The preponderance of evidence portrays adults and adolescents under the control of the criminal and juvenile justice systems as disproportionately shouldering the burden of nearly every type of negative health condition, from premature death to representing the single largest infectious disease carrying population. As such, the tens of millions of people currently involved in the criminal and juvenile justice systems are critical to the public health of their larger communities, while also representing an overwhelming loss of human potential. Despite these facts, there remains a dearth of coherent policy specifically designed to address the health of, and the health service delivery for, this population. The lack or rational policy and evidence-based guidelines may be viewed as the failure of the scientific community to rigorously organize the knowledge base on health prevalence, interventions and outcomes, and to disseminate findings in a manner conducive to guideline development that will resonate with care providers. It has been left to the courts to be the lone actors establishing standards in this realm. Through several Supreme Court cases, health care for incarcerated persons has been deemed legally required, but at what level and for what conditions is open to wide legal interpretation. This is most vividly demonstrated in the billion dollar state response to judicial intervention in a class action suit claiming inhumane health care for California prisoners (Plata v Schwarzenegger). The proposed manuscript takes on this critical policy vacuum, relying on tenets of the systematic review process to ensure an exhaustive and comprehensive coverage of health outcomes, interventions, and current conditions in confinement and in the community for people controlled or affected by the justice systems reach. Findings will be made accessible through graphical displays of relative risk ratios and mapping of current knowledge by subpopulations and settings. The current system, its obstacles, and the complexity of the population are also depicted using comprehensive, recent national data. These data will be brought to life by weaving compelling first hand descriptions of current conditions. This will provide an accurate and resonating description of the meaning of health in this population and the futility of our efforts without evidence-based guidance. This work, newly under contract for publication with Springer Verlag, is intended to engage the medical, public health, criminal justice, policy, legal and advocacy communities by uniting diverse disciplines around a common issue - improving the health of this population, their communities, and the byproducts of strengthening our society through greater equality
The preponderance of evidence portrays justice-involved persons as disproportionately shouldering the burden of nearly every type of negative health condition. This population represents the single unhealthiest group across a wide variety of psycho-social and physical health measures. As such, people involved in the criminal and juvenile justice systems are critical to the public health of their larger communities (as the vast majority of them will be released back into the community) while also representing an overwhelming loss of human potential. The current project seeks to address the dearth of coherent policy specifically designed to address the health of- and the health service delivery for- this population.
