Anti-Racism in Correctional Health Care: Position Statement

NCCHC’s newest position statement, Anti-Racism in Correctional Health Care, is an attempt to outline concrete steps that correctional health professionals, administrators, and decision-makers can take to begin to mitigate systemic racism and its effects on both the incarcerated population – disproportionately people of color – and correctional staff.

Background
It is widely understood that people of color are disproportionately represented in the American criminal justice system. People of color are more likely to be targeted for arrest, arrested, convicted, and sentenced to a term of incarceration, resulting in a significant overrepresentation of people of color in prisons and jails throughout the country. The U.S. population is comprised of about 13% Black people, while about 35% of people in jail are Black. While individuals are incarcerated, correctional health and custody professionals can work to mitigate further harm and minimize health disparities by following the nine steps outline in this position statement.

Action Steps

1. Acknowledge that while respect of incarcerated individuals and coworkers is necessary, the need to address systemic racism, including multigenerational trauma, goes beyond respect; thus, having a right to health care is not enough.
2. Cultivate an environment of openness, inclusion, and effective communication around racism and its impact on staff and incarcerated individuals.
3. Ensure that standard of care is provided to all patients, regardless of race and ethnicity, and with respect for how they self-identify.
   • Develop policies and procedures that dictate equitable care.
   • Collect and analyze clinical data in a way that allows for the identification of racial disparities in care.
   • Conduct continuous quality improvement studies using collaborative strategies to understand the root cause of disparities.
   • Take corrective action to improve care through appropriate means and conduct follow-up assessment of the corrective action to ensure effectiveness.
4. Cultivate a culture where health professionals are comfortable advocating for the needs of incarcerated individuals and addressing disparate care.
5. Acknowledge how personal biases influence those who provide health care to the incarcerated.
6. Promote the use of humanizing, non-stigmatizing language in health care and custody settings.
7. Define and measure key indicators related to race and ethnicity to identify and assess disparities in health care outcomes using consistent methods.
   • Include such data, when possible, in quality assurance and other evaluation and monitoring processes.
8. Implement action to address racism encountered by correctional health and correctional staff.
   • Establish action steps to combat overt and covert racism and microaggressions faced by Black, Indigenous, people of color who work in correctional health care.
   • Provide evidence-based education and training on racism and biases.
   • Collect and analyze racial, ethnic, and other demographic information for correctional health and correctional staff and the population served.
     1. Use these findings to support staffing practices focused on individuals who come from, and/or are sensitive and responsive to the needs of individuals from, the same communities and reflect the racial and ethnic background of the population served.
9. Implement a grievance system that accurately tracks and addresses patient and staff complaints about racism.

Although this position statement focuses on systemic racism, NCCHC acknowledges that historical disenfranchisement and societal mechanisms disproportionately harming people of color may also negatively impact Indigenous, LGBTQ+, women, and other minority populations in both similar and different ways. The impacts of systemic racism and the related disenfranchisement of people of color and their communities is particularly evident in the United States criminal legal system, historically and today. This position statement intends to provide a targeted and specific approach toward systemic racism as experienced by Black people in the United States.

The position statement was drafted by NCCHC’s Committee on Systemic Racism, formed in 2021 to address the issue of systemic racism in correctional health care, and recently approved by the NCCHC Governance Board. It is the culmination of the hard work and dedication of all members of the Committee on Systemic Racism, as well as input from participants at three open forums on the topic held during NCCHC conferences.

Read the new position statement on anti-racism.

Read the position statement on Addressing Systemic, Structural, and Institutional Racism in the Juvenile Legal System (2023).

See all NCCHC’s position statements.

By Joel T. Andrade, PhD, LICSW, CCHP-MH, and Mary Muse, MSN, RN, CCHP-RN, CCHP-A, co-chairs of the NCCHC Committee on Systemic Racism, and Claire Wolfe, MPH, MA, CCHP, staff liaison to the committee