Health Promotion in Jails and Prisons: An Alternative Paradigm for Correctional Health Services

  • Megha Ramaswamy
  • Nicholas Freudenberg

According to the World Health Organization, health promotion describes the “process of enabling people to increase control over and to improve their health.” Health promotion seeks to bring about changes in individuals, groups, institutions, and policies in order to improve population health. The Ottawa Charter for Health Promotion, adopted by the WHO in 1986, identifies five critical activities for health promotion: developing personal skills for health, creating supportive environments, strengthening community action for health, reorienting health services, and building healthy public policy (Ottawa Charter for Health Promotion, World Health Organization, 1986). At first sight, this expansive conception of health promotion seems too idealistic to serve as a useful guide for the consideration of its role in prisons and jails. However, in this chapter, we make the case that a comprehensive definition of health promotion can serve as a useful paradigm that links correctional health care to the larger public health system, expands the focus of correctional health services from medical care during custody to preparation for healthy living after release, and provides a rationale for expanding the goals of incarceration to include not only punishment but also rehabilitation. In this chapter, we consider health promotion as both a set of activities within the five categories identified by the World Health Organization and as a mindset that views CHS as an integral element of public health that is judged by its contribution to improved population health. We distinguish this perspective from the more traditional view that CHS simply provide care that meets minimal legal standards to those in custody.


Health Promotion Criminal Justice Chronic Disease Management Urban Health Correctional System 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. American Public Health Association. (2003). Standards for health services in correctional institutions (3rd ed.). Washington, DC: Author.Google Scholar
  2. Austin, J., & Hardyman, P. (2004). The risks and needs of the returning prisoner population. Review of Policy Research, 21, 13–29.CrossRefGoogle Scholar
  3. Bauserman, R.L., Richardson, D., Ward, M., Shea, M., Bowlin, C., Tomoyasu, N. & Solomon, L. (2003). HIV prevention with jail and prison inmates: Maryland’s Prevention Case Management program. AIDS Education and Prevention, 15, 465–480.PubMedCrossRefGoogle Scholar
  4. Beck, A.J. (2006). The importance of successful reentry to jail population growth. Presented at The Jail Reentry Roundtable, The Urban Institute, Washington, DC, June 27, 2006. Available at
  5. Beck, J., Sullivan, P., & Walker, J. (2001). Prisons: Advocates say inmate medical services are public health issue. AIDS Policy Law, 16, 1–8.PubMedGoogle Scholar
  6. Bell, J.F., Zimmerman, F.J., Cawthon, M.L., Huebner, C.E., Ward, D.H., & Schroeder, C.A. (2004). Jail incarceration and birth outcomes. Journal of Urban Health, 81, 630–644.PubMedGoogle Scholar
  7. Berkman, L.F., Glass, T., Brissette, I., & Seeman, T.E. (2000). From social integration to health: Durkheim in the new millennium. Social Science and Medicine, 51, 843–857.PubMedCrossRefGoogle Scholar
  8. Blankenship, K.M., Smoyer, A.B., Bray, S.J., & Mattocks, K. (2005). Black–white disparities in HIV/AIDS: The role of drug policy and the corrections system. Journal of Health Care for the Poor and Underserved, 16(4 Suppl. B), 140–156.PubMedCrossRefGoogle Scholar
  9. Bloom, B., Owen, B., & Covington, S. (2003). Gender-responsive strategies: Research, practice, and guiding principles for women offenders, Washington, DC: U.S. Department of Justice, National Institute of Corrections.
