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Henrie M. Treadwell, PhD and Joyce H. Nottingham, MS, PhD

National Center for Primary Care, Morehouse School of Medicine, Atlanta, Ga

The United States is undergoing what has been provocatively described as one of the largest mass migrations in our nation’s history. Every year, 630 000 residents will cross the border between the community and the correctional system, and they will make the journey virtually unseen and unheard. Many of these voiceless migrants might have stayed at home if they had only had access to comprehensive primary health care services, including substance use prevention and treatment services. While US prisons have traditionally held poor men, disproportionate numbers of whom have been African American, and increasing numbers of whom are Latino, the numbers of women in prison are rising exponentially. The demographics of women prisoners are tellingly similar to those of their male counterparts.

One out of every 5 African American men born between 1965 and 1969 served time in prison by the time he reached his early 30s. Nearly 60% of African American high school dropouts born during this period served time in state or federal prison by their early 30s. Formative research in the Overtown community of Miami, Fla—a community of 9000 mostly African American residents, whose wages are among the lowest in the country—revealed that 66% of the 129 men interviewed had been incarcerated at some point in their lives, 17% had experienced homelessness in the 30 days before the interview, and 53% earned less than $10 000 per year at the time of the interview (Community Voices, unpublished survey, May 2005).

In effect, individuals like these now live with the residual effects of imprisonment. Their chances of remaining in their communities have been compromised by poor health insurance coverage, gaps in social services, and public policy limitations that make it difficult for them to apply for education loans or secure public housing. Inadequately funded public health clinics cannot provide this population with needed culturally competent mental health services or adult oral health care.

When we began work on this special theme issue, we knew we faced a challenge, but we had no idea how truly monumental the task was that we had set for ourselves. We had hoped to construct a compendium of best practices on prisons and health to fast-forward effective partnerships between public health and social services with the goal of healing people while rapidly reducing recidivism. Instead, we learned that although we as a nation are very good epidemiologists and can tell what is wrong and how many are affected, we do a very poor job of moving beyond simply quantifying or describing the problem.

The loss of so many people to prison is felt not only by those behind bars, but by their families, potential employers, and entire communities. Many leave home for prison far too young. Some grow old in prison, where they develop chronic conditions in the absence of primary care. Was it our intention to replace the old mental health system with a prison industrial complex to stimulate economic development? Was it our goal to eliminate services for prisoners reentering our communities to ensure that they would repopulate the prisons when their health care needs were not addressed? Did we intend for unmet health and educational needs to drive investment in prison construction? With this issue, we "stand in the gap" on behalf of the land (Ezekiel 22:30). We hope to find supporters who will stand with us.

This article has been cited by other articles:

				M. G. Vaughn, J. M. Wallace Jr., L. E. Davis, G. T. Fernandes, and M. O. Howard Variations in Mental Health Problems, Substance Use, and Delinquency Between African American and Caucasian Juvenile Offenders: Implications for Reentry Services Int J Offender Ther Comp Criminol, June 1, 2008; 52(3): 311 - 329. [Abstract] [PDF]

				E. M. Whitley, N. C. Jarrett, A. M. W. Young, S. A. Adeyemi, and L. M. Perez Building Effective Programs to Improve Men's Health American Journal of Men's Health, December 1, 2007; 1(4): 294 - 306. [Abstract] [PDF]

				H. M. Treadwell, M. E. Northridge, and T. N. Bethea Confronting Racism and Sexism to Improve Men's Health American Journal of Men's Health, March 1, 2007; 1(1): 81 - 86. [Abstract] [PDF]

This Article Extract Full Text (PDF) Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Treadwell, H. M. Articles by Nottingham, J. H. Search for Related Content PubMed Articles by Treadwell, H. M. Articles by Nottingham, J. H. Related Collections Health Policy Other Race/Ethnicity Socioeconomic Factors Government