The Health of our Criminal Justice System: Re-imagining 'Restorative' Justice

In April of this year, I had the distinct privilege of presenting at Columbia University with the most precocious minds in criminal justice reform assembled to discuss the subject. This convening was led by JustLeadership USA in association with CU’s Center for Institutional & Social Change. An epistle of criminal justice leadership was premiered entitled: Leading with Conviction: The Transformative Role of Formerly Incarcerated Leaders in Reducing Mass Incarceration.

Among the panelist was my mentor and colleague, Maritza Bond, Director of Public Health and Social Services for the City of Bridgeport, CT. Maritza Bond lent insightful thoughts on restorative justice that were so noteworthy, she was invited to co-contribute to this article. Readers...Maritza Bond....

I think we can all agree that we ideally want to live in communities that are free of crime and mayhem. Communities where we don’t need home security systems, where we don’t Google our neighbors, where we don’t need to bear as many arms as we do, and the likes thereof. We want to exist in a space with our neighbors where we can be in good hands with each other, without Allstate facilitating the need to be.

Often, when we imagine criminal “justice”, the lens that we are viewing it through is eclipsed by the “public safety” perspective society has positioned us to see. The lock-em-up and throw away the key lens. However, criminal justice is far much more complex than the black and white lines we attempt to separate it by. It lies somewhere in a grey area that involves families, friends, employers, neighbors, and the likes thereof.

Let’s start with the facts:

1. There are over 70,000,000 individuals with criminal histories in the United States of America. Yes. 70 million — with an M. That means 1-in-3 person that you come in contact with on any given day may have a criminal history that ranges from as little of a degree as disturbing the peace to as egregious as murder or sexual assault.
2. Black men are six times more likely to be incarcerated than white men, and Hispanic men are 2.5 times more likely to be incarcerated than white men.
3. 180,000 women are subject to the lifetime ban on Temporary Assistance for Needy Families.
4. Approximately 20 percent of inmates in jails and 15 percent of inmates in state prisons have a serious mental illness. Based on the total number of inmates, this means that there are approximately 356,000 inmates with serious mental illness in jails and state prisons. This is 10 times more than the approximately 35,000 individuals with serious mental illness remaining in state hospitals.
5. In 2011–12, an estimated 40% of state and federal prisoners and jail inmates report having a current chronic medical condition while about half report ever having a chronic medical condition.
6. Twenty-one percent of prisoners and 14% of jail inmates report ever having tuberculosis, hepatitis B or C, or other STDs (excluding HIV or AIDS).
7. Among prisoners and jail inmates, females are more likely than males to report ever having a chronic condition.

Incarceration rates amongst racial and ethnic minorities, namely African Americans, Latinos, and American Indians and Alaska Natives, continue to be disproportionately represented in the justice system. The effects of incarceration are felt far beyond prison walls and impact health. In addition to pressing needs such as housing, employment, and educational opportunities, justice-involved individuals have disproportionately high rates of chronic health conditions, and mental health issues and substance use disorders are common. While medical care is available to individuals while incarcerated, physical and behavioral health conditions remain prevalent among justice involved populations. Many offenders who are impacted with communicable diseases such as tuberculosis, Hepatitis B, Hepatitis C and HIV/AIDS are then released from prison and left to secure and access healthcare services, in many cases to no avail.

Ex-offenders commonly reenter communities with pressing health conditions but encounter obstacles to accessing care and remaining in care. The lack of health insurance coverage and medical treatment emerge as the some of the most reported reentry health needs and may contribute to observed health disparities. Linking ex-offenders to care and services upon release increases the likelihood that they will remain in care and practice successful disease management. The Affordable Care Act (ACA) offers opportunities to address health disparities experienced by the reentry population that places them at risk for negative health outcomes and recidivism. Coordinated efforts to link ex-offenders with these newly available opportunities may result in a trajectory for positive health and overall well-being as they reintegrate into society.

Reducing or eliminating access to health coverage and health care pose significant challenges for this population, can contribute to a worsening of their health status, and are associated with higher rates of recidivism. The health sector, therefore, has an important role to play in supporting formerly incarcerated individuals to address their health needs. Access to health care and improved health status may also lead to improved opportunities for employment, housing, and family support. All Americans, including those who are formerly incarcerated and have paid their debt to society, should have the opportunity to reach their full potential for health.

In Connecticut, Access Health CT, the state’s marketplace has successful enrolled individuals to affordable healthcare. However, given are most recent change in Administration this may pose a threat to individuals being released into society. More than ever, it is critical that we continue to advocate on the importance of maintaining the ACA so we can continue to ensure individuals maintain and have access needed healthcare services. Health equity is achieved when every person can attain their health potential, and no one is unjustly denied care, concern, or coverage. This is true for the citizen who has crossed on the green and not in between, as well as the returning citizen who is attempting to walk the straight and narrow.