  10. Boudin, K., Carrero, I., Clark, J., Flournoy, V., Loftin, K., Martindale, S., Martinez, M., Mastroieni, R.E., & Richardson, S. (1999). ACE: A peer education and counseling program meets the needs of incarcerated women with HIV/AIDS issues. J Assoc Nurses AIDS Care, 10, 90–98.PubMedCrossRefGoogle Scholar
  11. Brownson, R.C., Haire-Joshu, D., & Luke, D.A. (2006). Shaping the context of health: A review of environmental and policy approaches in the prevention of chronic diseases. Annual Review of Public Health, 27, 341–370.PubMedCrossRefGoogle Scholar
  12. Bureau of Justice Statistics. (2006). Prison statistics.
  13. Clarke, J.G., Rosengard, C., Rose, J.S., Hebert, M.R., Peipert, J., & Stein, M.D. (2006). Improving birth control service utilization by offering services prerelease vs. postincarceration. American Journal of Public Health, 96, 840–845.PubMedCrossRefGoogle Scholar
  14. Des Jarlais, D.C., McKnight, C., & Friedmann, P. (2002). Legal syringe purchases by injection drug users, Brooklyn and Queens, New York City, 2000–2001. Journal of the American Pharmaceutical Association, 42(6 Suppl. 2), S73–S76.PubMedGoogle Scholar
  15. Di Placido, C., Simon, T.L., Witte, T.D., Gu, D., & Wong, S.C. (2006). Treatment of gang members can reduce recidivism and institutional misconduct. Law and Human Behavior, 30, 93–114.PubMedCrossRefGoogle Scholar
  16. Dvoskin, J.A., & Spiers, E.M. (2004). On the role of correctional officers in prison mental health. Psychiatric Quarterly, 75, 41–59.PubMedCrossRefGoogle Scholar
  17. Ehrmann, T. (2002). Community-based organizations and HIV prevention for incarcerated populations: Three HIV prevention program models. AIDS Education and Prevention, 14(5 Suppl. B), 75–84.PubMedCrossRefGoogle Scholar
  18. El-Bassel, N., Ivanoff, A., Schilling, R., Borne, D., & Gilbert, L. (1997). Skills building and social support enhancement to reduce HIV risk among women in jail. Criminal Justice and Behavior, 24, 205–223.CrossRefGoogle Scholar
  19. Freudenberg, N. (2001). Jails, prisons, and the health of urban populations: A review of the impact of the correctional system on community health. Journal of Urban Health, 78, 214–235.PubMedGoogle Scholar
  20. Freudenberg, N. (2002). Adverse effects of US jail and prison policies on the health and well-being of women of color. American Journal of Public Health, 92, 1895–1899.PubMedCrossRefGoogle Scholar
  21. Freudenberg, N., Daniels, J., Crum, M., Perkins, T., & Richie, B.E. (2005). Coming home from jail: The social and health consequences of community reentry for women, male adolescents, and their families and communities. American Journal of Public Health, 95, 1725–1736.PubMedCrossRefGoogle Scholar
  22. Freudenberg, N., Rogers, M., Ritas, C., & Nerney, M. (2005). Policy analysis and advocacy: An approach to community-based participatory research. In B Israel et al. (Eds.), Methods in community-based participatory research for health San Francisco: Jossey–Bass.Google Scholar
  23. Gaiter, J.L., Potter, R.H., & O’Leary, A. (2006). Disproportionate rates of incarceration contribute to health disparities. American Journal of Public Health, 96, 1148–1149.PubMedCrossRefGoogle Scholar
  24. Gatherer, A., Moiler, L., & Hayton, P. (2005). The World Health Organization European Health in Prisons Project after 10 years: Persistent barriers and achievements. American Journal of Public Health, 95, 1696–1700.PubMedCrossRefGoogle Scholar
  25. Gilligan, J., & Lee, B. (2005a). The Resolve to Stop the Violence Project: Reducing violence in the community through a jail-based initiative. Journal of Public Health, 27, 143–148.PubMedCrossRefGoogle Scholar
