcerated adults with age- and sex-specific strategies might reduce injuries and ED visits in this population.

Altmetric:
Citations:
Views:

Views equals page views plus PDF downloads

During 2010–2019, United States. correctional authorities held 1.4–1.6 million persons in state and federal prisons annually, and 10.3–12.9 million persons were admitted to local jails each year (1,2). Incarcerated persons experience a disproportionate burden of negative health outcomes, including unintentional and violence-related injuries (3,4). No national studies on injury-related emergency department (ED) visits by incarcerated persons have been conducted, but a previous study demonstrated a high rate of such visits among a Seattle, Washington jail population (5). To examine nonfatal injury-related ED visits among incarcerated adults, CDC analyzed 2010–2019 National Electronic Injury Surveillance System–All Injury Program (NEISS-AIP) data. During 2010–2019, an estimated 733,547 ED visits by incarcerated adults occurred in the United States. The proportion of ED visits resulting from assault* and self-harm among incarcerated adults was five times as high as those among nonincarcerated adults. Among incarcerated adults, men and adult persons aged <65 years had the highest proportion of assault-related ED visits. Falls accounted for the most ED visits among incarcerated adults aged ≥65 years. A higher proportion of ED visits by incarcerated women than incarcerated men were for overdose or poisoning. These findings suggest that injuries among incarcerated adults differ from those among nonincarcerated adults and might require development and implementation of age- and sex-specific prevention strategies for this population.

NEISS-AIP collects data on patients treated in EDs for nonfatal injuries from a nationally representative, stratified probability sample of hospitals. Data are weighted by the inverse probability of selection to provide annual national estimates. A visit by an incarcerated person was defined as an ED visit by a person aged ≥18 years who was transported to an ED from a jail or prison for an injury.§ A visit by a nonincarcerated person was defined as an ED visit by any other persons aged ≥18 years. Data include a narrative summarizing the circumstances of each visit written by a trained data abstractor. Specific terms within narratives were used to identify visits by incarcerated persons. An iterative process was used to improve identification of visits by incarcerated persons through manual review of a sample of narratives by two authors to ensure that selected visits met the case definition and to identify additional terms.

The weighted number of ED visits among incarcerated and nonincarcerated adults were calculated using SAS-callable SUDAAN (version 11.0.1; RTI International). Visits were stratified by patient sex, age group, injury intent, mechanism of injury,** and disposition,†† and the proportion of visits with these characteristics was calculated separately for incarcerated and nonincarcerated adults. Ratio of proportions (RPs) with 95% CIs were calculated to compare ED visits by incarcerated and nonincarcerated adults. Rao-Scott chi-square tests were used to calculate p-values, and p-values <0.05 were considered statistically significant. SUDAAN Rlogist procedure was used to estimate RPs with 95% CIs by sex and age group among incarcerated adults. This activity was reviewed by CDC and was conducted consistent with applicable federal law and CDC policy.§§

During 2010–2019, an estimated 733,547 ED visits by incarcerated adults and 211,497,918 by nonincarcerated adults occurred in the United States (Table 1). Compared with ED visits among nonincarcerated adults, a higher proportion of ED visits among incarcerated adults were among men (83.7% versus 50.9%) and adults aged <45 years (77.1% versus 51.0%). The proportion of visits due to assault and self-harm was about five times as high among incarcerated adults (34.6% and 9.1%, respectively) than among nonincarcerated adults (6.5% and 1.9%, respectively). The most common mechanism of injury among incarcerated adults with an ED visit was being struck by or against an object (44.0%); among nonincarcerated adults, this mechanism accounted for 14.7% of ED visit injuries. The most common mechanisms of injury among nonincarcerated adults with an ED visit were “other” mechanisms (e.g., transportation-related injuries and drowning) (41.0%). A higher proportion of ED visits by incarcerated adults resulted in hospitalization or transfer to another hospital (17.3%) than did ED visits by nonincarcerated adults (13.2%).

Among incarcerated adults, the mechanism of injury for ED visits differed by age group (Table 2). When compared with ED visits by incarcerated adults aged ≥65 years, a higher proportion of ED visits by those aged 18–24 years resulted from being struck by or against an object or being cut or pierced, and a lower proportion of visits resulted from a fall. A higher proportion of ED visits by incarcerated adults aged 18–24 years was attributable to assault or self-harm compared with those by incarcerated adults aged ≥65 years. A lower proportion of ED visits in this youngest age group resulted in hospitalization or transfer to another hospital.

