Returning cohorts also have disproportionate rates of HIV/AIDS, hepatitis C, and sexually transmitted infections, and these infections can spill over to affect communities with high incarceration rates. Reentering citizens experience higher rates of overdose, suicide, disabilities and physical disorders, homelessness, and death compared with the general population. Rates of mental health problems, substance use disorders, lifetime suicide attempts, opioid use, and pain medication dependence are dramatically elevated for justice-involved populations compared with the general population. Compounding these problems are barriers to health care and basic social determinants of health such as shelter, food, and employment. People released from incarceration have a high risk for adverse health outcomes and death due to preexisting behavioral health and chronic medical conditions and the negative effect of incarceration itself. We argue that criminal justice reform coupled with targeted upstream efforts such as investment in criminal justice–based reentry programs, support for communities and the community health systems to which people return, and enhanced research evaluation of reentry programming are necessary to mitigate the negative health impacts of mass incarceration. This brief provides an overview of research regarding the health outcomes associated with prior incarceration, a review of strategies currently used to support the health and well-being of the reentry population, and high-level recommendations to improve health and justice outcomes. More than 600,000 people are released from prison and more than nine million cycle through jails annually. Release back to the community after incarceration is the norm, as nearly all incarcerated people are released from prison and jail at some point. Jails are managed by local law enforcement and confine people with sentences of one year or less and those awaiting trial. Prisons are state or federal correctional facilities that hold people with sentences generally longer than one year. Incarceration takes place in prisons and jails. This creates challenges related to public health, housing, education, and employment for reentering people, families, and the communities hit hard by mass incarceration. Adding to its many other negative health effects, incarceration is often associated with coerced mobility, as it forces the relocation of people away from their communities. Contemporarily, the root causes of this phenomenon point to long-standing structural oppression.Įxperts have pointed to incarceration as a public health crisis. Black and Brown people are substantially overrepresented among incarcerated people. A 500 percent increase in incarceration in the US during the last forty years was not merely a result of rising crime but also a result of the increasing criminalization of behaviors, exemplified by the “ War on Drugs,” incarceration of people with serious mental illness, and increased sentencing for disadvantaged populations. The United States incarcerates more people than any other country in the world, having more than two million adults behind bars at an estimated annual cost of $182 billion. Public officials should include health care as a key component of community reentry programming by supporting access to Medicaid prerelease and seamless coordination of health care in communities postrelease.

Savings from reform of the criminal justice system could be reinvested to make successful reentry achievable.

Compared with approaches that focus on health and well-being, these programs are unlikely to achieve identity transformation and self-efficacy in managing health and other needs.

Justice-based interventions for the reentry population generally focus on life skills or individual deficits.

The reentry population faces complex barriers to health care access and often experiences homelessness, unemployment, and a lack of social and family support.Disproportionate rates of mental health issues, suicide, substance use disorders, disabilities, and physical disorders plague the reentry population.Incarceration can exacerbate health conditions and complicate health and justice outcomes for both reentering people and the communities to which they return. Mass incarceration in the United States is a public health crisis that disproportionately affects Black and Brown people and their communities.

Social questions about prison