Reaching seriously at-risk populations: health interventions in criminal justice settings

More than 6 million people are under some form of criminal justice supervision in the United States on any given day. The vast majority are arrested in and return to urban, low-income communities. These are men, women, and adolescents with high rates of infectious diseases such as HIV/AIDS, other sexually transmitted diseases (STDs), and tuberculosis (TB), as well as substance abuse and other health problems. A review of recent literature indicates that an increasing problem for these populations is that they have had little prior access to primary health care or health interventions, and many are returning to their communities without critical preventive health information and skills, appropriate medical services, and other necessary support. Periods of incarceration and other criminal justice supervision offer important opportunities to provide a range of health interventions to this underserved population, and general evaluations show the potential for this strategy. Public health and criminal justice agencies have the expertise and should collaborate to provide interventions needed by incarcerated populations. Moreover, many recently released inmates require primary care for HIV/AIDS, other STDs, and TB. Consequently, timely discharge planning is essential, as are linkages with community-based organizations and agencies that can provide medical care, health education, and necessary supportive services.