Correctional Health Care: A Public Health Opportunity

  1. Jordan B. Glaser, MD; and
  2. Robert B. Greifinger, MD
  1. From Staten Island University Hospital, Staten Island, New York; the New York State Department of Correctional Services, Albany, New York. Requests for Reprints: Jordan B. Glaser, MD, Division of Infectious Diseases, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY 10305. Disclaimer: The opinions expressed in this article do not necessarily represent those of the New York State Department of Correctional Services. Acknowledgment: The authors thank Lorraine LoPrete and Nora McGrath for secretarial assistance; and Maura Bluestone for advice.

    Abstract

    The approximately 1.2 million inmates in U.S. correctional institutions have a high prevalence of communicable diseases, such as human immunodeficiency virus (HIV) infection, tuberculosis, hepatitis B virus infection, and gonorrhea. Before their incarceration, most inmates had limited access to health care, which, together with poor compliance because of lifestyle, made them difficult to identify and treat in the general community. Because of the high yearly turnover (approximately 800% and 50% in jails and prisons, respectively), the criminal justice system can play an important public health role both during incarceration and in the immediate postrelease period. A public policy agenda for criminal justice should include an epidemiologic orientation, as well as resources for education, counseling, early detection, and treatment. Taking advantage of the period of confinement would serve both the individual and society by controlling communicable diseases in large urban communities.

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