Health equity, the ability for all to obtain the best level of care for one’s health, is a vital concern for all individuals, including both incarcerated people and the employees who work in the criminal justice system, formal institutions designed to enforce, arbitrate, and carry out the laws of the society, especially prisons. Incarcerated populations face higher risks for chronic diseases, long-lasting health problems that normally cannot be cured and only controlled, such as heart disease, cancer, and strokes. As well as higher risks for mental health challenges and substance use disorders, these health issues are often compounded by stigma, a negative label characterized by one or more personal traits that form a stereotype about the individual. Similarly, prison staff, including correctional officers, experience significant health disparities, such as elevated rates of mental health issues like post-traumatic stress disorder (PTSD) and depression. These health challenges are particularly pronounced in rural areas, where the majority of U.S. prisons are located, and healthcare resources are already limited.
I’m currently working on a National Institute of Health (NIH)– funded research project based out of a community nonprofit collaborating with a team of university researchers and staff that aims to address health disparities, preventable differences in the burden of disease, injury, or opportunities to obtain optimal health that are experienced by socially disadvantaged people, by focusing on reducing stigma around healthcare utilization and incarceration. This project is an example of applied sociology, the use of sociological theory, research, and methodologies to find solutions to problems in society. One key solution is to reduce the stigma surrounding healthcare access in and out of prisons, which can often deter individuals from seeking necessary medical or mental health care. The project aims to increase the use of healthcare services, especially mental health awareness, and care for those incarcerated, recently released individuals, and prison staff.
Our project addresses health disparities in Maryland and Tennessee state prisons, with a focus on three key populations most impacted by prisons: racial and ethnic minorities, people from lower socioeconomic backgrounds, and those in rural communities. These groups are disproportionately represented in the carceral system, the policies, institutions, and practices of controlling individuals and incarceration, which exacerbates their existing health disparities. Research indicates that individuals in prison are more likely to suffer from communicable diseases, chronic health conditions, mental health struggles, and substance use issues. In rural areas, where 70 percent of U.S. prisons are situated, healthcare access is often even more limited, often due to frequent hospital closures. Incarcerated individuals and correctional staff in these areas face additional barriers to receiving timely and adequate care, deepening the inequities they face. Plus, those reentering society often face challenges like homelessness and limited access to healthcare, which unduly affects people of color and rural areas.
Community-Based Participatory Research
A promising approach to addressing health disparities is community-based participatory research (CBPR). CBPR involves directly engaging those most affected by health disparities, like in our project formerly incarcerated individuals and prison staff in the research process. By incorporating their lived experiences, CBPR ensures that the research is not only data-driven but also culturally relevant and informed by the real-world challenges people face in carceral and reentry settings. This approach empowers marginalized populations to become active participants in designing solutions to their health inequities.
Our project uses a CBPR approach to reduce stigma around healthcare utilization in prisons, aiming to decrease incarceration or mental health stigma and increase access to mental health services for both incarcerated individuals and prison staff. The core of the project’s goal is developing stigma-reducing education alongside health and digital literacy resources for all impacted. This combination seeks to normalize mental health care, healthcare-seeking behaviors, challenge harmful stereotypes, and encourage both incarcerated individuals and correctional staff to prioritize their health and access the care they need.
A key aspect of this project is the involvement of currently and formerly incarcerated individuals in the research process. To ensure that the voices of those directly impacted are included, the project established a Prison Health Care Advisory Board (PH-CAB) in Maryland. This board consists of roughly 15 men who are or have been incarcerated and play an active role in advising the research process. For example, they have helped design study content, provide feedback on materials, and assist in refining the interview guides based on their lived experiences. The PH-CAB meets monthly with the research team through virtual meetings to ensure that the research remains culturally relevant and effective. Culture, a society’s socially learned and shared ideas, behaviors, and material components, plays a very important role in people’s lifestyles and healthcare. Once data collection is complete and analyzed, the PH-CAB members will be invited to discuss and interpret the findings, collaborating to create final deliverables. Educational pamphlets of the research findings will be distributed to formerly incarcerated individuals and staff through in– person and online platforms like listservs and social media. Through this collaborative approach, the project ensures that the research remains grounded in the lived experiences of formerly incarcerated individuals, increasing its potential for long-lasting, meaningful change by normalizing healthcare– seeking behavior.
Health Equity
By addressing the health equity needs of incarcerated individuals, prison staff, and rural communities, the project aims to significantly reduce disparities in health outcomes. It offers a real-world approach to tackling the complex health challenges faced by marginalized populations, fostering a positive shift in the social climate for those with lived experiences in prisons and benefiting not just those incarcerated, but also correctional staff and the broader communities impacted by the criminal justice system. Through these efforts, the project seeks to enhance continuity of care, improve overall health outcomes, and contribute to greater health equity for some of the most underserved populations in the U.S.
Our project combines stigma reduction, health education, the transmission of knowledge, skills, values, and beliefs from one group to another, and the encouragement of healthcare access, aiming to create a healthier and more equitable society. Ultimately, the goal is to normalize healthcare seeking behaviors among incarcerated individuals, formerly incarcerated individuals, and prison staff. This would lead to healthier prison populations, better health outcomes, and more resilient communities both inside and outside of carceral settings. Above all, the goal is to create a healthier and more equitable society by improving care within carceral systems and empowering the individuals most impacted by these inequities to engage with healthcare in meaningful ways.
Mooney is a guest blogger at UITAC Publishing. UITAC’s mission is to provide high-quality, affordable, and socially responsible online course materials.
Images used in this blog:
- “Corrections, Towers, Prison” by PublicDomainPictures is licensed by Pixabay. This image has not been altered.
- “Friends, Group, Silhouettes” by ahnaf sakil is licensed by Pixabay. This image has not been altered.