  26. Gilligan, J., & Lee, B. (2005b). The Resolve to Stop the Violence Project: Transforming an in-house culture of violence through a jail-based programme. Journal of Public Health, 27, 149–155.PubMedCrossRefGoogle Scholar
  27. Glaser, J., & Greifinger, R. (1993). Correctional health care: A public health opportunity. Annals of Internal Medicine, 118, 139–145.PubMedGoogle Scholar
  28. Golembeski, C., & Fullilove, R. (2005). Criminal (in) justice in the city and its associated health consequences. American Journal of Public Health, 95, 1701–1706.PubMedCrossRefGoogle Scholar
  29. Gondles, E.F. (2005). A call to immunize the correctional population for hepatitis A and B. The American Journal of Medicine, 118(Suppl. 10A), 84S–89S.PubMedCrossRefGoogle Scholar
  30. Green, L.W., Kreuter, M.W., Partridge, K., & Deeds, S. (1999). Health education planning: A diagnostic approach (3rd ed.). Mountain View, CA: Mayfield.Google Scholar
  31. Greene, E., Lucarelli, P., & Shocksnider, J. (1999). Health promotion and education in youth correctional facilities. Pediatric Nursing, 25, 312–314.PubMedGoogle Scholar
  32. Grinstead, O., Zack, B., & Faigeles, B. (2001). Reducing post release risk behavior among HIV seropositive prison inmates: The health promotion program. AIDS Education and Prevention, 13, 109–119.PubMedCrossRefGoogle Scholar
  33. Hairston, C.F. (1998). The forgotten parent: Understanding the forces that influence incarcerated fathers’ relationships with their children. Child Welfare, 77, 617–639.PubMedGoogle Scholar
  34. Hammett, T.M. (2001). Making the case for health interventions in correctional facilities. Journal of Urban Health, 78, 236–240.PubMedGoogle Scholar
  35. Harlow, C. (1998). Profile of jail inmates 1996. Bureau of Justice Statistics Special Report.Google Scholar
  36. Harner, H.M. (2004). Relationships between incarcerated women: Moving beyond stereotypes. Journal of Psychosocial Nursing and Mental Health Services, 42, 38–46.PubMedGoogle Scholar
  37. Harrison, K. (1997). Parental training for incarcerated fathers: Effects on attitudes, self-esteem, and children’s self-perceptions. Journal of Social Psychology, 137, 588–593.PubMedCrossRefGoogle Scholar
  38. Hoge, C.W., Reichler, M.R., Dominguez, E.A., Bremer, J.C., Mastro, T.D., Hendricks, K.A., Musher, D.M., Elliott, J.A., Facklam, R.R., & Breiman, R.F. (1994). An epidemic of pneumococcal disease in an overcrowded, inadequately ventilated jail. The New England Journal of Medicine, 331, 643–648.PubMedCrossRefGoogle Scholar
  39. Holzer, H.J., Raphael, S., & Stoll, M.A. (2003). Employment barriers facing ex-offenders. Prepared for the Urban Institute Reentry Roundtable.Google Scholar
  40. Iguchi, M.Y., Bell, J., Ramchand, R.N., & Fain, T. (2005). How criminal system racial disparities may translate into health disparities. Journal of Health Care for the Poor and Underserved, 16(4 Suppl. B), 48–56.PubMedCrossRefGoogle Scholar
  41. Iguchi, M.Y., London, J.A., Forge, N.G., Hickman, L., Fain, T., & Riehman, K. (2002). Elements of well-being affected by criminalizing the drug user. Public Health Reports, 117(Suppl. 1), S146–S150.PubMedGoogle Scholar
  42. Institute of Medicine. (2002). Future of the public’s health in the 21 st century. Washington, DC: National Academy Press.Google Scholar
  43. James, D. (2004). Profile of jail inmates, 2002. Bureau of Justice Statistics Publication No. NCJ 201932. Washington, DC: U.S. Department of Justice.Google Scholar
  44. Jones, T.F., Craig, A.S., Valway, S.E., Woodley, C.L., & Schaffner, W. (1999). Transmission of tuberculosis in a jail. Annals of Internal Medicine, 131, 557–563.PubMedGoogle Scholar
  45. Kraut-Becher, J.R., Gift, T.L., Haddix, A.C., Irwin, K.L., & Greifinger, R.B. (2004). Cost-effectiveness of universal screening for chlamydia and gonorrhea in US jails. Journal of Urban Health, 81, 453–471.PubMedGoogle Scholar
