Journal of Correctional Health Care
Article Abstracts
Volume 10, Issue 3 — Fall 2003
·
Preface Jeremy Travis, JD, MPA, and Anna S. Sommers, PhD By most measures,
prisoners are burdened by health concerns at levels far higher
than in the general U.S. population. They exhibit markedly
higher rates of HIV and AIDS, tuberculosis, hepatitis C, and
mental illness. They have significant histories of alcohol and
substance abuse, with addiction levels that exceed those found
in the general population (National Commission on Correctional
Health Care, 2002). Yet, unlike most Americans, prisoners have
access to a health care system, paid for by state and federal
taxpayers, that attends to a wide range of their health needs.
They are typically screened for a variety of illnesses at
admission, and can call upon this health care system to respond
to health needs ranging from routine illnesses to kidney
dialysis and even heart transplants.
(complete Preface continues here…)
·
Prison Health Services: An Overview B. Jaye Anno, PhD, CCHP-A
This article presents a brief overview of prison health services
30 years ago and compares that picture to prison health services
today. While there have been substantial improvements in the
development of adequate health care delivery systems in prisons,
the author notes that there are still underserved populations in
our nation’s prison systems. Among them are the mentally
retarded, the nonaggressive mentally ill, substance abusers, sex
offenders, hepatitis C-infected inmates, and the terminally ill.
Other areas where prison systems could improve include the
development of effective quality improvement programs and the
initiation of discharge planning programs for inmates with
serious health needs. Financing for prison health services is
also discussed. The article concludes with a call for prison
health staff to develop better linkages with their public health
colleagues, particularly in information sharing, to avoid
duplication of services.
·
Health Profile of the State Prison
Population and Returning Offenders: Public Health Challenges Lois M. Davis, PhD; Sharon Pacchiana, FNP
This paper first presents an overview of the changing
characteristics of the reentry population and its demographics.
Second, it presents national estimates of the prevalence of
certain chronic medical conditions, infectious diseases, mental
illness, and substance abuse and dependency within the state
prison and soon-to-be-released populations. Third, it discusses
comorbidity and the limitations in our ability to determine what
medical conditions among released offenders may have been
preexisting. Fourth, it considers some key treatment and ethical
dilemmas that improved screening raises for the correctional
health and public health systems, and examines some emerging
challenges.
·
Linkages Between In-Prison and
Community-Based Health Services Cheryl Roberts, MPA; Sofia Kennedy, MPH; Theodore M.
Hammett, PhD This
paper draws on a study of discharge planning for HIV-infected
inmates in 10 large state correctional systems as well as on a
review of literature to identify key elements associated with
successful programs in the areas of organization and structure
(e.g., dedicated staff and formal collaborations with health
departments, community-based organizations, and parole
agencies), program operations (e.g., continuity of care
mechanisms, access to eligible clients, arrangement of specific
appointments with community providers, provision of supplies of
medications at release, and assistance with basic needs) and
policy (e.g., dedicated funding, improved community-based
services, and better and more timely access to public benefit
programs).
·
Community Health Services for
Returning Jail and Prison Inmates Nicholas Freudenberg, DrPH
Inmates leaving jail and prison often return to an environment
in which a significant portion of the population lacks health
insurance coverage, different types of health care are
inadequately coordinated, and the quality of care is often
suboptimal. Many encounter discrimination based on race,
ethnicity, drug use, mental health status, or criminal justice
history. Moreover, returning inmates have health and social
needs that the health care system has difficulty meeting. These
include co-occurring disorders such as infectious and chronic
diseases, addiction, and other mental health problems; low
literacy; other serious life problems; and difficulty in
navigating complex systems. Strategies to improve health care
for returning inmates include better linkages between correction
and community health services, case management, publicly funded
health insurance that covers inmates as soon as they are
released, and partnerships between correctional agencies, health
departments, and service providers.
·
What is Known About the
Cost-Effectiveness of Health Services for Returning Prisoners? Embry M. Howell, PhD; Robert B. Greifinger, MD; Anna S.
Sommers, PhD
This literature review on the cost-effectiveness of health
services for returning prisoners focuses on studies related to
screening and treatment for five conditions disproportionately
prevalent among returning prisoners: HIV, sexually transmitted
diseases, tuberculosis, mental illness, and substance abuse.
Research suggests that programs addressing all of these
conditions are cost-effective. However, there are not enough
well-designed studies that include returning prisoners — or
very similar populations — to draw definite conclusions. More
research is needed to assess the impacts of such on returning
prisoners. Community coalitions are needed to generate financial
support and negotiate the allocation of programs across
governmental sectors for this population.
·
Insiders as Outsiders: Race,
Gender, and Cultural Considerations Affecting Health Outcome
After Release to the Community Raymond F. Patterson, MD; Robert B. Greifinger, MD
This paper describes the formidable barriers to the design and
implementation of successful illness prevention programs behind
bars, some having to do with the experience and culture of the
individual inmate, and some having to do with the culture and
biases of correctional facility staff and operations. The
implementation of a primary care model with attention to race
and culture will go a long way toward improving diagnosis.
Treatment planning and prerelease planning can then be designed
to improve the opportunities for successful community
reintegration.
·
Dynamics of Social Capital of
Prisoners and Community Reentry: Ties That Bind? Nancy Wolff, PhD, and Jeffrey Draine, PhD
This paper focuses on the social capital of prisoners and the
impact of criminal behavior and incarceration on its formation
and mobilization. Emphasis is on the time-varying nature of four
attributes of social capital: the strength of connections, the
ability to mobilize them, the endowment of resources within
these relationships, and their social context. The incarceration
experience has the potential to alter the attributes of social
capital in ways that reduce its ability to improve health and
justice outcomes. To offset this effect, an investment strategy
is recommended that could have a positive impact on the
prisoner’s social capital and prospects for successful
reentry.
