The criminal justice population is disproportionately poor and is a highly vulnerable population that faces a disparate burden of substance use disorder (SUD) and other chronic health conditions, barriers to obtaining healthcare, employment, housing, and social services, and live in communities with limited health promoting resources. After their release they have a high risk of hospitalizations and of deaths from overdose and other preventable health conditions. The overall objective of this application is to describe the health impact of Hurricanes Irma and Maria on the criminal justice population in Puerto Rico, and to identify individual, institutional and community characteristics that promote resiliency and recovery. We will look at physical and mental health conditions, hospitalizations and mortality in this population. Specifically, we will assess mortality among individuals recently released from prison as well as those under community supervision and compare their all-cause and cause-specific mortality rates to those of the general population for two years before and two years after the landfall of Hurricanes Irma and Maria in Puerto Rico. We will also assess hospitalization rates and the major health risks of those under community supervision and identify the challenges and strengths affecting their responses to the post-hurricane hazards. The central hypothesis of this proposal, ?Assessing responses to disaster related stressors and their association to morbidity and mortality in criminal justice populations,? is that organizational factors within the relevant public agencies as well as the degree of social vulnerability of their community contribute to population-specific changes in morbidity and mortality in this vulnerable population. The underlying rationale for this research is that there is a gap in knowledge of which factors contribute to resiliency in this population and within the criminal justice and health systems with which this population interacts. Our team is ideally positioned to conduct this time-sensitive research, given our over a decade long collaboration with the Puerto Rico Department of Corrections (PR DOC) and established memorandums of understandings to link and analyze administrative data from PRDOC to that of the PR Department of Health?s Vital Statistics. Completion of these proposed aims are expected to positively impact ongoing policy discussion on how to build disaster resilience to natural hazards that includes and adequately addresses the needs of criminal justice populations and the communities to which they return. These findings will enable design of future research proposal aimed at testing interventions to develop resilience in the community, among individuals, and in the criminal justice organization
The proposed project is fundamental in contributing to the knowledge in understanding resilience in the communities under criminal justice supervision after natural hazards as to improve their health and general well-being. These communities inherently suffer multiple social and personal barriers that make social reentry very challenging. This Project will help inform public policy in regards to the community?s needs when facing a catastrophic event in order to successfully reduce preventable adverse health and social outcomes.
