HEALTH AND
INCARCERATION
A Workshop Summary
Amy Smith, Rapporteur
Committee on Causes and Consequences of High Rates of Incarceration
Committee on Law and Justice
Division of Behavioral and Social Sciences and Education
Board on the Health of Select Populations
Institute of Medicine
NATIONAL RESEARCH COUNCIL AND
INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
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NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.
This study was supported by Grant No. 70863 from the Robert Wood Johnson Foundation, Grant No. 99472-0 from the John D. and Catherine T. MacArthur Foundation, and Grant No. 2011-DJ-BX-2029 from the National Institute of Justice. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the views of the organizations or agencies that provided support for the project.
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Suggested citation: National Research Council and Institute of Medicine. (2013). Health and Incarceration: A Workshop Summary. A. Smith, Rapporteur. Committee on Law and Justice, Division of Behavioral and Social Sciences and Education and Board on the Health of Select Populations, Institute of Medicine. Washington, DC: The National Academies Press.
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COMMITTEE ON CAUSES AND CONSEQUENCES OF HIGH RATES OF INCARCERATION
JEREMY TRAVIS (Chair), John Jay College of Criminal Justice, City University of New York
BRUCE WESTERN (Vice Chair), Department of Sociology and the Malcolm Wiener Center for Social Policy at the Harvard University Kennedy School of Government
JEFFREY BEARD, California Department of Corrections and Rehabilitation
ROBERT D. CRUTCHFIELD, Department of Sociology, University of Washington
TONY FABELO, Council of State Governments Justice Center
MARIE GOTTSCHALK, Department of Political Science, University of Pennsylvania
CRAIG HANEY, Department of Psychology, Graduate Program in Social Psychology, and Program in Legal Studies, University of California, Santa Cruz
RICHARDO H. HINOJOSA, U.S. District Court, Southern District of Texas
GLENN C. LOURY, Department of Economics, Brown University
SARA S. McLANAHAN, Department of Sociology and Public Affairs, Princeton University
LAWRENCE M. MEAD, Department of Politics and Public Policy, New York University
KHALIL GIBRAN MUHAMMAD, Schomburg Center for Research in Black Culture, New York Public Library
DANIEL S. NAGIN, Department of Public Policy and Statistics, Carnegie Mellon University
DEVAH PAGER, Department of Sociology and the Joint Degree Program in Social Policy, Princeton University
ANNE MORRISON PIEHL, Department of Economics and Program in Criminal Justice, Rutgers University
JOSIAH D. RICH, Department of Medicine and Epidemiology, Warren Alpert Medical School of Brown University, and the Center for Prisoner Health and Human Rights at the Miriam Hospital Immunology Center
ROBERT J. SAMPSON, Department of Sociology, Harvard University
HEATHER ANN THOMPSON, Department of History, Temple University
MICHAEL TONRY, University of Minnesota Law School
AVELARDO VALDEZ, School of Social Work, University of Southern California
COMMITTEE ON LAW AND JUSTICE 2013
JEREMY TRAVIS (Chair), John Jay College of Criminal Justice, City University of New York
RUTH D. PETERSON (Vice Chair), Department of Sociology, Ohio State University
CARL C. BELL, Community Mental Health Council, Inc.
JOHN J. DONOHUE III, Stanford Law School
MARK A.R. KLEIMAN, Department of Public Policy, University of California, Los Angeles
GARY LAFREE, Department of Criminology and Criminal Justice, University of Maryland, College Park
JANET L. LAURITSEN, Department of Criminology and Criminal Justice, University of Missouri
GLENN LOURY, Department of Economics, Brown University
CHARLES F. MANSKI, Department of Economics, Northwestern University
DANIEL S. NAGIN, Department of Public Policy and Statistics, Carnegie Mellon University
ANNE MORRISON PIEHL, Department of Economics and Program in Criminal Justice, Rutgers University
DANIEL B. PRIETO, Public Sector Strategy and Innovation, IBM Global Business Services, Washington, DC
DAVID WEISBURD, Center for Evidence-Based Crime Policy, George Mason University
PAUL K. WORMELI, Integrated Justice Information Systems, Ashburn, VA
CATHY SPATZ WIDOM, Psychology Department, John Jay College of Criminal Justice, City University of New York
ARLENE LEE, Director
BOARD ON THE HEALTH OF SELECT POPULATIONS 2013
DAN G. BLAZER (Chair), Duke University Medical Center
KATHLEEN BRADY, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina
JOHN C.S. BREITNER, Department of Psychiatry, McGill University, Montreal, Quebec, Canada
MICHAEL L. COWAN, Broadlands, VA
WALTER R. FRONTERA, Vanderbilt University School of Medicine and Vanderbilt University Medical Center
GREGORY C. GRAY, Department of Environmental and Global Health and Department of Infectious Diseases and Pathology, University of Florida, Gainesville
KURT KROENKE, Department of Medicine, Indiana University School of Medicine
JANICE L. KRUPNICK, Department of Psychiatry, Georgetown University School of Medicine
STANLEY M. LEMON, Department of Medicine and Microbiology and Immunology Inflammatory Diseases Institute, University of North Carolina at Chapel Hill
VICKIE M. MAYS, Department of Psychology, University of California, Los Angeles, Fielding School of Public Health
M. JEANNE MIRANDA, Center for Health Services and Society, University of California, Los Angeles
FRANCES M. MURPHY, Sigma Health Consulting, LLC, Silver Spring, MD
KENNETH OLDEN, National Center for Environmental Assessment and Human Health Risk Assessment Research Program, Environmental Protection Agency
MICHAEL D. PARKINSON, UPMC Health Plan and WorkPartners, Pittsburgh, PA
JENNIFER D. PECK, Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center
CAROL K. REDMOND, Department of Public Health, University of Pittsburgh
GRACE S. ROZYCKI, Emory University School of Medicine/Grady Memorial Hospital
GEORGE W. RUTHERFORD, Department of Epidemiology, University of California, San Francisco School of Medicine
MURRAY B. STEIN, Department of Psychiatry and Family and Preventive Medicine, University of California, San Diego
FREDERICK (RICK) ERDTMANN, Director
Preface
Over the past four decades, the rate of incarceration in the United States has skyrocketed to unprecedented heights, both historically and in comparison to that of other developed nations. At far higher rates than the general population, those in or entering U.S. jails and prisons are prone to many health problems. This is a problem not just for them, but also for the communities from which they come and to which, in nearly all cases, they will return.
