The Need for Higher Standards in Correctional Healthcare to Improve Public Health

Excerpt

Over the last 40 years, the United States has experienced an “epidemic” of incarceration, in which millions of Americans have spent days to years of their lives in jails or prisons. During this time, correctional medicine has undergone major changes.1,2 In 1976, the U.S. Supreme Court affirmed that failure to provide basic medical care to a prisoner violates the Eighth Amendment to the Constitution banning cruel and unusual punishment.3 Over the ensuing decades, additional litigation or threat of litigation has forced correctional institutions to provide a minimum community standard of healthcare to prisoners. In response, accreditation bodies such as the National Commission on Correctional Health Care have codified these minimum standards for prison and jail-based health systems to follow through voluntary accreditation. However, a minority of the 4,575 correctional institutions across the U.S. have volunteered to become accredited using these standards. As a result, litigation remains the mainstay of enforcing correctional healthcare standards,4 and correctional healthcare improvements have transpired piecemeal, typically with a focus only on reaching the minimum standards that have been established. …