State and Local Correctional Health Care

State Prisons and the Delivery of Hospital Care

Delivering adequate medical care to the more than 1 million adults in state prisons is a growing challenge for states, in part because of the high costs and complex logistics required to hospitalize people who are incarcerated.

Jails: Inadvertent Health Care Providers

Every year, millions of people are booked into U.S. jails. During 2015, the latest year for which data are available, there were 10.9 million admissions to these correctional facilities, which hold individuals who are awaiting trial or serving short sentences. The government running the jail—usually a county—has a constitutional mandate to provide people booked into these facilities with necessary health care. Counties designing a jail health care program targeted to meet the needs of their incarcerated population have the opportunity to improve the health of people in jail and the broader community, spend public dollars more effectively, and, in some cases, reduce recidivism.

Adults who are incarcerated have a higher-than-average prevalence of infectious diseases, hypertension, asthma, arthritis, mental illness, and substance use disorders, often in combination. Since departments of corrections (DOCs) are legally obligated to treat individuals in their custody, they—like all health care purchasers in this country—face the challenge of pharmaceutical prices that seem to rise constantly, and sometimes rapidly.

Prison health care sits at the intersection of pressing state priorities. From protecting public safety to fighting disease and promoting physical and behavioral health, and from fine-tuning budgets that trim waste to investing in cost-effective programming with long-term payoffs, the health care that prisons provide to incarcerated individuals and the care that prisons facilitate post-release is a critical linchpin with far-reaching implications.