Ellen R. Murray-Clouse, PhD StudentWalden University, PUBH-8165-3 Instructor: Dr. Jeff WuSummer term, 2009

The overall goal of this program is to enhance the learner’s knowledge of

correctional facilities and their involvement in communities where

inmates are released.

At the end of this presentation, participants will:

Develop a greater understanding of correctional facilities as they exist in communities

Understand the increasing need for better healthcare and education in correctional facilities

Correlate correctional health with community health

Associate recidivism rates with an awareness of the need for increased education and health programs in correctional facilities

Background Statistics

Releases to the community

Environment of Correctional Facilities

Disease Prevalence

Recidivism

Cost of Correctional Health

Cost to the Community

Early Release or Reentry Programs

Community public health and corrections partnerships

Source: U.S. Department of Justice, Bureau of Justice Statistics

0%

5%

10%

15%

20%

25%

30%

Non-Injecting Drug Use Injecting Drug Use Excess Alcohol Use Homeless

Correctional

Non-Correctional

Slide courtesy of Dr. Mark Lobato, Centers for Disease Control and Prevention, 2005

Picture courtesy of ClipArt

March, 2002, a report to Congress by the National Commission on Correctional Healthcare reported that: “Each year the Nation’s prisons and jails

release more than 11.5 million inmates. The potential that ex-offenders may be

contributing to the spread of infectious disease in the community became of increasing concern.”

Affects all levels▪ Inmates▪ Staff▪ Community

Picture Source: Southeastern National TB Center archive

HIV estimates 2003 - 1.9% - 2.8% of HIV+

▪ Approximately 4% of U.S. AIDS burden

Tuberculosis diagnosed in correctional facilities 2007 – 3.8% of all TB cases diagnosed in the U.S.

Hepatitis C 2003 - 16% - 41% of all inmates have sero-

prevalence

Flu and other infectious diseases

Hypertension 18% of all inmates

Diabetes 5% of all inmates

Mental Illness 50% - 65% of all inmates have some form

of mental illness

Re-arrest within 3 yearsCategory of Offense

1983 (%) 1994 (%) Change (%)

All 62.5 67.5 8%

Property 68.1 73.8 8%

Drug 50.4 66.7 32%

Public Order 54.6 62.2 14%

Violent Offenders 59.6 61.7 4%

Routine care of inmates 2008 - $20,108 per prison inmate per year Medical contracts – differ per institution

Cost effectiveness and Cost Saving

Source: Florida Department of Corrections

Source: Centers for Disease Control and Prevention

Infectious Diseases

Chronic Diseases

• Prevention of future cases

• Universal screening and testing

• Counseling, testing and treatment

• No cost saving for corrections

Assess each community individually Cost savings to corrections

Ultimately cost savings to communities that fund correctional facilities

Need for discharge planning in corrections Continuity of care essential for controlling

diseases in community

Staff Correctional staff Medical staff Volunteer staff

Impact on services in the community

▪ Increase in contracts for ▪ Food services▪ Laundry services▪ Other programs

“If there is any one secret of success, it lies in the ability to get the other person's point of view and see things from that person's angle as well as from your own.”

Henry Ford

Pictures courtesy of ClipArt

Project Greenlight Looked at Reentry programs and designs Applied evidence-based principles in design Several areas of concern

▪ Flaws in design▪ Lack of evaluation components▪ Found early release or reentry programs may

not solve recidivism – but may even increase it

Source: http://www.urban.org/ UploadedPDF/1001016_reentry_programs.pdf

Public Health

Corrections

Community LeadersThe ability to promote positive change in

communities begins with partnership.Together we can bring about positive

change for all!Picture courtesy of ClipArt

You must be the change you wish to see in the world.        

Mahatma Gandhi

On the ashram precincts, Segaon, January 1938Source: http://www.mkgandhi.org/gphotgallery/1933-1948/pages/d99.htm

Thank You!

Contact Ellen Murray-Clouse, RN, BSN

Home email: TBLdy56@windstream.net School email: ellen.murray-

clouse@waldenu.edu

A complete list of references can be seen on the accompanying word document entitled

The Correctional Environment and Its Impact on the Health of Communities

• ACA: American Correctional Association– www.aca.org

• AJA: The American Jail Association – www.corrections.com/aja/

• APHA: American Public Health Association– www.apha.org/

• BOJ: Bureau of Justice – www.ojp.usdoj.gov/bjs/

• CDC: Centers for Disease Control & Prevention - Corrections Webpage

– www.cdc.gov/correctionalhealth

• NCCHC: National Commission on Correctional HealthCare

– www.ncchc.org

• NSA: National Sheriffs Association– www.sheriffs.org