Health challenges of returning prisoners in New York City and criminal involvement

This study examines health challenges of returning prisoners in New York City using a cohort of 120 male prisoners released from maximum security prison. The study has four distinctive goals: documentation of health challenges of returning prisoners in urban areas; examination of relationships and interaction between public health and public safety; examination of relationships between socioeconomic and racial disparities in health challenges and medical care utilization; and reflection upon the possibility of incorporating healthcare as an integral component of justice administration and crime prevention.

There are four hypotheses in this study related to impacts of chronic and acute health challenges, substance abuse, lack of adequate healthcare in the community on criminal involvement. The hypotheses are; i) many health risks are also crime risks, therefore, the failure or exposure to health risks increase the probability of criminal recidivism; ii) substance abuse increases the likelihood of re-arrest; iii), chronic or acute medical conditions decrease employability, access to adequate housing, and social support which raise the chances of recidivism; and iv) lack of adequate healthcare in inner-city neighborhoods makes prison healthcare an attractive service, which reduces the deterrent impact of incarceration on offenders facing daunting health challenges.

These hypotheses will be tested using five main data sources: survey data (baseline and follow-up), focus groups, archival criminal history data, archival medical data, and 2010 Census data. The in-person baseline survey will be conducted before inmate's release, and follow-up survey will be conducted at three month post release in the community. The archival data will be used to address possible threats to the study findings. The study sample, inmates released from a maximum security prison returning to New York City, is at the extreme end of convicted offender population. This may have implications on findings. More specifically, inmates returning to urban areas or those who did not volunteer may be different from the study sample in regards to their health challenges or recidivism. To address this threat to conclusions drawn, I will compare all released inmate during the recruitment period and the study sample on key characteristics including criminal history and health challenges using archival data. The 2010 Census data will be utilized in GIS programs to examine neighborhood characteristics. In addition, spatial analysis will be performed to analyze whether the areas where inmates return to have impacts on health challenges or healthcare utilization, therefore, possibly influencing recidivism.