Using GIS to Understand Prisoner Reentry Challenges and Their Public Health Implications: California at the Crossroads

The increasing numbers of ex-offenders released in California raises serious public health concerns. This reentry population is, on average, disproportionately sicker than the general population, with more infectious diseases (e.g., HIV/AIDS, tuberculosis, hepatitis B and C), mental illness, substance abuse, and chronic conditions such as diabetes. Gross inadequacies in California prison healthcare and poor planning for care upon release increase this population's vulnerability. This study, conducted by researchers and a faith-based organization focusing on re-entry issues, examines characteristics (demographic, offense, and address) of recent California parolees to determine the impact of reentry on communities and public health institutions and policies. Sources include parolee data, census data, state and county health care data, and other publicly available data. We also conducted outreach with re-entry stakeholders in counties with the largest numbers of releasees (Alameda, Los Angeles, and San Diego). We use Geographic Information System (GIS) to map the spatial distribution of releasees and cluster detection methods to delineate the area of spatial clustering of parolees at the neighborhood level. Results are used to describe the socio-demographic and health care system characteristics of communities with concentrations of parolees. The maps visually provide information on where the reentry population is concentrated, and can help determine the proximity, availability, and suitability of formal and informal health care services available to parolees. Our findings will be publicly available through the internet, for use by community providers for their own local and state policy and advocacy efforts.