  46. Kyei-Aboagye, K., Vragovic, O., & Chong, D. (2000). Birth outcome in incarcerated, high-risk pregnant women. The Journal of Reproductive Medicine, 45, 190–194.PubMedGoogle Scholar
  47. Laufer, F., Jacob Arriola, K., Dawson-Rose, C., Kumaravelu, K., & Krane Rapposelli, K. (2002). From jail to community: Innovative strategies to enhance continuity of HIV/AIDS care. The Prison Journal, 82, 84–100.CrossRefGoogle Scholar
  48. Leh, S.K. (1999). HIV infection in U.S. correctional systems: Its effect on the community. Journal of Community Health Nursing, 16, 53–63.PubMedCrossRefGoogle Scholar
  49. Lincoln, T., Kennedy, S., Tuthill, R., Roberts, C., Conklin, T.J., & Hammett, T.M. (2006). Facilitators and barriers to continuing healthcare after jail: A community-integrated program. The Journal of Ambulatory Care Management, 29, 2–16.PubMedGoogle Scholar
  50. Lindquist, C.H., & Lindquist, C.A. (1999). Health behind bars: Utilization and evaluation of medical care among jail inmates. Journal of Community Health, 24, 285–292.PubMedCrossRefGoogle Scholar
  51. Lowenkamp, C.T., Latessa, E.J., & Smith, P. (2006). Does correctional program quality really matter? The impact of adhering to principles of effective intervention. Criminology and Public Policy, 5, 201–220.Google Scholar
  52. Lurie, N. (2002). What the federal government can do about the nonmedical determinants of health. Health Affairs (Millwood), 21, 94–106.CrossRefGoogle Scholar
  53. May, J.P., & Williams, E.L., Jr. (2002). Acceptability of condom availability in a U.S. jail. AIDS Education and Prevention, 14(5 Suppl. B), 85–91.PubMedCrossRefGoogle Scholar
  54. McCoy, M.L., Roberts, D.L., Hanrahan, P., Clay, R., & Luchins, D.J. (2004). Jail linkage assertive community treatment services for individuals with mental illnesses. Psychiatric Rehabilitation Journal, 27, 243–250.PubMedCrossRefGoogle Scholar
  55. McGinnis, J.M., Williams-Russo, P., & Knickman, J.R. (2002). The case for more active policy attention to health promotion. Health Affairs (Millwood), 21, 78–93.CrossRefGoogle Scholar
  56. McLean, R.L., Robarge, J., & Sherman, S.G. (2006). Release from jail: Moment of crisis or window of opportunity for female detainees? Journal of Urban Health, 83, 382–393.PubMedCrossRefGoogle Scholar
  57. Mertz, K.J., Voigt, R.A., Hutchins, K., Levine, W.C., & Jail STD Prevalence Monitoring Group. (2002). Findings from STD screening of adolescents and adults entering corrections facilities: Implications for STD control strategies. Sexually Transmitted Disease, 29, 834–839.CrossRefGoogle Scholar
  58. Merzel, C., & D’Afflitti, J. (2003). Reconsidering community-based health promotion: Promise, performance, and potential. American Journal of Public Health, 93, 557–574.PubMedCrossRefGoogle Scholar
  59. Milio, N. (1998). Priorities and strategies for promoting community-based prevention policies. Journal of Public Health Management and Practice, 4, 14–28.PubMedGoogle Scholar
  60. Miller, R.D., & Metzner, J.L. (1994). Psychiatric stigma in correctional facilities. The Bulletin of the American Academy of Psychiatry and the Law, 22, 621–628.PubMedGoogle Scholar
  61. Myers, J., Zack, B., Kramer, K., Gardner, M., Rucobo, G., & Costa-Taylor, S. (2005). Get Connected: An HIV prevention case management program for men and women leaving California prisons. American Journal of Public Health, 95, 1682–1684.PubMedCrossRefGoogle Scholar
  62. Nathan, V.M. (2004). Taking stock of the accomplishments and failures of prison reform litigation: Have the courts made a difference in the quality of prison conditions? What have we accomplished to date? Pace Law Review, 24, 419–425.Google Scholar
