Research Activities February 2013, No. 390
Criminal justice system may create and aggravate health disparities among minorities
Health disparities among racial and ethnic minorities may become exacerbated at several stages of the criminal justice system, resulting in poor health outcomes, reveals a new study. One model suggests that incarceration impacts health outcomes independent of race and ethnicity. However, given that blacks and Hispanics are more likely to be incarcerated compared to whites, this makes them disproportionately affected by any impact.
Those involved with the criminal justice system already are at risk for poor health outcomes. The health care provided in different situations can greatly affect these racial and ethnic disparities. This is particularly true for those on probation and parole, who have inadequate access to quality care. Another model suggests no causal relationship between incarceration and health. In this case, factors related to poor health, such as educational level and violence exposure, also have a disproportionate effect on predisposing someone to become involved in the criminal justice system.
A final model suggests that the criminal justice system does have a differential effect among racial and ethnic groups. It assumes that this system has the same disparities observed in the general health care system. Regardless of the model used to look at this problem, the researchers see the criminal justice system as an opportunity to decrease health disparities among its population.
More interventions are needed at entry into incarceration, during custody, when transitioning to the community, and during parole and probation. The researchers recommend conducting evidence-based screenings, not only for standard health conditions, but also for high-risk issues faced by this population, such as HIV infection, hepatitis C infection, and tuberculosis. Since those on parole and probation are particularly vulnerable to inadequate access to care, coordination between correctional and community health services is critical. Getting individuals back on health insurance coverage and providing community supervision environments can also help promote continued screenings, follow-up, and medication compliance. The study was supported in part by the Agency for Healthcare Research and Quality (HS19464).
See "Health disparities and the criminal justice system: an agenda for further research and action," by Ingrid A. Binswanger, M.D., M.P.H., Nicole Redmond, M.D., Ph.D., M.P.H., John F. Steiner, M.D., M.P.H., and Le Roi S. Hicks, M.D., M.P.H., in the Journal of Urban Health 89(1), pp. 98-107, 2012.