The Correctional Environment and its Impact on the Health of Communities

1. Ellen R. Murray-Clouse, PhD Student Walden University, PUBH-8165-3 Instructor: Dr. Jeff Wu Summer term, 2009 The Correctional Environment and its Impact on the Health of Communities

2. Purpose The overall goal of this program is to enhance the learner’s knowledge of correctional facilities and their involvement in communities where inmates are released.

3. Expected Learning Outcomes At the end of this presentation, participants will: • Develop a greater understanding of correctional facilities as they exist in communities • Understand the increasing need for better healthcare and education in correctional facilities • Correlate correctional health with community health • Associate recidivism rates with an awareness of the need for increased education and health programs in correctional facilities

4. Outline • Background Statistics • Releases to the community • Environment of Correctional Facilities • Disease Prevalence • Recidivism • Cost of Correctional Health • Cost to the Community • Early Release or Reentry Programs • Community public health and corrections partnerships

5. Background - Incarceration Statistics Source: U.S. Department of Justice, Bureau of Justice Statistics

6. Background – Risk Factors of Inmates Slide courtesy of Dr. Mark Lobato, Centers for Disease Control and Prevention, 2005

7. Background – The U.S. is the World’s Leader in Incarceration

8. And the World is Becoming a Very Small Place Picture courtesy of ClipArt

9. Releases to the Community • March, 2002, a report to Congress by the National Commission on Correctional Healthcare reported that: • “Each year the Nation’s prisons and jails release more than 11.5 million inmates. • The potential that ex-offenders may be contributing to the spread of infectious disease in the community became of increasing concern.”

10. Environment of Correctional Facilities • Affects all levels • Inmates • Staff • Community • Picture Source: Southeastern National TB Center archive

11. Infectious Diseases in Corrections • HIV estimates • 2003 - 1.9% - 2.8% of HIV+ • Approximately 4% of U.S. AIDS burden • Tuberculosis diagnosed in correctional facilities • 2007 – 3.8% of all TB cases diagnosed in the U.S. • Hepatitis C • 2003 - 16% - 41% of all inmates have sero-prevalence • Flu and other infectious diseases

12. Chronic Diseases in Corrections • Hypertension • 18% of all inmates • Diabetes • 5% of all inmates • Mental Illness • 50% - 65% of all inmates have some form of mental illness

13. Recidivism (Re-arrest)

14. Cost of Correctional Health • Routine care of inmates • 2008 - $20,108 per prison inmate per year • Medical contracts – differ per institution • Cost effectiveness and Cost Saving Source: Centers for Disease Control and Prevention Source: Florida Department of Corrections

15. Cost to Community • Assess each community individually • Cost savings to corrections • Ultimately cost savings to communities that fund correctional facilities • Need for discharge planning in corrections • Continuity of care essential for controlling diseases in community

16. Indirect Benefit of Corrections to the Community • Staff • Correctional staff • Medical staff • Volunteer staff • Impact on services in the community • Increase in contracts for • Food services • Laundry services • Other programs

17. “If there is any one secret of success, it lies in the ability to get the other person's point of view and see things from that person's angle as well as from your own.” Henry Ford Pictures courtesy of ClipArt

18. Early Release or Reentry Programs – Do they work? • Project Greenlight • Looked at Reentry programs and designs • Applied evidence-based principles in design • Several areas of concern • Flaws in design • Lack of evaluation components • Found early release or reentry programs may not solve recidivism – but may even increase it Source: http://www.urban.org/ UploadedPDF/1001016_reentry_programs.pdf

19. Partnerships • Public Health • Corrections • Community Leaders The ability to promote positive change in communities begins with partnership. Together we can bring about positive change for all! Picture courtesy of ClipArt

20. Thank You! You must be the change you wish to see in the world. Mahatma Gandhi On the ashram precincts, Segaon, January 1938 Source: http://www.mkgandhi.org/gphotgallery/1933-1948/pages/d99.htm

21. Questions? Contact • Ellen Murray-Clouse, RN, BSN Home email: TBLdy56@windstream.net School email: ellen.murray-clouse@waldenu.edu A complete list of references can be seen on the accompanying word document entitled The Correctional Environment and Its Impact on the Health of Communities

22. Resources • ACA: American Correctional Association • www.aca.org • AJA: The American Jail Association • www.corrections.com/aja/ • APHA: American Public Health Association • www.apha.org/ • BOJ: Bureau of Justice • www.ojp.usdoj.gov/bjs/ • CDC: Centers for Disease Control & Prevention - Corrections Webpage • www.cdc.gov/correctionalhealth • NCCHC: National Commission on Correctional HealthCare • www.ncchc.org • NSA: National Sheriffs Association • www.sheriffs.org