What is it about?
More than 1,000,000 women in the U.S. are currently under supervision of the criminal legal system (CLS). Since 1980, the number of women in prison has increased by over 800%. CLS involvement increases risk of physical and sexual violence, with direct or indirect health and health care effects, which impact families and communities. These risks are consequences of pre-incarceration factors, including poverty, structural racism, and inadequate health care access; limited jail and prison health care; and the health impacts of carceral systems themselves. Furthermore, parenting and reproduction, health care needs as they age, and reentry challenges of WICLS are underrepresented in current policy, research, and clinical contexts. We delineate reproductive health and motherhood, aging in prison, and reentry as critical areas exemplifying women's complex health related needs, which may be best addressed via gender-responsive and trauma-informed care. Bipartisan criminal justice reform legislation, which includes improving the health of WICLS, is gaining support. As a public health community committed to advancing equity, we must evaluate and support legal and legislative reform that seeks to improve health care quality and access for this often overlooked population.
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Why is it important?
Bipartisan criminal justice reform legislation, which includes improving the health of WICLS, is gaining support. The SecondChance Act, the Fair Sentencing Act, and the First Step Act of 2018have been enacted. The Dignity for Incarcerated Women Act, which focuses on health, visitation, programming, oversight, and telecommunications, was reintroduced by Senators ElizabethWarren and Cory Booker in April 2019. The First Step Act, which only applies to federal contexts, contains some of the DignityAct’s clauses: menstrual product provision, shackling bans, and incarceration closer to home. Moreover, the proposed 2018 Pregnant Women in Custody Act supports data collection and reporting on pregnant women, prohibiting restrictive housing and restraints, and addressing health care needs in federal prisons. Relatedly, Senators Ann McLane Kuster and Booker’s proposed Humane Correctional Health Care Act seeks to improve health care delivery and treatment behind bars. As a public health community committed to advancing equity, we must evaluate and support legal and legislative reform that seeks to improve health care quality and access for this often overlooked population.
Perspectives
Decarceration, drug policy reform, and alternatives to incarceration are necessary criminal justice reform efforts, which may improve health outcomes further upstream and aid women in addressing underlying challenges while maintaining and strengthening positive ties to families and communities. From a systems perspective, it is less costly and disruptive to avoid incarceration altogether and deliver continuous care in the community for chronic health conditions including substance use and psychiatric disorders (Meyer, 2019b). Women have strengths, needs, risks, and pathways into the justice system that often differ from men’s (Binswanger et al., 2013; Richie, 2012; Machtinger, Cuca, Khanna, Rose, & Kimberg, 2015). Gender-responsive, trauma-informed, strength-based care supports women’s reintegration and recovery. Relevant clinical training, capacity building, material resources and structural support in communities are also necessary to sustain such efforts .
Robert Wood Johnson Foundation Health Policy Research Scholar Cynthia A Golembeski
The New School
Read the Original
This page is a summary of: Improving Health Equity for Women Involved in the Criminal Legal System, Women s Health Issues, September 2020, Elsevier,
DOI: 10.1016/j.whi.2020.06.007.
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