Category Archives: Prisoner reentry
To mark National Minority Health Month, the Human Capital Blog asked several Robert Wood Johnson Foundation (RWJF) scholars to respond to questions about improving health care for all. In this post, Elizabeth Barnert, MD, MPH, MS, a pediatrician and clinical instructor in the UCLA Department of Pediatrics, responds to the question, “What does the country need to do to address disparities and build a culture of health that includes all people?” Barnert is an RWJF Clinical Scholar at UCLA.
While there is much to be done to improve equity and access to health care for all Americans, I believe that the most important strides in health we can make will occur by directly addressing the social and environmental determinants of health. Racial/ethnic and economic inequities strongly play out in the criminal justice system. This has important implications for health. Incarceration itself is a determinant of health.
Breaking cycles of incarceration has the potential to dramatically improve the health of entire communities, setting individuals and families on trajectories that are healthier, safer, more fulfilling, and more productive. To address incarceration, America must recognize that the patterns of mass incarceration prevalent in many disadvantaged communities perpetuate poor health outcomes, further widen social inequities, and often lead to further incarcerations within and across generations. Currently, 1 in 28 U.S. children, and 1 in 9 African American children, have a parent who is incarcerated. Two-thirds of these parents are incarcerated for non-violent offenses. By virtue of having an incarcerated parent, these children are at much higher risk of themselves becoming incarcerated at least once during their life course.
Human Capital News Roundup: Gun violence, incarceration and psychiatric disorders, extremes in body weight, and more.
Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows and grantees. Some recent examples:
RWJF Clinical Scholars program alumnus Arthur Kellerman, MD, MPH, FACEP, was quoted in a Washington Post story on the Obama Administration's push to renew federal funding for public health research on gun violence. Language initially included in a 1996 appropriations bill has, he said, "virtually stopped good public health science on [gun research] for the last 10 to 15 years.” White House lawyers recently concluded that the law doesn’t prohibit such research. Kellermann, also an alumnus of the RWJF Health Policy Fellows program, co-authored an article on the subject in the Journal of the American Medical Association with Clinical Scholars alumnus Frederick Rivara, MD, MPH.
RWJF Health & Society Scholars Program Director and Health Policy Fellows alumna Jo Ivey Boufford, MD, was also in the news discussing gun violence. Boufford wrote an op-ed that appeared in the Idaho Statesman and Long Island, New York's Newsday, about the public health effects of gun violence. “As a society, we address public health threats by identifying the root causes, reducing exposure, and instituting protective measures… In the same way, we must protect Americans from irresponsible gun use,” she writes.
A study by RWJF Investigator Awards in Health Policy Research recipients Jason Schnittker, PhD, and Chris Uggen, PhD, finds that incarceration increases the risk of mood disorders such as major depressive disorder, bipolar disorder, and dysthymia after release. That, in turn, is strongly related to disability and increased incidence of substance abuse and impulse control disorders. United Press International, Medical Xpress and Science Day are among the outlets to report on the findings. Read an RWJF Human Capital Blog post about the study.
Jason Schnittker, PhD, and Chris Uggen, PhD, both recipients of Robert Wood Johnson Foundation (RWJF) Investigator Awards in Health Policy Research, recently published a study in the Journal of Health and Social Behavior on incarceration and psychiatric disorders. They found that incarceration increases the risk of mood disorders after release and that these disorders increase disability. Schnittker is an associate professor in the Department of Sociology at the University of Pennsylvania. Uggen is the Distinguished McKnight Professor in the Department of Sociology at the University of Minnesota.
More than 650,000 inmates are released from prison every year.[i] Although their debt to society may be paid, their struggles have just begun. Reentry is not easy. Former inmates need to find a place to live. They need to find a job. And many need to support families. All told, 4 million people in the U.S. are dealing with the “mark” of a prison record and its consequences for their work and personal lives.[ii] Most will struggle for years following their release.
Given all these difficulties, it’s hard to imagine health being a major part of their struggle. After all, many former inmates are still quite young and, for that reason, unlikely to suffer from major health problems. Mental health is part of the picture, but usually considered through a different lens: policy-makers ask how mental illness affects criminal offending—that is, what leads to prison in the first place—but rarely consider the pivotal role of mental health in making a successful return to the community.
Yet the role of mental illness is just as relevant after release as before.[iii]