Reasons for ED visits by incarcerated adults also differed by sex (Table 3). Compared with ED visits by incarcerated men, a lower proportion of visits by incarcerated women resulted from being struck by or against an object, and a higher proportion were for fall-related injuries and overdose or poisoning. The proportion of ED visits attributable to assault by incarcerated women (20.0%) was lower than that by incarcerated men (37.4%).

Discussion

During the study period, an estimated 750,000 ED visits by incarcerated adults and >200 million by nonincarcerated adults occurred. The proportion of ED visits for assault and self-harm was five times as high among incarcerated adults than among nonincarcerated adults. A higher proportion of ED visits by incarcerated adults resulted from being struck by or against an object, compared with ED visits by nonincarcerated adults. Among incarcerated adults with injury-related ED visits, there were differences in injury mechanisms by age group and by sex. This study is the first to present national estimates of nonfatal injury-related ED visits by incarcerated adults in the United States.

A majority of ED visits among incarcerated adults were made by men and persons aged ≤45 years, likely reflecting the makeup of the incarcerated population (1,2). However, because older adults are the fastest growing segment of prison populations (6,7), it is notable that a higher proportion of ED visits for unintentional injuries, including falls, and a higher proportion of ED visits resulting in hospitalization occurred among incarcerated adults aged ≥65 years than occurred among younger incarcerated adults. A higher proportion of ED visits among incarcerated women were related to poisoning and falls, and a lower proportion were related to assault than were those by incarcerated men. These findings illustrate the importance of age- and sex-specific injury prevention strategies for incarcerated adults.

Approximately 50,000 assaults occurring within public correctional facilities are reported annually (7). Persons aged ≥18 years detained in jails were twice as likely to die by suicide in 2019 compared with persons in the overall United States. adult population (8). The higher proportion of assault- and self-harm–related ED visits among incarcerated persons, particularly among younger adults and men, points to the need for the development and implementation of violence and suicide prevention strategies that consider the intersectional factors related to incarceration.

The findings in this report are subject to at least five limitations. First, there are differences in health care access for incarcerated persons, which might partially explain the observed differences. For example, some correctional facilities have the capacity to provide health care on-site, and therefore, a subset of injuries among incarcerated adults might not be represented in these findings. The decision to seek ED care is made by authorities rather than patients, which can affect the types of ED visits made by incarcerated persons and be biased toward more serious injuries. Second, it is unclear how the proximity of NEISS-AIP–participating hospitals to correctional facilities affects national estimates presented in this study. Third, classification of incarcerated status was based on text narratives written by NEISS-AIP data abstractors, which might have led to misclassification of incarceration status. Fourth, it was not possible to determine when the injury occurred for incarcerated cases; therefore, data include injuries that can have occurred before incarceration. Finally, data on race and ethnicity were not presented because these data in NEISS-AIP are incomplete; however, United States. Department of Justice statistics consistently demonstrate that Black or African American men are disproportionately overrepresented in the correctional system (1,2) stemming from upstream factors, particularly structural racism (9), and are therefore likely overrepresented in these data.

Nearly one in every 100 persons in the United States is in a prison or jail (10), and this study found that characteristics of ED visits by incarcerated adults differ from those by nonincarcerated adults. These differences suggest that setting-appropriate risk-prevention strategies that account for the conditions experienced while incarcerated can help prevent injuries among incarcerated persons. Increased availability of community- and facility-level resources for comprehensive mental health services and creating protective environments can help mitigate the risk for self-harm and violence associated with incarceration. CDC has created technical packages and resources that outline evidence-based strategies for communities for preventing suicide,¶¶ interpersonal and community violence,*** overdose,††† and falls§§§; tailoring these strategies and developing interventions for the jail and prison setting with age-appropriate and sex-specific recommendations might reduce injuries and ED visits in this population.

Acknowledgments

Dana Flanders, Amy Funk Wolkin, Keming Yuan, National Center for Injury Prevention and Control, CDC.


