Workshop on Health and Incarceration
Download the report and the workshop highlights
The rate of incarceration in the United States is very high both historically and in comparison to that of other developed nations. Those in or entering U.S. jails and prisons experience symptoms of drug dependence or abuse, severe mental illness, HIV infection, diabetes mellitus and other chronic medical conditions at far higher rates than the general population. This is a problem not just for them but for the communities from which they come and to which, in nearly all cases, they will return.
A public workshop, jointly sponsored by the Institute of Medicine’s Board on Health of Select Populations and the National Academy of Science’s DBASSE Committee on Law and Justice, brought together leading academic and practicing experts to summarize what is known and remains to be known about these issues. Participants explored opportunities to improve health care for those who are at risk of incarceration and for their home communities.
The workshop discussion informed an NAS study by an ad hoc committee on causes, consequences, and alternatives to high rates of incarceration in the U.S.
► Summary of the Workshop
► Background paper by Dr. Josiah Rich for the event.
► Workshop Agenda
Bruce Western, Harvard University*
Josiah Rich, M.D., Brown University Medical School*
Craig Haney, University of California, Santa Cruz*
Scott Allen, University of California, Riverside (Presentation)
Redonna Chandler, NIDA (Presentation)
Jennifer Clarke, M.D., Brown University Medical Center
Robert Greifinger, M.D., John Jay College of Criminal Justice, CUNY (Presentation)
Jamie Fellner, Human Rights Watch (Presentation)
Newton Kendig, M.D., Federal Bureau of Prisons
Marc Mauer, The Sentencing Project
Fred Osher, M.D., Council of State Governments (Presentation)
Steven Rosenberg, Community Oriented Correctional Health Services
Faye Taxman, George Mason University (Presentation)
Emily Wang, M.D., Yale University (Presentation)
Brie Williams, M.D., University of California San Francisco (Presentation)
Chris Wildeman, Yale University (Presentation)
*Indicates a member of NAS study committee on causes and consequences of high rates of incarceration in the U.S.
Roundtable presentations and discussion addressed one or more of the following questions:
- What can we say with confidence about the incidence and sources of major health problems among the population subject to incarceration? What are the critical gaps in our knowledge of these questions?
- What is the status and range of variation in the quality of care, including screening and treatment, provided upon incarceration, while in jail or prison, and linkage to care upon release? What are the characteristics of high-performing systems (i.e., best practices) providing screening and care to prisoners, coordinating access to care during and following incarceration, and transferring medical information and records to and from other medical care providers? How are these related empirically to the health of prisoners and communities with a high incidence of incarceration and release?
- What is and what determines the impact of incarceration and release on the health of populations where incarceration and release are concentrated? What are their effects on racial or ethnic disparities in health care and health?
- From a public health standpoint, what are the best opportunities for improving both the health of those in prisons and jails and the health risks they present when released? How can implementation of the Affordable Care Act ensure continuity of medical care for those released from prison? What existing programs at the federal, state, and local/community levels are novel and evidence promise of reducing morbidity among prisoners and ensuring continuity of care following release?
- What promising innovative outreach and engagement models exist such as successfully employing prisoners or former prisoners in peer health education and/or in caretaker programs directed toward elderly/disabled prisoners and those with substance abuse histories?