Investing in Healthy Communities

Elizabeth F. Gondles, Ph.D.
Institute for Criminal Justice Healthcare

October 2009, Corrections Today

 
Many who commit crimes are unable to sustain healthy lives. They often come from poor neighborhoods and dysfunctional families and lack formal education, job opportunities, and quality health care. According to the Bureau of Justice Statistics, as of 2007 there were more than 7.3 million people in correctional systems (jails, prisons, probation, parole and community corrections). This population has a high prevalence of chronic medical and mental health issues, high rates of infections and sexually transmitted diseases, and substantial substance abuse disorders.

When I interview offenders, most of them say that they want help with their health problems, but have had limited or no access to health care throughout their lives. Time spent incarcerated may be the only time these men and women have access to adequate care.

The majority of the diseases and disorders found in correctional populations are contracted or developed in the community as a result of high-risk behaviors: substance abuse, unsafe sexual practices, violence, smoking and poor diet. This offender population with infectious or chronic diseases moves from the community, through correctional systems, and back to the community. Offenders in our correctional system today have been given the chance to improve their health through quality health care and to learn what they can do to support their continued wellness both “inside” and when they reenter the community.

Correctional health care professionals and public health agencies have a responsibility to reach this population. Together, in partnership, we have a responsibility to society and to offenders to continue developing and evaluating efficient, effective, and cost-conscience methods of delivering valid, evidence-based treatment and programs. We also have a legal, ethical and moral obligation to return offenders to the community in a reasonable state of health to facilitate their successful reentry.

In state correctional systems, at least 95 percent of all inmates will be released to the community — and more than 12 million people pass through our nation’s jails annually. While incarcerated, inmates receive health care that requires continuity in community health systems. In order to optimize this care they receive in our facilities, inmates must not return to a society plagued with social disparities, exhausted community resources, poorly equipped health clinics, and economic disadvantages. To address these public health challenges and ensure continued wellness and quality of life, community leaders must work with correctional health professionals, nurses, and the allied health professions to improve access to health, mental health and support services to the correctional population in our charge.

Our professional and fiscal responsibility is clear: corrections, public health agencies, and community health programs must collaborate to promote continuity of care for the incarcerated and ex-offenders. Correctional systems should have access to public health services in the community, and more attention should be focused on preventive care, as well as connecting successful interventions to both correctional and communal settings. Using evidence-based research, we must develop innovative programs that involve community educators and stakeholders in these health care initiatives. Correctional health professionals can help improve the health of communities throughout the country when they address the health concerns of offenders.

Health care is an ever-growing and ever-changing field. Correctional health care is growing and changing as well. These developments are not only the concern of health personnel, they affect all corrections professionals from line personnel to wardens to agency directors. It is important for society to recognize that the health care and education of offenders is closely tied to improved community health. Investing in the health care of adult and juvenile offenders and returning them back home healthy is a key to overall public wellness. By reaching offenders in the criminal justice system, we in corrections have the ability to deliver vital messages about healthy practices and strengthen and improve the health of the overall community. We must continue to reinforce and develop new strategies, as well as revamp old partnerships and form new ones to improve the health of all.