Health and Incarceration: A Workshop Summary (2013)

Appendix

Workshop Agenda and Participants

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.

To explore and expand the knowledge basis for policies to address the health needs of those in prison and benefit them and their home communities, a public workshop will bring together leading academic and practicing experts, to summarize what is known about these issues, what critical gaps in our knowledge should be filled with new research, and what appear to be the best opportunities to improve healthcare for those who are now or will be incarcerated. The half-day workshop will be held at the National Academy of Sciences’ (NAS’) Keck Center, Room 110, 500 5th Street NW, Washington, DC, from 12:30 to 4:30 p.m., on Wednesday, December 5, 2012.

This workshop is jointly sponsored by the Institute of Medicine’s Board on the Health of Select Populations and the National Research Council’s (NRC’s) Committee on Law and Justice. Its products will inform a current study by an ad hoc committee of the NRC on causes, consequences, and alternatives to high rates of incarceration in the United States.

Presentations and discussion will address one or more of the following questions:

1. 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?

2. 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?

3. 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 healthcare and health?

4. 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?

5. 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?

Invited participants include

Bruce Western, Harvard University*

Josiah Rich, M.D., Warren Alpert Medical School of Brown University*

Craig Haney, University of California, Santa Cruz*

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* Indicates a member of the National Research Council and Institute of Medicine Committee on Causes and Consequences of High Rates of Incarceration.

Scott Allen, University of California, Riverside

Redonna Chandler, National Institute on Drug Abuse

Jennifer Clarke, M.D., Brown University Medical Center

Jamie Fellner, Human Rights Watch

Robert Greifinger, M.D., John Jay College of Criminal Justice, City University of New York

Newton Kendig, M.D., Federal Bureau of Prisons

Marc Mauer, The Sentencing Project

Fred Osher, M.D., Council of State Governments

Steven Rosenberg, Community Oriented Correctional Health Services

Faye Taxman, George Mason University

Emily Wang, M.D., Yale University

Chris Wildeman, Yale University

Brie Williams, M.D., University of California, San Francisco

The workshop will be in a roundtable format. Brief presentations will be followed by questions and discussion organized to address the questions posed above.

AGENDA