1Division of Injury Prevention, National Center for Injury Prevention and Control, CDC.

References

  1. Carson A. Prisoners in 2020—statistical tables. Washington, DC: US Department of Justice, Bureau of Justice Statistics; 2021. https://bjs.ojp.gov/content/pub/pdf/p20st.pdf
  2. Minton TM, Zeng Z. Jail inmates in 2020—statistical tables. Washington, DC: US Department of Justice, Bureau of Justice Statistics; 2021. https://bjs.ojp.gov/library/publications/jail-inmates-2020-statistical-tables
  3. Haber LA, Erickson HP, Ranji SR, Ortiz GM, Pratt LA. Acute care for patients who are incarcerated: a review. JAMA Intern Med 2019;179:1561–7. https://doi.org/10.1001/jamainternmed.2019.3881 PMID:31524937
  4. Fazel S, Baillargeon J. The health of prisoners. Lancet 2011;377:956–65. https://doi.org/10.1016/S0140-6736(10)61053-7 PMID:21093904
  5. Maher PJ, Adedipe AA, Sanders BL, Buck T, Craven P, Strote J. Emergency department utilization by a jail population. Am J Emerg Med 2018;36:1631–4. https://doi.org/10.1016/j.ajem.2018.06.034 PMID:29960660
  6. Psick Z, Simon J, Brown R, Ahalt C. Older and incarcerated: policy implications of aging prison populations. Int J Prison Health 2017;13:57–63. https://doi.org/10.1108/IJPH-09-2016-0053 PMID:28299972
  7. Maruschak LM, Buehler ED. Census of state and federal adult correctional facilities, 2019—statistical tables. Washington, DC: US Department of Justice, Bureau of Justice Statistics; 2021. https://bjs.ojp.gov/content/pub/pdf/csfacf19st.pdf
  8. Carson A. Mortality in local jails, 2000–2019—statistical tables. Washington, DC: US Department of Justice, Bureau of Justice Statistics; 2021. https://bjs.ojp.gov/library/publications/mortality-local-jails-2000-2019-statistical-tables
  9. Dumont DM, Allen SA, Brockmann BW, Alexander NE, Rich JD. Incarceration, community health, and racial disparities. J Health Care Poor Underserved 2013;24:78–88. https://doi.org/10.1353/hpu.2013.0000 PMID:23377719
  10. Wagner P, Burtram W. What percent of the United States. is incarcerated? (and other ways to measure mass incarceration). Northampton, MA: Prison Policy Initiative, 2020. https://www.prisonpolicy.org/blog/2020/01/16/percent-incarcerated/

