Health Disparities and the Criminal Justice System: An Agenda for Further Research and Action

Abstract

Although racial and ethnic minorities are more likely to be involved with the criminal justice system than whites in the USA, critical scientific gaps exist in our understanding of the relationship between the criminal justice system and the persistence of racial/ethnic health disparities. Individuals engaged with the criminal justice system are at risk for poor health outcomes. Furthermore, criminal justice involvement may have direct or indirect effects on health and health care. Racial/ethnic health disparities may be exacerbated or mitigated at several stages of the criminal justice system. Understanding and addressing the health of individuals involved in the criminal justice system is one component of a comprehensive strategy to reduce population health disparities and improve the health of our urban communities.

What The Affordable Care Act Means For People With Jail Stays

“…For example, compared to the general population, people in jail have higher rates of arthritis, diabetes, hepatitis B and C, tuberculosis, HIV/AIDS, and sexually transmitted illnesses. 10 In addition, these conditions tend to be diagnosed at more advanced stages in inmates than in age-adjusted comparison populations. 11 Untreated and unmanaged, these conditions worsen over time, placing greater burdens on the individual and driving up health care costs through inefficient use of health services.…”

Caring for Those in Custody: Identifying High-Priority Needs to Reduce Mortality in Correctional Facilities

“…Stress associated with institutional life, overcrowding, inadequate access to exercise, improper diet, exposure to infectious diseases, and poor sanitation and ventilation can all contribute to mortality. Finally, while inmates have a constitutional right to health care, the access to and the quality of the care in correctional facilities are variable (Binswanger, Redmond, et al, 2012). Insufficient resources play a key role here.…”

“…These factors, can contribute to increased risk of overdose in the period immediately following release (Binswanger, Redmond, et al, 2012). Second, panelists articulated the need to more effectively link inmates with sources of substance abuse treatment and, in particular, sources of medication-assisted therapies, such as methadone and buprenorphine, before they are released.…”

The Need for Higher Standards in Correctional Healthcare to Improve Public Health

“…With 2.2 million Americans behind bars, and 10 million cycling through correctional systems each year, 5 U.S. correctional healthcare has provided medical care to 1 in 30 living American adults, the majority of whom are from impoverished communities, where poor healthcare access is the norm. [6][7][8][9][10] Since more than 95% of prisoners eventually return to the community, correctional healthcare has the opportunity, and the obligation, to transform care for persons and communities most in need. 11 Moreover, given that incarcerated populations are disproportionately from traditionally underserved and/or disadvantaged backgrounds and have a high burden of disease, these goals also hold the promise of reducing health disparities.…”

“…11 Moreover, given that incarcerated populations are disproportionately from traditionally underserved and/or disadvantaged backgrounds and have a high burden of disease, these goals also hold the promise of reducing health disparities. 6,8,12 We delineate three areas-screening and treatment for hepatitis C, improved mental health care, including treatment for addiction disorders, and attention to geriatric care-that exemplify the critical need for proactive, evidence-based correctional healthcare that reaches beyond minimum standards and integrates prisoner healthcare into mainstream medicine in order to improve the health of individuals and communities.…”