Social Determinants that Represent Barriers to Comprehensive Primary Health Care Services and Well-Being Among Ex-Offenders in the United States

The United States is the world’s top jailer in the world and spends $75 billion on incarceration alone each year. No definitive cost estimates are available on percent of the $75 billion that is spent on health care alone. Twenty percent of those incarcerated have been diagnosed with a mental illness.  Another 75-80% have a substance use disorder. HIV/AIDS, diabetes, hypertension, and other chronic conditions are also common. Fully 95% of those incarcerated are released over time and return home (at the rate of 700,000 per year. Few of these individuals quality for public insurance and are therefore barred from health care services and from establishing a permanent source of care.  Analysts estimate that 35% of the approximately 15 million that will be covered by the Affordable Care Act that was passed under the Obama administration will have a criminal justice background (viz. a felony conviction). This number may be too small though we know that at least 5 million individuals that have been released from prison have no health insurance and guarantee of continual care. In addition to direct access to health care, the ability to find employment, housing, and further their education is curtailed by public policy. The presentation will explore the data needed to better assess the health and social services care needs of those released along with the needs of their families and present promising practices that improve access to primary health care and prevention by utilizing community health workers and outreach practices that are individually and family focused.  More appropriate population-based care can be designed with the inclusion of these individuals in data banks while they are incarcerated and once they are released.