TABLE 1. Estimated number of nonfatal injury-related emergency department visits among incarcerated and nonincarcerated adults — National Electronic Injury Surveillance System–All Injury Program, United States, 2010–2019Return to your place in the text
Characteristic Incarcerated Nonincarcerated RP p-value
No.* % (95% CI) No. % (95% CI)
Total 733,547 211,497,918
Sex
Men 614,174 83.7 (78.9–88.5) 107,723,904 50.9 (48.9–53.0) 1.64 <0.001
Women 119,373 16.3 (11.5–21.1) 103,771,368 49.1 (47.0–51.1) 0.33 <0.001
Age group, yrs
18–24 146,858 20.0 (17.4–22.7) 33,850,167 16.0 (15.0–17.0) 1.25 0.004
25–34 261,062 35.6 (33.7–37.5) 41,261,154 19.5 (18.6–20.4) 1.82 <0.001
35–44 158,055 21.5 (20.2–22.9) 32,846,662 15.5 (14.9–16.2) 1.39 <0.001
45–54 95,325 13.0 (11.7–14.3) 33,670,314 15.9 (15.1–16.7) 0.82 <0.001
55–64 46,951 6.4 (5.1–7.7) 26,762,203 12.7 (12.4–12.9) 0.51 <0.001
≥65 25,296 3.4 (2.2–4.7) 43,107,418 20.4 (17.8–23.0) 0.17 <0.001
Injury intent
Unintentional or undetermined 413,518 56.4 (51.5–61.3) 193,843,811 91.7 (90.0–93.3) 0.62 <0.001
Assault 253,561 34.6 (29.2–39.9) 13,733,851 6.5 (4.9–8.1) 5.32 <0.001
Self-harm 66,468 9.1 (7.1–11.0) 3,920,256 1.9 (1.6–2.2) 4.89 <0.001
Mechanism of injury
Struck by or against an object 323,085 44.0 (38.7–49.4) 31,057,444 14.7 (13.6–15.7) 3.00 <0.001
Other 149,666 20.4 (17.3–23.5) 86,763,946 41.0 (39.1–42.9) 0.50 <0.001
Fall 145,096 19.8 (17.4–22.2) 62,093,113 29.4 (27.1–31.6) 0.67 <0.001
Overdose or poisoning 56,319 7.7 (5.7–9.7) 14,602,531 6.9 (5.9–7.9) 1.11 0.388
Cut or pierce 48,405 6.6 (5.2–8.0) 14,359,137 6.8 (6.3–7.3) 0.97 0.814
Inhalation or suffocation 6,881 0.9 (0.5–1.3) 400,448 0.2 (0.1–0.2) 4.96 <0.001
Fire or burn 4,096 0.6 (0.4–0.7) 2,221,300 1.1 (1.0–1.1) 0.53 <0.001
Disposition
Treated and released 585,293 79.8 (76.4–83.2) 176,024,926 83.3 (80.0–86.7) 0.96 0.053
Transferred or hospitalized 126,702 17.3 (13.8–20.8) 27,899,796 13.2 (11.4–15.1) 1.31 <0.001
Other (AMA/LWBS, Unk, or observation) 21,552 2.9 (1.3–4.6) 7,308,060 3.5 (0.7–6.2) 0.85 0.393

Abbreviations: AMA = against medical advice; LWBS = left without being seen; RP = ratio of proportions; Unk = unknown.
* Numbers are weighted.
The nonincarcerated sample was used as the referent group for this analysis.

