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1 Introduction1 The United States is home to 4.4 percent of the worldâs population, yet it has 21.3 percent of the worldâs individuals experiencing incarceration (Walmsley, 2015). Though the total is down from its peak in 2008, in 2016 1.5 million people were in prison and 630,000 were in jailsâa seven-fold increase since the 1970s (see Figure 1-1). The high rate of incarceration in the United States is a major con- tributor to the nationâs health inequities. Black Americans are more than three times as likely to be incarcerated as whites, and incarceration rates are also elevated for Hispanics, Native Americans, and other popula- tion groups compared with the general population. In addition, people who are incarcerated differ from the general U.S. population in terms of poverty levels, geographic origins, gender, and a wide range of health indicators. Health equity, then, intersects with incarceration, reentry, and community health. To examine the connection between incarceration and health inequi- ties, the Roundtable on the Promotion of Health Equity held a workshop on June 6, 2018, titled The Effects of Incarceration and Reentry on Com- munity Health and Well-Being. 1 The planning committeeâs role was limited to planning the workshop, and the Proceed- ings of a Workshop was prepared by the rapporteurs as a factual account of what occurred at the workshop. Statements, recommendations, and opinions expressed are those of indiÂ vidual presenters and participants and are not necessarily endorsed or verified by the N Â ational Academies of Sciences, Engineering, and Medicine. They should not be construed as reflecting any group consensus. 1 PREPUBLICATION COPYâUncorrected Proofs
2 THE EFFECTS OF INCARCERATION AND REENTRY FIGURE 1-1â The rate of incarceration in the United States has grown dramatically since the 1970s. SOURCES: Vera Institute of Justice. As presented by Jim Parsons, June 6, 2018. As part of its commitment to hold workshops in parts of the United States that are particularly affected by the issues being discussed, the roundtable held the workshop at the University of Pennsylvania in P Â hiladelphia, which has one of the highest rates of incarceration of any major American city. It is important to note that the programs and models that are described in this Proceedings of a Workshop are all Â hiladelphia P based, as this is where the workshop took place. As Antonia Villarruel, Margaret Bond Simon Dean of Nursing at the University of Pennsylvania Â School of Nursing and chair of the roundtable, said in her opening remarks, holding the workshop at the University of Pennsylvania ârepre- sents the universityâs commitment, as well as the schoolâs commitment, to working with vulnerable populations, health equity, and social justice.â Winston Wong of Kaiser Permanente also emphasized the place-based nature of the roundtableâs work. âWe look at people and we look at com- munities,â he said. âWe look at how individuals who are part of the fabric of our communities are impacted. And we look at assets as much as we look at barriers and obstacles.â The workshop objectives were the following: 1. Better understand the distributive impact of incarceration on low- income families and communities of color. PREPUBLICATION COPYâUncorrected Proofs
INTRODUCTION 3 2. Examine the effects of the post-incarceration reentry process on families and communities. 3. Explore promising models and best practices for improving and enhancing the reentry process. This publication summarizes the presentations and discussions of the workshop. This proceedings reflect the observations made by workshop participants and should not be seen as representing a consensus of the workshop participants, the roundtable, or the National Academies of Sciences, Engineering, and Medicine. The Statement of Task given to the planning committee can be found in Appendix D. ORGANIZATION OF THE PROCEEDINGS After this brief introductory chapter, Chapter 2 summarizes the remarks of Kempis âGhaniâ Songster, who was released 9 months before the workshop (in December 2017) after serving 30 years in prison. Chap- ter 3 provides a broad overview of the state of incarceration in the United States and its effects on public health. Chapter 4 looks specifically at the health of women in prisons and jails and at their needs during and after incarceration. Chapter 5 lays out the challenges to individuals and to com- munities when people held in prisons and jails reenter society. Chapter 6 presents promising practices and models that can help individuals and communities deal with the challenges of reentry. Chapter 7 summarizes the remarks at the workshop of Philadelphiaâs district attorney, who has been working to ameliorate what he termed âthe twin evils of mass incar- ceration and mass supervision.â Finally, Chapter 8 provides reflections from several roundtable members on important lessons that emerged from the workshop. PREPUBLICATION COPYâUncorrected Proofs
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