Incarceration may even have some health benefits (for example, when it results from domestic violence or when prisoners receive health care during incarceration that is not available to them in the community). Consequences of parental incarceration thereby become concentrated among black children.Īn argument can certainly be made that the families and communities most affected were already troubled and prone to poor health or unhealthy behaviors before the incarceration. However, among black men, the incarceration rate is 3074 per 100 000 persons. The overall incarceration rate in this country is 492 per 100 000 persons, well above the tipping point beyond which incarceration becomes criminogenic ( 6, 7). Incarceration thus plays a role in not only health but also health disparities in the United States. The additional stress may also contribute to their partners’ unhealthy stress-coping behaviors, such as smoking or drinking, with further adverse health consequences for children in the household. The incarceration of a family member can further reduce already-limited family resources-such as child care- even if the prisoner did not contribute substantial income to the household, and efforts to stay in touch by telephone or visits are costly. Incarceration is not only a health issue for former prisoners, it also affects the well-being of family members, especially children ( 5). Many states ban former prisoners from receiving food stamps, and convictions even for drug possession (that is, without intent to sell) reduce eligibility for federal student financial aid ( 4).Įven pediatricians may unknowingly encounter the health consequences of incarceration among their patients. Accessing other forms of public assistance associated with health is also more difficult for former prisoners. Public housing authority bans on persons with drug convictions have made it particularly difficult for releasees to reunite with their families or find affordable housing. These risks are exacerbated by the frequent exclusion of persons with criminal records from antipoverty programs. They are far less likely to have health insurance than the general population, and-although the Patient Protection and Affordable Care Act will make some inroads into this problem by extending Medicaid eligibility to many low-income releasees-many will probably remain unenrolled without deliberate outreach and assistance with the enrollment process. Persons who have been incarcerated have reduced odds of marriage and employment and are at high risk for homelessness and lack of access to nonemergency health care ( 1- 3). Actual incarceration may last a finite time, but a history of incarceration often locks former prisoners into a permanent underclass. Incarceration in turn increases social and economic insecurity by reducing access to social resources, especially programs associated with health and access to health care. These SDOHs also affect the risk for incarceration, even for the same action (for example, selling a marijuana joint in a college dormitory is far less likely to result in a jail sentence than doing so in a low-income neighborhood). Medical providers have become increasingly familiar with the idea that SDOHs, such as housing, poverty, and education, shape their patients’ health and access to care. Social determinants affect health and incarceration in turn, incarceration itself is an SDOH. Understanding the 2-way relationship between incarceration and social determinants of health (SDOHs) is a step forward. In such cases, incarceration will improve neither the imprisoned person nor the social problem without medical intervention. However, the actions resulting in incarceration surprisingly often stem from untreated mental illness or addiction. Without a doubt, many persons need to be imprisoned to protect public safety. The United States has the highest incarceration rate in the world, but we should not conclude from this that it has the highest rate of criminality. This Muppet is another sign of the growing public awareness of the collateral damage of incarceration for the families of prisoners, which are concentrated in disadvantaged communities. In 2013, Sesame Street introduced a new character with 2 defining features: a shock of blue hair and an incarcerated father.
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