TABLE 2. Characteristics of nonfatal injury-related emergency department visits among incarcerated adults, by age group — National Electronic Injury Surveillance System–All Injury Program, United States, 2010–2019Return to your place in the text
Characteristic Age group, yrs
18–24 25–34 35–44 45–54 55–64 ≥65
% (95% CI) RP (95% CI) % (95% CI) RP (95% CI) % (95% CI) RP (95% CI) % (95% CI) RP (95% CI) % (95% CI) RP (95% CI) % (95% CI) RP (95% CI)
Injury intent
Unintentional or undetermined 51.6
(46.6–56.6)
0.6*
(0.6–0.6)
52.6
(47.3–57.9)
0.6*
(0.6–0.7)
54.8
(50.8–58.9)
0.6*
(0.6–0.7)
63.7
(57.6–69.8)
0.8*
(0.7–0.8)
66.2
(58.6–73.8)
0.8*
(0.7–0.8)
86.6
80.0–93.2)
Ref
Assault 39.1
(33.1–45.1)
3.1*
(2.2–4.4)
36.3
(29.9–42.6)
2.9*
(2.1–4.1)
35.3
(30.9–39.7)
2.8*
(2.0–4.0)
30.3
(24.8–35.7)
2.4*
(1.7–3.4)
29.0
(21.4–36.7)
2.3*
(1.6–3.3)
12.6
(5.8–19.4)
Ref
Self-harm 9.3
(6.8–11.9)
11.5*
(3.3–40.3)
11.1
(7.9–14.3)
13.7*
(4.0–47.6)
9.9
(7.2–12.5)
12.2*
(3.5–42.4)
6.0
(4.7–7.4)
7.5*
(2.1–26.4)
4.8
(2.9–6.7)
5.9*
(1.6–21.7)
Ref
Mechanism of injury
Struck by or against an object 51.8
(45.5–58.1)
2.7*
(2.0–3.5)
45.8
(39.7–52.0)
2.4*
(1.8–3.5)
43.4
(38.5–48.4)
2.2*
(1.7–2.9)
37.7
(32.6–42.8)
1.9*
(1.5–2.5)
38.0
(31.3–44.7)
2.0*
(1.5–2.6)
19.5
(12.2–26.8)
Ref
Other 18.3
(14.9–21.7)
1.0
(0.8–1.3)
21.0
(17.4–24.7)
1.2
(0.9–1.5)
21.6
(18.3–25.0)
1.2
(0.9–1.6)
21.6
(17.3–25.9)
1.2
(0.9–1.6)
18.0
(12.5–23.4)
1.0
(0.7–1.4)
18.4
(13.4–23.3)
Ref
Fall 14.2
(12.2–16.2)
0.3*
(0.2–0.3)
16.3
(13.4–19.3)
0.3*
(0.3–0.4)
18.8
(16.5–21.0)
0.4*
(0.3–0.4)
23.9
(19.9–27.8)
0.5*
(0.4–0.5)
33.5
(27.2–39.7)
0.6*
(0.5–0.7)
53.6
(43.5–63.7)
Ref
Overdose or poisoning 7.8
(4.6–11.0)
1.4
(0.8–2.5)
7.3
(5.0–9.6)
1.4
(0.8–2.3)
7.8
(5.6–10.1)
1.5
(0.8–2.5)
9.7
(7.0–12.5)
1.8*
(1.0–3.2)
5.9
(3.1–8.7)
1.1
(0.6–2.0)
Ref
Cut or pierce 6.7
(5.0–8.4)
3.5*
(1.5–8.1)
7.9
(5.7–10.2)
4.2*
(1.8–9.5)
6.8
(5.1–8.6)
3.6*
(1.6–8.3)
5.1
(3.6–6.7)
2.7*
(1.2–6.4)
3.5
(1.8–5.2)
1.9
(0.7–4.7)
Ref
Inhalation or suffocation 1.1
(0.5–1.7)
3.3
(0.4–24.3)
Ref
Fire or burn 0.6
(0.3–1.0)
0.7
(0.2–2.9)
Ref
Disposition
Treated and released 86.7
(83.8–89.5)
1.2*
(1.1–1.3)
80.3
(76.6–84.0)
1.1*
(1.0–1.2)
79.3
(75.0–83.7)
1.1
(1.0–1.2)
74.5
(69.3–79.8)
1.0
(0.9–1.1)
70.3
(65.4–75.2)
0.9
(0.9–1.0)
74.7
(68.1–81.3)
Ref
Transferred or hospitalized 10.5
(8.3–12.7)
0.5*
(0.3–0.6)
16.5
(12.8–20.2)
0.7*
(0.6–0.9)
18.3
(13.7–22.9)
0.8*
(0.6–1.0)
21.6
(16.6–26.6)
0.9
(0.7–1.2)
27.2
(22.3–32.0)
1.2
(0.9–1.5)
23.7
(16.8–30.5)
Ref
Other (AMA/LWBS, Unk, or observation) 3.9
(1.8–5.9)
2.4
(1.0–6.0)
Ref

Abbreviations: AMA = against medical advice; LWBS = left without being seen; Ref = referent group; RP = ratio of proportions; Unk = unknown.
* Statistically significant at p<0.05.
Dashes indicate that values were suppressed because of one of the following criteria: small sample size (<20 cases), a weighted estimate <1,200, or a coefficient of variation >30%.

TABLE 3. Characteristics of nonfatal injury-related emergency department visits among incarcerated adults, by sex — National Electronic Injury Surveillance System–All Injury Program, United States, 2010–2019Return to your place in the text
Characteristic Men Women
% (95% CI) RP % (95% CI) RP
Injury intent
Unintentional or undetermined 53.5 (48.8–58.1) Ref 71.3 (68.0–74.7) 1.3* (1.3–1.4)
Assault 37.4 (32.0–42.8) Ref 20.0 (17.4–22.6) 0.5* (0.5–0.6)
Self–harm 9.1 (6.8–11.4) Ref 8.7 (6.4–11.0) 1.0 (0.8–1.2)
Mechanism of injury
Struck by or against an object 46.6 (40.9–52.2) Ref 31.1 (27.8–34.5) 0.7* (0.6–0.7)
Other 19.1 (16.0–22.1) Ref 27.2 (23.8–30.6) 1.4* (1.3–1.6)
Fall 19.0 (16.7–21.3) Ref 23.8 (18.9–28.7) 1.3* (1.1–1.4)
Overdose or poisoning 7.1 (4.9–9.3) Ref 10.7 (8.0–13.5) 1.5* (1.3–1.8)
Cut or pierce 6.9 (5.2–8.6) Ref 5.2 (3.7–6.8) 0.8* (0.6–1.0)
Inhalation or suffocation 0.9 (0.5–1.4) Ref
Fire or burn 0.5 (0.4–0.6) Ref
Disposition
Treated or released 79.5 (75.8–83.2) Ref 81.4 (78.1–84.6) 1.0 (1.0–1.1)
Transferred or hospitalized 17.8 (13.9–21.6) Ref 14.8 (11.9–17.7) 0.8* (0.7–1.0)
Other (AMA/LWBS, Unk, or observation) 2.8 (1.2–4.4) Ref 3.8 (1.8–5.8) 1.4* (1.0–1.9)