A changing policy environment calls for a fresh look at the connections between health and incarceration. Costs of providing care to prisoners are rising, driven partly by an aging of that population. Fiscal pressures, litigation, and judicial oversight are pushing states to look for alternatives that better meet health needs of the incarcerated. The Patient Protection and Affordable Care Act (ACA), in addition to insuring mil–lions of previously uninsured people, creates specific new opportunities to ensure continuity of medical coverage and care when prisoners are released.
On December 5, 2012, the Committee on Law and Justice of the National Research Council (NRC) and the Board on Health and Select Populations of the Institute of Medicine (IOM) sponsored a workshop on health and incarceration that brought together leading academic and practicing experts to review what is known about these health issues and what appear to be the best opportunities to improve healthcare for those who are now or will be incarcerated. The workshop was designed as a
roundtable with brief presentations from 16 experts and time for group discussion.
The purpose of the workshop was to inform a current consensus study by the NRC Committee on Causes and Consequences of High Rates of Incarceration. In addition, participants hoped that a stand-alone document of the workshop proceedings could educate the healthcare and policy communities and provide a platform for visions of how the world of incarceration health can be a better place. I thank the Robert Wood Johnson Foundation for the generous support to enable this publication. This summary provides an objective report of what occurred at the workshop, drawing on views presented by individual participants and focusing on the possibilities for improving the health of incarcerated and formerly incarcerated populations and implications of the implementation of the ACA on public health.
As the vice chair of the committee that co-organized the workshop, I extend our thanks, first to committee member Josiah (Jody) Rich, Department of Medicine and Epidemiology, Warren Alpert Medical School of Brown University, and the Center for Prisoner Health and Human Rights at the Miriam Hospital Immunology Center, for his key role in identifying the expert participants and moderating the event. The success of the workshop was a result of a talented and thoughtful group who gave generously of their knowledge and time, whom we thank: Scott Allen, University of California, Riverside; Redonna Chandler, National Institute on Drug Abuse; Jennifer Clarke, Brown University Medical Center; Jamie Fellner, Human Rights Watch; Robert Greifinger, John Jay College of Criminal Justice, City University of New York; Newton Kendig, Federal Bureau of Prisons; Marc Mauer, The Sentencing Project; Fred Osher, Council of State Governments; Steven Rosenberg, Community Oriented Correctional Health Services; Faye Taxman, George Mason University; Emily Wang, Yale University; Christopher Wildeman, Yale University; and Brie Williams, University of California, San Francisco. In addition, my fellow committee member, Craig Haney, University of California, Santa Cruz, joined Jody Rich and me at the workshop.
I also thank Steve Redburn, study director for the committee, and Rick Erdtmann, director of IOM’s Board on Health and Select Populations, for their ongoing consultation in preparation for the workshop. Barbara Boyd and Julie Schuck from the NRC’s Committee on Law and Justice also provided valuable support to the workshop and production of the workshop summary. I also thank the executive office reports staff of the Division of Behavioral and Social Sciences and Education, especially Eugenia Grohman, who provided consultation with staff and the rapporteur on the writing and editing of this summary; Kirsten Sampson
Snyder, who managed the report review process; and Yvonne Wise, who managed the production process.
Finally, I thank our rapporteur, Amy Smith, who did a wonderful job capturing the many visions presented at the workshop.
This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the NRC’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We thank the following individuals for their review of this report: Ingrid Binswanger, Primary Care Residency Research, School of Medicine, University of Colorado, Denver; Josiah D. Rich, Department of Medicine and Epidemiology, Warren Alpert Medical School of Brown University, and the Center for Prisoner Health and Human Rights at the Miriam Hospital Immunology Center; Emily Wang, General Internal Medicine, Yale School of Medicine; Brie Williams, Division of Geriatrics, University of California, San Francisco; and Lester N. Wright, Discipline of Public Health, University of Adelaide.
Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the report nor did they see the final draft of the report before its release. The review of this report was overseen by Philip J. Cook, Sanford School of Public Policy, Duke University. Appointed by the NRC, he was responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the author and the institution.
Bruce Western, Vice Chair
Committee on Causes and Consequences of
High Rates of Incarceration