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LETTER |
The authors are with the Baltimore City Health Department, Baltimore, Md.
Correspondence: Requests for reprints should be sent to Sherry A. Adeyemi, Baltimore City Health Department, 210 Guilford Ave, 3rd Floor, Baltimore, MD 21202 (e-mail: sherry.adeyemi{at}baltimorecity.gov).
We applaud the October issue of the Journal for examining the public health consequences of incarceration—in particular, the work of Freudenberg et al.1 As reiterated throughout the issue, the incarcerated population in the United States is disproportionately male, African American, and poor. This profile coincides with the men who receive medical care at the Baltimore City Health Department’s Men’s Health Center, a primary care center for uninsured men. The Men’s Health Center is funded in part by the W.K. Kellogg Foundation in partnership with the National Center for Primary Care.
In a culture where poor men of color are undervalued, discounted, and viewed as dispensable, the founders of the Men’s Health Center chose the motto "Building Healthy Families . . . One Man at a Time" because they believed that uninsured men, like most Americans, seek to improve their life situations. Nearly 1 of every 5 men who seek care at the Men’s Health Center is newly released from prison or jail. As these men try to manage the various areas of their reentry into society, including reuniting with families, finding employment, and adhering to probationary regulations, they face the challenge of meeting their medical needs without the benefit of health insurance. As noted by Freudenberg et al., lack of health insurance is associated with higher recidivism rates.1 By providing medical care to ex-offenders, MHC potentially helps reduce rates of recidivism and provides a needed public health service.
We encourage future research and policy development that integrates access to primary care with access to mental health and substance abuse treatment in models of community reentry. Our efforts to improve the health status of uninsured men have led to collaborations between the Men’s Health Center and the Maryland Reentry Partnership Initiative in which referrals to the center are given to men soon to be released from prison or jail. Representatives from the Men’s Health Center also participate on the Committee of the Baltimore City Ex-Offender Initiative, whose aim is to improve reentry outcomes. The Committee of the Baltimore City Ex-Offender Initiative recently opened the Re-entry Center, which serves as a one-stop shop for social resources for men, including medical referrals to the Men’s Health Center.
The health of a community depends in part on the health of its individual members. Criminal justice, housing, education, human services, employment, and public health policies must be viewed holistically. We encourage other safety net providers to specifically target ex-offenders for outreach and to form local collaborations and linkages, and we advocate a health care system that does not leave its most vulnerable citizens without the ability to obtain affordable medical care.
References
1. Freudenberg N, Daniels J, Crum M, Perkins T, Richie BE. Coming home from jail: the social and health consequences of community reentry for women, male adolescents, and their families and communities. Am J Public Health. 2005;95:1725–1736.
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