Abbreviations: AMA = against medical advice; LWBS = left without being seen; Ref = referent group; RP = ratio of proportions; Unk = unknown.
* Statistically significant at p<0.05.
Dashes indicate that values were suppressed because of either small sample size (<20 cases) or a weighted estimate <1,200.

Suggested citation for this article: Wulz A, Miller G, Navon L, Daugherty J. Emergency Department Visits by Incarcerated Adults for Nonfatal Injuries — United States, 2010–2019. MMWR Morb Mortal Wkly Rep 2023;72:278–282. DOI: http://dx.doi.org/10.15585/mmwr.mm7211a2.


MMWR and Morbidity and Mortality Weekly Report are service marks of the United States. Department of Health and Human Services.

Use of trade names and commercial sources is for identification only and does not imply endorsement by the United States. Department of
Health and Human Services.
References to non-CDC sites on the Internet are
provided as a service to MMWR readers and do not constitute or imply
endorsement of these organizations or their programs by CDC or the United States.
Department of Health and Human Services. CDC is not responsible for the content
of pages found at these sites. URL addresses listed in MMWR were current as of
the date of publication.

All HTML versions of MMWR articles are generated from final proofs through an automated process.
This conversion might result in character translation or format errors in the HTML version.
Users are referred to the electronic PDF version (https://www.The Centers for Disease Control and Prevention headquartered in Atlanta (CDC).gov/mmwr)
and/or the original MMWR paper copy for printable versions of official text, figures, and tables.

Questions or messages regarding errors in formatting should be addressed to
mmwrq@The Centers for Disease Control and Prevention headquartered in Atlanta (CDC).gov.


Disasters Expo USA, is proud to be supported by Inergency for their next upcoming edition on March 6th & 7th 2024!

The leading event mitigating the world’s most costly disasters is returning to the Miami Beach

Convention Center and we want you to join us at the industry’s central platform for emergency management professionals.
Disasters Expo USA is proud to provide a central platform for the industry to connect and
engage with the industry’s leading professionals to better prepare, protect, prevent, respond
and recover from the disasters of today.
Hosting a dedicated platform for the convergence of disaster risk reduction, the keynote line up for Disasters Expo USA 2024 will provide an insight into successful case studies and
programs to accurately prepare for disasters. Featuring sessions from the likes of The Federal Emergency Management Agency,
NASA, The National Aeronautics and Space Administration, NOAA, The National Oceanic and Atmospheric Administration, TSA and several more this event is certainly providing you with the knowledge
required to prepare, respond and recover to disasters.
With over 50 hours worth of unmissable content, exciting new features such as their Disaster
Resilience Roundtable, Emergency Response Live, an Immersive Hurricane Simulation and
much more over just two days, you are guaranteed to gain an all-encompassing insight into
the industry to tackle the challenges of disasters.
By uniting global disaster risk management experts, well experienced emergency
responders and the leading innovators from the world, the event is the hub of the solutions
that provide attendees with tools that they can use to protect the communities and mitigate
the damage from disasters.
Tickets for the event are $119, but we have been given the promo code: HUGI100 that will
enable you to attend the event for FREE!

So don’t miss out and register today: https://shorturl.at/aikrW

And in case you missed it, here is our ultimate road trip playlist is the perfect mix of podcasts, and hidden gems that will keep you energized for the entire journey

-

This website uses cookies to improve your experience. We'll assume you're ok with this, but you can opt-out if you wish. Accept Read More