Editor's Letter.

Abstract

Journal of Correctional Health CareVol. 28, No. 6 EditorialFree AccessEditor's LetterJohn R. MilesJohn R. MilesEditor-in-Chief Journal of Correctional Health CareSearch for more papers by this authorPublished Online:14 Dec 2022https://doi.org/10.1089/jchc.2022.29018.editorialAboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail Dear Colleagues,More than 1.3 million people are in U.S. state and federal prisons on any given day. Bureau of Justice Statistics (BJS) survey data show that many are dealing with physical and mental illness and disability (Maruschak et al., 2021). Overwhelmingly, these individuals are poor and disproportionately Black, Native American, Hispanic, and/or lesbian, gay, bisexual, transgender, or queer (Wang, 2022).Individuals in prisons and jails are disproportionately likely to have chronic health problems as well as substance use and mental health problems. A BJS report based on their 2016 Survey of Prison Inmates clearly shows the frequency of illness among those housed in state and federal prisons. About 51% of state and 43% of federal prisoners reported ever having a chronic condition and 40% of state and 33% of federal prisoners reported a current chronic condition. Chronic conditions included cancer, high blood pressure, stroke, diabetes, arthritis, asthma, cirrhosis of the liver, and heart or liver problems; the most common were high blood pressure (29%), arthritis (17%), and asthma (16%). Infectious diseases included tuberculosis, hepatitis B and C, HIV/AIDS, and sexually transmitted diseases (Maruschak et al., 2021).Although an individual's health issues may begin before their incarceration, their incarceration often exacerbates existing conditions or creates new ones. We understand that people in prison have a constitutional right to basic health care, but the care provided tends to be reactionary due to the volume of patients. In most institutions, care is focused on treating acute health problems rather than preventing or effectively treating/managing chronic disease/illness. Improvements are being made, but they are slow and require an ongoing commitment by correctional administrations and care providers.People who go into prison disproportionately lack health insurance before incarceration, which may account for their difficulty in accessing health care before incarceration. More than half of people in prisons (50%) lacked health insurance at the time of their arrest; in comparison, the rate of uninsured among the general population was just 15.5% (Wang, 2022). This alone may explain the disproportionate need for both acute and chronic care among incarcerated people: Most have not had access to any ongoing care or medical services.For many people, prison improves their access to health care. More than one fourth (27%) of people who came to prison with a chronic condition were first diagnosed with it while incarcerated (Wang, 2022). This is a positive outcome for the individual, but it points out the inequity of the health care system to serve everyone, especially the poor and those most at risk. With the ongoing substance abuse and mental health needs seen in the general population in the United States, the need for health care and mental health services in corrections only continues to increase.Knowing these facts, correctional health care providers must address these challenges and continue to look for ways to enhance care before, during, and after their patients' incarceration. Community partnerships with primary care providers, hospitals, mental health providers, and substance abuse services can help support continuity of care on the outside and the inside to improve outcomes for chronic disease and mental illness. Coordinated case management is one piece of the puzzle to improve the care of the individual before, during, and after incarceration.This issue highlights the diversity of health concerns faced by today's correctional care providers.Sincerely,John R. Miles, MPAEditor-in-ChiefJournal of Correctional Health CareReferencesMaruschak , L. M., Bronson , J., & Alper , M. (2021). Survey of Prison Inmates, 2016: Medical problems reported by prisoners (NCJ 252644). Bureau of Justice Statistics. https://bjs.ojp.gov/sites/g/files/xyckuh236/files/media/document/mprpspi16st.pdf Google ScholarWang , L. (2022). Chronic punishment: The unmet health needs of people in state prisons [Report]. Prison Policy Initiative. https://www.prisonpolicy.org/reports/chronicpunishment.html Google ScholarFiguresReferencesRelatedDetails Volume 28Issue 6Dec 2022 InformationCopyright 2022, The Author(s) 2022To cite this article:John R. Miles.Editor's Letter.Journal of Correctional Health Care.Dec 2022.359-360.http://doi.org/10.1089/jchc.2022.29018.editorialPublished in Volume: 28 Issue 6: December 14, 2022Online Ahead of Print:November 14, 2022PDF download