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In the past 30 years, the population of prisoners in the United States has expanded almost 5-fold, correctional facilities are increasingly overcrowded, and more of the country's disadvantaged populations—racial minorities, women, people with mental illness, and people with communicable diseases such as HIV/AIDS, hepatitis C, and tuberculosis—are under correctional supervision. Because prisoners face restrictions on liberty and autonomy, have limited privacy, and often receive inadequate health care, they require specific protections when involved in research, particularly in today's correctional settings. Given these issues, the Department of Health and Human Services' Office for Human Research Protections commissioned the Institute of Medicine to review the ethical considerations regarding research involving prisoners. The resulting analysis contained in this book, Ethical Considerations for Research Involving Prisoners, emphasizes five broad actions to provide prisoners involved in research with critically important protections: • expand the definition of "prisoner"; • ensure universally and consistently applied standards of protection; • shift from a category-based to a risk-benefit approach to research review; • update the ethical framework to include collaborative responsibility; and • enhance systematic oversight of research involving prisoners.
After decades of stability from the 1920s to the early 1970s, the rate of imprisonment in the United States has increased fivefold during the last four decades. The U.S. penal population of 2.2 million adults is by far the largest in the world. Just under one-quarter of the world's prisoners are held in American prisons. The U.S. rate of incarceration, with nearly 1 out of every 100 adults in prison or jail, is 5 to 10 times higher than the rates in Western Europe and other democracies. The U.S. prison population is largely drawn from the most disadvantaged part of the nation's population: mostly men under age 40, disproportionately minority, and poorly educated. Prisoners often carry additional deficits of drug and alcohol addictions, mental and physical illnesses, and lack of work preparation or experience. The growth of incarceration in the United States during four decades has prompted numerous critiques and a growing body of scientific knowledge about what prompted the rise and what its consequences have been for the people imprisoned, their families and communities, and for U.S. society. The Growth of Incarceration in the United States examines research and analysis of the dramatic rise of incarceration rates and its affects. This study makes the case that the United States has gone far past the point where the numbers of people in prison can be justified by social benefits and has reached a level where these high rates of incarceration themselves constitute a source of injustice and social harm. The Growth of Incarceration in the United States examines policy changes that created an increasingly punitive political climate and offers specific policy advice in sentencing policy, prison policy, and social policy. The report also identifies important research questions that must be answered to provide a firmer basis for policy. This report is a call for change in the way society views criminals, punishment, and prison. This landmark study assesses the evidence and its implications for public policy to inform an extensive and thoughtful public debate about and reconsideration of policies.
The Federal Bureau of Prisons (BOP), the component of the Department of Justice (DOJ) responsible for incarcerating all federal defendants sentenced to prison, was operating at 20% over its rated capacity as of December 2015. To alleviate overcrowding, in 1997 the BOP had begun contracting with privately operated institutions (contract prisons), to confine federal inmates who are primarily low security, criminal alien adult males with 90 months or less remaining to serve on their sentences. This report examined how the BOP monitors these facilities and assessed whether contractor performance meets certain inmate safety and security requirements. It found that, in most key areas, contract prisons incurred more safety and security incidents per capita than comparable BOP institutions and that the BOP needs to improve how it monitors contract prisons. Figures. This is a print on demand report.
Based on the experience of many countries in the WHO European Region and the advice of experts, this guide outlines some of the steps prison systems should take to reduce the public health risks from compulsory detention in often unhealthy situations, to care for prisoners in need and to promote the health of prisoners and prison staff. This requires that everyone working in prisons understand how imprisonment affects health, what prisoners' health needs are, and how evidence-based health services can be provided for everyone needing treatment, care and prevention in prison. Other essential elements are being aware of and accepting internationally recommended standards for prison health; providing professional care with the same adherence to professional ethics as in other health services; and, while seeing individual needs as the central feature of the care provided, promoting a whole-prison approach to care and promoting the health and well-being of people in custody.
Public Health Behind Bars From Prisons to Communities examines the burden of illness in the growing prison population, and analyzes the impact on public health as prisoners are released. This book makes a timely case for correctional health care that is humane for those incarcerated and beneficial to the communities they reenter.
According to the Centers for Disease Control and Prevention (CDC), 115 Americans die each day from an opioid overdose, which averages one death every 12.5 minutes. Between 1999 and 2016, the number of drug overdoses catapulted by 300 percent, with injection drug use increasing by 93 percent between 2004 and 2014 and opioid-related hospital admissions increasing by 58 percent over the past decade. And an inexorable sequela of the opioid epidemic is the spread of infectious diseases. To address these infectious disease consequences of the opioid crisis, a public workshop titled Integrating Infectious Disease Considerations with Response to the Opioid Epidemic was convened on March 12 and 13, 2018, by the National Academies of Sciences, Engineering, and Medicine. Participants discussed strategies to prevent and treat infections in people who inject drugs, especially ways to work efficiently though the existing public health and medical systems. This publication summarizes the presentations and discussions from the workshop.