Two ways to improve inmate health in Nassau

As public health experts in correctional health, including health education, we are deeply concerned about the recent string of deaths at the Nassau County Correctional Center.

Incarcerated populations have higher rates of mental illness, chronic medical conditions, and infectious diseases compared with the general population, according to the Centers for Disease Control and Prevention. Research also demonstrates that access to health care and the quality of that care in jails are often deficient. What’s more, many formerly incarcerated people are unable to manage health conditions after they are released.

This should concern not only inmates but also correction staff and Nassau County residents. There are many factors contributing to the state of inmate health at the jail, and our purpose is not to assign blame. And as tragic as the deaths at the jail are, they present us with an opportunity to focus on how we can best address the long-term health concerns at the jail.

We urge all Nassau County agencies responsible for the well-being of inmates at the beleaguered jail to consider a more comprehensive public health approach to how they provide health, mental health, social services and disease prevention programs not only for those incarcerated but also those formerly at the jail who are re-entering communities on Long Island.

We propose two approaches:

• First, too often correctional health focuses on immediate medical and clinical issues and not on disease prevention and health promotion. To improve the quality of jail health care, we suggest following guidelines established through the CDC and other proven approaches to correctional health. Public health initiatives, such as increasing awareness of communicable diseases (HIV and other sexually transmitted infections) and promoting healthy behaviors (prenatal and infant care), have been successful in jails. Also, correctional facilities have been useful for substance abuse intervention, rehabilitation and control.
• Second, we propose additional training for jail staff about the health conditions (mental health, substance abuse, untreated chronic health conditions, trauma, etc.) of inmates before they enter the jail. Understanding the inmate population’s health needs and how they impact health care would allow staff to anticipate problems.

Incarcerated persons in Nassau County and in the United States experience health disparities and barriers to accessing health and social service programs, thus perpetuating recidivism.

A public health approach can help improve not only correctional health but ultimately the health of all Nassau County residents.

Anthony Santella and Martine Hackett are assistant professors of health professions at Hofstra University.