  63. National Commission on Correctional Health Care. (2001). Clinical guides.
  64. National Commission on Correctional Health Care. (2002a). The health status of soon-to-be-released inmates: A report to Congress. Vol. 1. Chicago: Author.Google Scholar
  65. National Commission on Correctional Health Care. (2002b). The health status of soon-to-be-released inmates: A report to Congress (Vol. 2, pp. 81–166). Chicago: Author.Google Scholar
  66. National Commission on Correctional Health Care. (2003). Standards for health services in jails. Chicago: Author.Google Scholar
  67. Needels, K., James-Burdumy, S., & Burghardt, J. (2005). Community case management for former jail inmates: Its impacts on rearrest, drug use, and HIV risk. Journal of Urban Health, 82, 420–433.PubMedGoogle Scholar
  68. No authors. (2002). US: Condoms distributed to gay inmates in LA. Canadian HIV/AIDS Policy & Law Review, 6, 18–19.Google Scholar
  69. Nurse, J., Woodcock, P., & Ormsby, J. (2003). Influence of environmental factors on mental health within prisons: Focus group study. British Medical Journal, 327, 480.PubMedCrossRefGoogle Scholar
  70. O’Donnell, M.P. (1989). Definition of health promotion: Part III: Expanding the definition. American Journal of Health Promotion, 3, 5.PubMedGoogle Scholar
  71. Olden, K., & White, S.L. (2005). Health-related disparities: Influence of environmental factors. The Medical Clinics of North America, 89, 721–738.PubMedCrossRefGoogle Scholar
  72. O’Leary, A., & Martins, P. (2000). Structural factors affecting women’s HIV risk: A life-course example. AIDS, 14, S68–S72.PubMedCrossRefGoogle Scholar
  73. Palmer, T. (1995). Programmatic and nonprogrammatic aspects of successful intervention: New directions for research. Crime & Delinquency, 41, 100–131.CrossRefGoogle Scholar
  74. Parece, M.S., Herrera, G.A., Voigt, R.F., Middlekauff, S.L., & Irwin, K.L. (1999). STD testing policies and practices in U.S. city and county jails. Sexually Transmitted Disease, 26, 431–437.CrossRefGoogle Scholar
  75. Petersilia, J. (2003). When prisoners come home: Parole and prisoner reentry. New York: Oxford University Press.Google Scholar
  76. Pouget, E.R., Deren, S., Fuller, C.M., Blaney, S., McMahon, J.M., Kang, S.Y., Tortu, S., Andia, J.F., Des Jarlais, D.C., & Vlahov, D. (2005). Receptive syringe sharing among injection drug users in Harlem and the Bronx during the New York State Expanded Syringe Access Demonstration Program. Journal of Acquired Immune Deficiency Syndromes, 39, 471–477.PubMedCrossRefGoogle Scholar
  77. Re-Entry Policy Council. (2005). Report of the Re-Entry Policy Council: Charting the safe and successful return of prisoners to the community. New York: Author.Google Scholar
  78. Restum, Z.G. (2005). Public health implications of substandard correctional health care. American Journal of Public Health, 95, 1689–1691.PubMedCrossRefGoogle Scholar
  79. Rhodes, L.A. (2005). Pathological effects of the supermaximum prison. American Journal of Public Health, 95, 1692–1695.PubMedCrossRefGoogle Scholar
  80. Rich, J.D., Holmes, L., Salas, C., Macalino, G., Davis, D., Ryczek, J., & Flanigan, T. (2001). Successful linkage of medical care and community services for HIV-positive offenders being released from prison. Journal of Urban Health, 78, 279–289.PubMedGoogle Scholar
  81. Richie, B., Freudenberg, N., & Page, J. (2001). Reintegrating women leaving jail into urban communities: A description of a model program. Journal of Urban Health, 78, 290–303.PubMedGoogle Scholar
  82. Robillard, A.G., Gallito-Zaparaniuk, P., Arriola, K.J., Kennedy, S., Hammett, T. & Braithwaite, R.L. (2003). Partners and processes in HIV services for inmates and ex-offenders: Facilitating collaboration and service delivery. Evaluation Review, 27, 535–562.PubMedCrossRefGoogle Scholar
