Author: Rebecca Bryant, Americorps Member
In January, the Center for Health and Social Care Integration at RUSH (CHaSCI) hosted a Social Work Grand Rounds led by Dr. Nicole Mushero named Incarceration in the United States: Health Impacts and Advocacy Opportunities. This session highlighted how limited access to health care in correctional facilities, like prisons and jails, is negatively impacting the health of incarcerated individuals and decreasing life expectancy even after release.
The Impacts of Health Care in Correctional Facilities
Many people in state prisons grew up facing serious family, housing, economic, and educational challenges. (2026a). Prison Policy Initiative. Retrieved March 16, 2026, from https://www.prisonpolicy.org/reports/pie2026.html
Many individuals who are incarcerated enter correctional facilities with mental health conditions, substance use disorders, chronic health conditions, or unmet social needs. Their lives are significantly impacted by the correctional facilities’ low investment in their health care and the inadequate care they may receive from correctional providers. Few resources are provided to address mental health and chronic conditions for incarcerated individuals. When health care is available inside correctional facilities, it is often costly, which further impacts their health and, ultimately, their life expectancy. Because prisons and jails aren’t classified as medical institutions, it is unlikely that incarcerated individuals have access to health care insurance within these facilities. As a result, incarcerated individuals have to pay full price for services while being paid little to nothing for their labor. On the other hand, incarcerated individuals who are inpatient for 24 hours or longer in a medical institution outside their correctional facilities can bill Medicaid to offset a portion of the medical expenses for coverable services. The Center for Medicare and Medicaid services provides guidance on which settings qualify as medical institutions. Among the criteria, care settings (e.g., hospitals, nursing facilities) must be certified Medicaid providers, serve members of the general public, and house and provide treatment based on medical need rather than incarceration status. Medicaid’s “patient in a medical institution” exception applies to federal inmates, but the Bureau of Prisons chooses to retain responsibility for the payment of health care services for its inmates; in practice, the policy is not applied to inmates in federal prisons. After the age of 55, the life expectancy of incarcerated individuals decreases two years for every one year they are incarcerated. The risk for suicide increases after one day in jail and remains that way even after release.
The U.S. Has a Jails Suicide Crisis on Its Hands. (2022). Statista. Retrieved March 16, 2026, from https://www.statista.com/chart/28290/suicide-rates-in-us-jails-prisons-and-general-public/.
Health Challenges After Incarceration
Once an incarcerated individual is released, they begin the process of reintegrating into society. If their health conditions are not treated during incarceration, they may worsen and remain untreated after being released. They then have the chance to resume, apply for, or reapply for Medicaid or Medicare for healthcare coverage. However, if they are applying or reapplying, there may be a gap between being uninsured and insured, which can limit their access to health care.
Additionally, unemployment is a significant barrier faced by formerly incarcerated individuals, particularly older adults. It can limit their ability to access adequate health care, negatively affecting their overall health and the well-being of their families.
Similarly, older adults who are released are more likely to experience homelessness than younger individuals, which can increase the risk of reincarceration or parole violations. This can place them back into a system that contributes to decreased life expectancy.
Advocacy Opportunities
There are different ways one can advocate for better health care in the prison system. For example, we can petition against unfair sentences that disproportionately affect people of color and support policies aimed at reforming the system. We can also speak up for older individuals who are denied or provided with inadequate help with activities of daily living while incarcerated, leading to worsening health while in prison. Additionally, supporting rehabilitation programs and organizations can help more individuals remain out of prison and gain access to health care. Here are some organizations that support prison healthcare reform:
They affirm that every person who is incarcerated, no matter their background, has the right to appropriate medical care. This right is guaranteed by the 8th Amendment of the Constitution. As medical professionals, they see it as their responsibility to protect this right.
The mission of the National Commission on Correctional Health Care is to improve the quality of health care in jails, prisons, and juvenile confinement facilities.
Based in Chicago, Transforming Reentry Services works to create an equitable future for reentry communities. Founded and incorporated by Black women and incarcerated individuals, they combine services, advocacy, and research to fill in the gaps in the system, restore families, and build economic and political power.
Final Thoughts
Racial and ethnic disparities in correctional facilities. (2026b). Prison Policy Initiative. Retrieved March 16, 2026, from https://www.prisonpolicy.org/reports/pie2026.html.
Access to health care is not a privilege; it is a right. Due to mass incarceration, many people of color and their families have had limited access to health care. Also, families struggle when one less person is able to contribute income to cover medical bills or help take family members to doctor’s appointments due to incarceration. Through various reentry programs and preventive services, underserved populations can receive proper and life-changing care.
As an AmeriCorps Member in the Department of Social Work and Community Health at RUSH University Medical Center, it is important for me to understand and learn more about the populations I am serving, because it helps me become more effective in my care coordination. My hope is for health care to be adequate and accessible to everyone, regardless of their status. When we know more, we can do better. CHaSCI is working to bring critical and often overlooked information about this and other marginalized populations to the forefront so that we can work to be inclusive of their needs and redefine the care systems that surround them.