Rebuilding Lives. Strengthening Communities.

Chapter 2: Health
By most measures, individuals in correctional facilities are
struggling with infectious disease, chronic illness,
addiction, and mental disorders at levels far higher than
the general public. There are a number of broad cultural
factors that contribute to these health challenges and
health disparities of people with criminal records, such as
low socioeconomic and employment status, lack of
adequate health care services and racial discrimination.
According to the Bureau of Justice Statistics, over 75 percent
of state prisoners and 80 percent of federal prisoners
are drug- or alcohol-involved. 1 More than two-thirds of
people in jail meet the criteria for substance dependence
or abuse. 2 The use of drugs and alcohol is linked to 80
percent of crimes committed in the United States. 3
Serious mental health disorders such as schizophrenia,
major depression, bipolar disorder, and post-traumatic
stress disorder among prisoners are two to four times
higher than the general population. 4 Up to 16 percent of
the nation’s prison population suffers from at least one
serious mental disorder and is in need of treatment. 5
Undeniably, there are individuals living behind bars
because they have committed crimes that may not have
occurred had they received treatment. Some of our
nation’s correctional institutions house more people with
mental illness than do our country’s mental health institutions;
Cook County Jail, for instance, is the largest mental
health care facility in the country today. 6
significant gap between the need for and the availability of
basic health care services. Access issues often are exacerbated
for returning prisoners who likely had their
Medicaid benefits terminated while incarcerated.
But health concerns affect not only returning prisoners. If
their health needs are not managed appropriately, they
also jeopardize the well-being of their family and the community
at large. They are at an elevated risk for falling
into a destructive cycle of arrest, incarceration, release,
deterioration, negative social outcomes, rearrest, and reincarceration.
Addressing prisoners’ health issues—substance abuse,
mental and physical health, chronic illness and infectious
diseases—is an essential component of successful reentry,
increasing the likelihood that they will find and keep jobs,
secure stable housing, and forge positive, lasting social
relationships with family and friends after release.
In 1997, prisoners constituted considerably less than one
percent of the country’s total population. However, that
year, nearly one-quarter of people living with HIV or
AIDS, nearly one-third of people with hepatitis C, and
more than one-third of those with tuberculosis were
released from a prison or jail. 7 Prisoners also have a higher
incidence of asthma, high blood pressure and diabetes
than the general public. 8
Virtually all of these prisoners will return home, bringing
their health concerns with them, and they will face a range
of obstacles as they make that adjustment. Health care
services play an important role in facilitating a smooth
transition back to the community. Unfortunately, despite
the tremendous growth of Chicago’s community-based
safety net system in recent years, there still remains a
MAYORAL POLICY CAUCUS ON PRISONER REENTRY
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