  83. Rogers, W., & Seigenthaler, C. (2001). Correctional health care as a vital part of community health. Journal of Ambulatory Care Management, 24, 45–50.PubMedGoogle Scholar
  84. Rose, D., & Clear, T. (2003). Incarceration, reentry, and social capital: Social networks in the balance. In J. Travis & M. Waul (Eds.), Prisoners once removed: The impact of incarceration and reentry on children, families, and communities (pp. 313–342). Washington, DC: Urban Institute Press.Google Scholar
  85. Schady, F.F., Miller, M.A., & Klein, S.J. (2005). Developing practical “tips” for HIV/AIDS service delivery in local jails. Journal of Public Health Management and Practice, 11, 554–558.PubMedGoogle Scholar
  86. Sinclair, C.T., & Porter-Williamson, K. (2004). Health care delivery in the Texas prison system. Journal of the American Medical Association, 292, 2212.PubMedCrossRefGoogle Scholar
  87. Strauss, S., & Falkin, G. (2000). The relationship between the quality of drug user treatment and program completion: Understanding the perceptions of women in a prison-based program. Substance Use & Misuse, 35, 2127–2159.CrossRefGoogle Scholar
  88. Tamasino, V., Swanson, A., Nolan, J., & Shuman, H. (2001). The Key Extended Entry Program (KEEP): A methadone treatment program for opiate-dependent inmates. The Mount Sinai Journal of Medicine, 68(1).Google Scholar
  89. Thompson, P.J., & Harm, N.J. (2000). Parenting from prison: Helping children and mothers. Issues in Comprehensive Pediatric Nursing, 23, 61–81.PubMedCrossRefGoogle Scholar
  90. Tomlinson, D.M., & Schechter, C.B. (2002). Cost-effectiveness analysis of annual screening and intensive treatment for hypertension and diabetes mellitus among prisoners in the United States. In Health status of soon-to-be-released inmates: A report to Congress. Vol. 2. Chicago: National Commission on Correctional Health Care.Google Scholar
  91. Travis, J. (2005). But they all come back: Facing the challenges of prisoner reentry. Washington, DC: Urban Institute Press.Google Scholar
  92. U.S. Department of Justice, National Institute of Corrections. (2004). Proceedings of the large jail network meeting.
  93. White, M.C., Duong, T.M., Cruz, E.S., Rodas, A., McCall, C., Menendez, E., Carmody, E.R., & Tulsky, J.P. (2003). Strategies for effective education in a jail setting: The Tuberculosis Prevention Project. Health Promotion and Practice, 4, 422–429.CrossRefGoogle Scholar
  94. Whitehead, D. (2006). The Health Promoting Prison (HPP) and its imperative for nursing. International Journal of Nursing Studies, 43, 123–131.PubMedCrossRefGoogle Scholar
  95. Wilson, A.B., & Draine, J. (2006). Collaborations between criminal justice and mental health systems for prisoner reentry. Psychiatric Services, 57, 875–878.PubMedCrossRefGoogle Scholar
  96. World Health Organization. (1986). Ottawa Charter for Health Promotion. 1st International Conference on Health Promotion. Ottawa, Canada.Google Scholar
  97. World Health Organization. (2002). Prevention and promotion in mental health. Mental Health: Evidence and Research, Department of Mental Health and Substance Dependence.Google Scholar
  98. World Health Organization. (2004). Code of good practices for NGOs responding to HIV/AIDS.Google Scholar
  99. World Health Organization. (2006). Health in Prisons Project. World Health Organization Regional Office for Europe.
  100. Yen, I., & Syme, S.L. (1999). The social environment and health. Annual Review of Public Health, 20, 287–308.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Megha Ramaswamy
    • 1
  • Nicholas Freudenberg
    • 2
  1. 1.Urban Public Health at Hunter College, CUNYNew YorkUSA
  2. 2.Hunter CollegeCity University of New YorkNew YorkUSA

Personalised recommendations