Ron Sanders, a community-health worker serving former prisoners at San Francisco’s Transitions Clinic, struggles to keep his clients from being among the 66 percent of parolees who eventually return to prison.
No easy task, as many are dealing with addiction, chronic illness, mental health problems — or all of the above. I first became interested in these issues when writing for the San Francisco Chronicle about Sanders, himself a former prisoner who is all to aware of the challenges parolees face.
But why should Californians care about chronically ill prisoner and parolee health? What’s the connection between prison reentry, medical care and our communities?
In fact, there’s a growing awareness of the public health and safety implications of ignoring this population. About 95 percent of the people in prisons or jails will eventually be released. Nationwide, that’s roughly 13 million releases each year — and when they get back home, these men and women aren’t exactly paragons of health.
More than 80 percent of 1,100 parolees from Texas and Ohio reported a chronic illness, according to a 2008 Urban Institute study, and more than 60 percent had no health insurance for nearly a year after release. A third sought medical care in emergency rooms, and 20 percent were hospitalized at one point during their first year out, creating costs that are passed on to taxpayers.
In Rhode Island, a program called Project Bridge connects the dots between parolees and public health, by hooking up HIV-positive parolees with medical care once they’re released.
Writing for Miller-McCune magazine about the program, I note that the moral issue of providing ex-inmates with health care is also a public health imperative:
In February, the Journal of the American Medical Association published the results of a four-year study of 2,000 HIV-positive Texas inmates and found that only 5 percent of parolees filled their prescription soon enough to avoid interrupting their treatment regime. The lack of medical continuity had dire consequences.
“If people are not getting their meds when they get out of prison, there’s a greater risk of medical complications for the patient, that the virus will spread and that drug-resistant strains will develop,” said Josiah Rich, the Project Bridge doctor and one of the authors of the study.
As one physician argued, connecting parolees to care is simply good public policy:
“The strongest argument at the moment (for post-incarceration health care) is not a humanitarian one, it’s an economic one,” said Dr. Robert Greifinger, a distinguished research fellow at John Jay College of Criminal Justice and the editor of the 2007 book “Public Health Behind Bars.”
“If we’re going to drive change in the costs of criminal justice and health care systems,” he said, “one very substantial area to look at is by providing through care for inmates.”
These are the issues I’ll be looking at through this blog, by telling the human stories behind the research, policy and news on inmate reentry and health care in California.