CPA Advocates for Better Correctional Health Care in the United States

The CPA calls for adequately funded policies and procedures to improve disparities in access to and quality of health care for individuals in US prisons.

In 2020, state and federal prisons incarcerated 1,215,800 people and an additional 8.7 million people were admitted to prison. This means that “millions of patients in America receive their primary health care in a prison setting”, New ringtone. Familiardoctor, a clinical professor of medicine at George Washington University, and his colleagues wrote in a position paper.

“Many incarcerated patients face significant unmet health care needs which can include chronic health conditions, infectious diseases, substance use disorders and mental health issues. We need to make sure these patients get the health care services they need,” Ryan D. Mire, MD, MACP, CPA president, said in a statement.

People from underrepresented racial and ethnic populations are “disproportionately affected by these incarceration rates, which are the highest in the world,” Kendig and colleagues wrote.

In 2020, detention rates in the United States were 938 per 100,000 for Blacks, 778 per 100,000 for Native Americans and Alaska Natives, 446 per 100,000 for Hispanics, and 183 per 100 000 for whites.

“Thus, for many Black, Indigenous, and Latino people in particular, the experience of incarceration is a major social determinant of health,” the authors wrote.

Just over 51% of people incarcerated in state prisons reported having a chronic condition in the 2016 Bureau of Justice Statistics surveys. Additionally, 43% said they had a history of mental health issues and 65% said they had used at least one drug in the 30 days prior to their arrest.

“These data underscore the importance of correctional medicine both in addressing health care disparities in an underserved patient population and in advancing our nation’s public health,” Kendig and colleagues wrote. . “Tackling public health priorities such as treating opioid use disorders, curing hepatitis C, eliminating HIV infection, and more humane management of patients with serious mental illness requires excellence in correctional medicine in American jails and prisons and the strategic engagement of health care partners in the community. .”

The CPA offered several policy recommendations, the first of which was that prisons, prisons and policy makers “adopt adequately funded policies and procedures to promote the engagement of vibrant clinical care teams.”

“The quality of care and ethical principles of professional engagement should be consistent with those provided to community patient populations,” Kendig and colleagues wrote. “Prisons and prisons must ensure that clinicians meet credentialing requirements and are granted privileges in accordance with the standards required for community clinicians.”

Other policy recommendations were:

• ensure rapid access to care;
• provide people with nutritious, safe, medically appropriate and appetizing food;
• provide regular opportunities for healthy exercise;
• adopt infection prevention and control programs developed jointly with local and state public health authorities that will promote the prevention, diagnosis and treatment of communicable diseases; and
• screening all persons entering jails or prisons for behavioral health conditions such as exposure to trauma, co-occurring substance use disorder, need for prescribed psychotropic medications, history of serious mental illness, and a risk of suicide.

The document also lists recommendations for specific populations in correctional facilities, including instructions to better meet the needs of LGBTQ+ people, aging people, women, people with disabilities and immigrants.

For example, the CPA recommends ensuring that anyone who identifies as LGBTQ+ “is treated with dignity and respect in a safe, non-discriminatory and gender-affirming correctional environment.” The organization also recommended that immigrant detainees be “treated with dignity and respect in a safe, non-discriminatory and culturally sensitive environment, including the provision of translation and interpretation services, as needed, to promote literacy. health matter”.

In conclusion, the authors detailed community reintegration planning “which helps ensure continuity of health care and social services for incarcerated patients returning to the community.”

Specifically, the CPA recommended policies that “would suspend rather than terminate enrollees who would be incarcerated, and support electronic and automated data exchange with correctional systems that facilitate Medicaid enrollment or reinstatement by the state”.

“The CPA recognizes that reducing health disparities in the quality or access to health care for incarcerated populations will require concerted efforts by policy makers, administrators, legislators, the community medicine and society as a whole,” Kendig and his colleagues concluded. “Achieving this goal will require funding and implementing a national public policy agenda that recognizes the vital importance of correctional health care in achieving health equity for all and promoting the public health of our communities.

References:

Internal medicine physicians call for improved access and quality of health care for incarcerated patients. https://www.acponline.org/acp-newsroom/internal-medicine-physicians-call-for-improved-access-and-quality-in-health-care-for-incarcerated. Published November 21, 2022. Accessed November 23, 2022.

Kendig NE, et al. Ann Medical Intern. 2022;doi:10.7326/M22-2370.