“For many people who are incarcerated, prison is the first time they have had any access to health care,” says Shira Shavit, M.D. “These individuals have high rates of hepatitis C, HIV/AIDS, tuberculosis and other diseases, so helping them manage or cure their diseases is also a public health issue.”
Shavit is in a position to know. As a medical resident, she worked in a clinic where incarcerated women gave birth. Many of the mothers had substance abuse problems or mental health disorders. After giving birth, they were allowed a three-month prison leave to breastfeed and bond with their babies before giving them to a family member and returning to prison. The experience forever changed Shavit’s perspective on prisoners and incarceration policies in the United States.
“We have tripled the number of people we incarcerate in the United States in the last 30 years, and we incarcerate far more people than any other nation,” said Shavit, who has become a passionate advocate for people she describes as having no voice. “One reason for our high incarceration rate is that we have criminalized medical issues like substance abuse and mental health disorders. I am compelled to advocate and work with this population because I don’t think prison is the appropriate place to treat these patients.”
After her medical residency, Shavit went to work as a physician in the Alameda County Jail. “I was hearing horror stories about how these people were treated, so I thought I could make a difference from the inside, only I couldn’t navigate the system,” she said. In her work she noticed a disturbing trend: former inmates had a high risk of dying during the first two weeks after their release as result of losing access to the medical care that they received while incarcerated.
To change that, she joined the Transitions Clinic in San Francisco, an independent clinic that works in collaboration with the San Francisco Department of Public Health’s “Healthy San Francisco” program. The clinic provides care for former inmates and focuses on managing their transition from prison. It also has a unique program with the San Quentin prison to provide health care services for inmates during their incarceration that continue when patients re-enter the community.
In recognition of her ongoing efforts to provide health care to current and former inmates, and thereby improve the health of the communities where they live, Shavit was one of 10 recipients of the Robert Wood Johnson Foundation Community Health Leaders Award, which honors exceptional men and women who have overcome significant obstacles to tackle some of the most challenging health and health care problems facing their communities.
Community Health Leaders National Program Director Janice Ford Griffin said that the selection committee honored Shavit for her courage and commitment to an often forgotten and unsympathetic population. “Dr. Shavit has a unique understanding of the barriers prisoners confront to maintain their health as they transition from prison back to their neighborhoods and communities. She works to assure that their physical and mental health needs are met within a community context that engages residents and ex-offenders as collaborators for the health of the community in a non-threatening atmosphere.”
“Our work has led to some exciting success stories,” said Shavit. “We’ve seen people who have been in and out of prison for years; then we help them manage their health conditions and they are able to start managing their lives again. Our work can help keep people from finding themselves in a position where they are sent back to prison, and that’s a win/win for everyone—the former inmate, the family, the community, and the taxpayer.” Shavit credits Transitions Clinic founders Emily Wang, M.D., and Clemens Hong, M.D., with developing the health care model for serving previously incarcerated individuals with chronic diseases.