One in 29 adults in the United States experience incarceration in their lifetime; men, minorities and poor populations are overrepresented in the justice system, especially black men, with one in three men expected to be incarcerated in their lifetimes. This crisis of mass incarceration is further exacerbated by the risk of reincarceration, with a 75 percent recidivism rate over five years. Former detainees experience barriers to employment, housing, food security and health insurance. In consideration of these social determinants of health, I believe that criminal justice involvement is our country’s greatest health disparity.
Scholars and clinicians engaged in criminal justice health research and care experience the lack of opportunity to study strategies to improve the health of detainees and to reduce incarceration every day. A published study in this month’s Annals of Internal Medicine confirms these impressions. Ahalt and colleagues reviewed the NIH database of funded research over five years from 2008 to 2012. The findings are worse than I had imagined. Of more than 250,000 funded NIH grants, only 180 or 0.1 percent focused on criminal justice health. In 2012, thanks in part to funding priorities by the National Institute of Drug Abuse and the National Institute of Mental Health, the total dollars invested in criminal justice health was 1.5 percent.
The Academic Consortium on Criminal Justice Health’s Board of Directors believes that Congress and the NIH need to take pause in consideration of these results in the face of the world’s worst incarceration rates in one of its wealthiest countries.