The effects of incarceration are felt far beyond prison and jail walls and impact health. In addition to pressing needs such as housing, employment, and educational opportunities, justice-involved individuals have disproportionately high rates of chronic health conditions, and mental health issues and substance use disorders are common. Poorer access to health coverage and health care pose significant challenges for this population, can contribute to a worsening of their health status, and are associated with higher rates of recidivism. The health sector, therefore, has an important role to play in supporting formerly incarcerated individuals to address their health needs. Access to health care and improved health status may also lead to improved opportunities for employment, housing, and family support. All Americans, including those who are formerly incarcerated and have paid their debt to society, should have the opportunity to reach their full potential for health.
Racial and ethnic minorities are disproportionately represented in the correctional system. While Blacks and Hispanics comprise 30 percent of the U.S. population, they constitute 57 percent of the prison population.
The Office of Minority Health (OMH) has initiated programs, policy efforts, and data initiatives to address the health needs of justice-involved individuals, and also has partnered with other federal agencies on key initiatives to support and improve the health of this population.
Programs
Re-Entry Community Linkages (RE-LINK)
The RE-LINK grant programs are aimed at demonstrating the effectiveness of multiple stakeholders within the public health system and other community support systems working together to implement a model transition process for minority and/or economically or environmentally disadvantaged populations returning to their communities after being incarcerated in jails. RE-LINK will establish connections between the jail reentry population, ages 18-26, and community-based organizations that provide linkages to health care including behavioral health care services, health insurance coverage, and other social services, such as housing, adult education, and employment assistance programs. The grants include $2.4 million in total annual funding for eight awardees and will allow each funded project to serve at least 50 individuals each year of the project. This five-year grant program began August 1, 2016 and ends June 30, 2021.
Minority Youth Violence Prevention (MYVP)
The MYVP grant program is a partnership between OMH and the U.S. Department of Justice Office of Community Oriented Policing Services (COPS Office) to support an initiative to integrate public health and violence prevention approaches. MYVP intends to demonstrate the effectiveness of integrating public health and community policing approaches to reduce disparities in access to public health services, reduce violent crimes, and improve the health and well-being of communities of color. MYVP supports program interventions developed through adaptations, refinements, and modifications of promising violence prevention and crime reduction models that are tailored to at-risk minority male youth (10-18 years-old) and integrate a problem-solving approach. The goals of the MYVP evidence-based interventions are to: improve coordination and linkages among state and local law enforcement, public health, social service, and private entities to address youth violence and crime prevention, improve academic outcomes among participants, reduce negative encounters with law enforcement, increase access to needed public health and/or social services, reduce community violence and crimes perpetuated by minority youth, and reduce violent crimes against minority youth.
In the first year, MYVP grantees provided direct services to over 2,900 youth, family services to 661 individuals, 128 linkages to supportive services, over 20 community education events for 1,448 participants, and mentoring/recreational activities to 2,000 youth. The grant includes approximately $2.8 million in annual total funding to nine grantees. This three-year grant program began in 2014 and ends August 31, 2017.
HIV/AIDS Health Improvement for the Re-Entry Population (HIRE)
The HIRE grant program aimed to improve the HIV/AIDS health outcomes of individuals who are formerly incarcerated by supporting community-based efforts to ensure their successful transition from state or federal incarceration back to their communities. Using a systems navigation approach, grantees provided access to prevention and treatment services to the re-entry population that included transition assistance, prescription drug assistance, substance use disorder treatment, mental health services, housing, education, employment assistance, family, and community involvement. For example, 95-98% of participants in the program run by Osborne Association in Bronx, NY that needed social services were assessed and appropriately connected to social services. Themajority of participants also either maintained or improved their CD4 counts, indicating compliance with their medication treatment. The Metro Charities-led program in St. Petersburg, FL reported that a majority of participants were retained in care without interruption, or to start care if not previously diagnosed. This four-year grant program began in 2012 and ended August 31, 2016.
Policy and Research
OMH supports health insurance enrollment efforts by helping to connect consumers in communities of color with information about affordable health insurance options and partnering with the Centers for Medicare & Medicaid Services and other federal agencies and private sector organizations to support outreach efforts. OMH also published a journal article in 2014 in AIMS Public Health examining health disparities experienced by formerly incarcerated individuals and opportunities to address those disparities and improve access to health care. The article can be accessed at: http://www.aimspress.com/article/10.3934/publichealth.2014.2.76?trendmd-shared=1
Data
OMH funded the National Academies of Sciences, Engineering, and Medicine Committee for National Statistics to conduct a workshop to identify measures to assess criminal justice involvement as a social determinant of health and an indicator of health status in population-based health data collections. This two-day workshop, held March 29-30, 2016, examined the effects of criminal justice involvement on health at the national, state, and local levels to determine which constructs need further exploration and what new measures could be developed for inclusion in population health surveys. A workshop summary was released in December 2016, and related papers will be released in fall 2017. More information on the workshop can be accessed at: http://sites.nationalacademies.org/DBASSE/CNSTAT/DBASSE_170301
Resources
In recognition of National Reentry Week in April 2016, OMH launched a webpage of resources for partners, organizations that work with justice-involved individuals, and resources for justice-involved individuals and their families. The webpage can be accessed at: https://www.minorityhealth.hhs.gov/omh/content.aspx?ID=10326
U.S. Department of Justice, Bureau of Justice Statistics (2015)