• Uncategorized

Correctional Healthcare of the US

CorrectionalHealthcare of the US

Therehave been several controversial factors that have led to thediscrepancies in the development of correctional healthcarefacilities in the United States. These facilities are formed in thesocietal margin to help change up citizens who are having hard timeto cooperate in the open (with the rest of the society). This is whyit is referred to as correctional facilities. In this concept, thereis a contemporary emergence of an issue of the spread of contagiousdiseases. This concern is developed or brought up in the squaremarginal thought of consideration of human rights. Herein, theseconcerns are allegedly put in study categorically following theexistence of a variety of such diseases. The state authority is alsolooked into on how it may influence the correctional healthcarefacilities.

Inthe evaluation of these key factors among several others, there isnot an emergence of the publication of these factors into the currentand future leadership ‘scriptures`. It is through this means thatthe key issues that are to be considered in the well-being of thecorrectional healthcare sector are taken care of. Meanwhile, theinmate population is currently growing much higher than expected, andthe issues of the spread of chronic illnesses are profoundly gettingan alarming existence. There should, therefore, never be animatedperception of the current situation based on the past facts. Thispaper discusses correctional healthcare, and looks at tuberculosis asan example of a health care concern in prisons.

Statementof Problem

Thestudy of diseases and their level of contagiousness is one of themost difficult tasks to conduct in the world of healthcare in mostprisons. There are two reasons that support this claim. The first isthat there is a huge mass of inmates whereby an outbreak of a diseasecan spread very fast. Secondly, getting information from the inmatesabout the kind of diseases they might be affected or infected withhas proven to be almost too impossible to carry out or bear no fruitat all. This is because most of these diseases are transmitted by theimmediate lifestyles of such inmates – it forms part of their wayof life. The definition of an inmate’s condition as into thecreation of attention to the moment of caring of the emergence andprevention of a chronic disease is a key factor in the mostcorrection facilities in the US. The most common diseases are:arthritis, cirrhosis, persistent hepatitis, HIV/AIDS, diabetesmellitus, kidney diseases, asthma, heart conditions,arteriosclerosis, prior malignancy, stroke, paralysis, myocardialinfarction, and angina among others. The different natures of each ofthese conditions makes them require unique attentions.

Amongother diseases, Tuberculosis is another chronic disease that hits thecorrectional healthcare facilities even more. It is becoming aglobal threat to human health (Nijhawanet al., 2016). According tothe CDC Report of 2014, a population of 9,421 individuals testedpositive for Tuberculosis in the US. The majority of them were maleaged from 26 to 40 years. The trend confirmed a gradual reduction inthe number of annual TB cases. Notably, the rate of infections is ona gradual decline (Lambert et al., 2016). For instance, the “Trendsin Tuberculosis Report – 2014” indicates the annual decline at1.5% and 2.2% in 2014 and 2013, respectively. An average of 2.6%decline in the number of TB cases is evident in the EU and ASEANmember countries. However, America poses as a competent nation in TBintervention over African and Latin American countries.

Comparedto other developed, developing, and least developed economies,American remains a competitive society in implementing diseaseintervention plans to counter the threat of TB. Least developed anddeveloping economies indicate a gradual increase in the yearly rateof TB infections (Centres for Disease Control and Prevention, 2014).According to the nation’s multicultural, social, economic, andethical differences, Tuberculosis is becoming a complex disease totackle in the Southern and East Coast states. Since African American,Latin American, and indigenous populations inhabit the regions, theintervention programs often fail to reach the anticipated populationhence, the increment of TB cases in the young adults’ population.

The“TB Surveillance Report of 2014” presents epidemiologicTuberculosis characteristics for the clustered data statisticscollected from American correctional facilities. According to thereview, 45.5% of the sample population acknowledged the prevalence ofinfections amongst prisoners. The indication provides an insight thatthe US is at the risk of suffering increased TB cases in future(Nijhawan et al., 2016). The US towards avoiding such implications,the country, must adapt different medical and non-medicalintervention plan to control and cure the disease (Nijhawan et al.,2016).

Quiteoften, drug-based clinical interventions are ideal strategies toevaluate, analyze, and cure disease epidemics. However, theprevalence of TB infections in correctional facilities challengesclinical professional to contemplate better solutions that wouldattract the multicultural population of inmates in the US (Nijhawanet al., 2016). Hence, the integration of educative workshops wouldserve as a prolific non-medicinal intervention plan. Clinicians wouldsucceed in the control and prevention of Tuberculosis with thedevelopment of new drugs to cure malignant strains of TB in thefacilities.


SLO#1clinical prevention interventions and strategies

Accordingto the article by Healthy People 2020 (2016) the major causes ofdiseases in correctional facilities is the issue of overcrowding. Asa result of overcrowding, sanitation is a major issue makingtransmission of diseases to easy. Tuberculosis is an airborne diseasethat can be transmitted by the simply breathing in contaminated air.The Healthy people 2020 proposes that the most ideal way ofpreventing tuberculosis is through the use of controlledenvironments. However, this technique is opposed by Lambert et al.(2016), who argues that it would not be easier to implement such acost-intensive interventions. As such they propose the simpler andcheaper alternatives like awareness campaigns where the correcthygiene and healthy living is emphasized.

SLO#2The effectiveness of clinical prevention interventions that affectindividual and population-based health outcomes using healthinformation technology and data sources.

Accordingto Dara et al. (2016), there is always a high number of tuberculosiscases reported in prisons in United States. The Study agree thattuberculosis is not the only disease common in prisons. In the jails,‘behind the walls,` there has been a notion of inmates indulging inunhealthy behaviors that create more harm than good to themselves andtheir fellow inmates. Such behaviors include rape, drug and substanceabuse and bullying – a condition that is commonly known as prisonexperience. It has been noted that the United States have ignoredgreatly its criminal acts against inmates whose rights are ignoredand are affected in one way or the other through overcrowding of theprisons. The study reports that the rate of contraction of TB inprisons is about 83 times more than when one is not in prison. Thestudy cites these high rates to the level of vulnerability ofindividuals while they are in prison. The vulnerability is not onlybased on the overcrowding but lack of knowledge about variousdiseases. The study remarks that the in as much as many correctionalsettings have embraced the use of other interventions, the level ofknowledge on TB epidemiology is very low. The authors believe that byteaching the prisoners the various ways through which diseases arecaused and transmitted, they are at a better position to preventthemselves from contracting these diseases.

SLO#3Patient-Centered and culturally responsive strategies in the deliveryof clinical prevention and health promotion interventions and/orservices to individuals, families, communities, andaggregates/clinical populations.

Sincethe individuals are in an enclosed facility, a lot of emphasis is puton them and not on their families. According to Dara et al. (2013),the patient care strategy involves adopting and implementinginternationally recommended stop TB interventions that includeconducting screening of newly admitted inmates as well as newlyrecruited staff. The strategy should also ensure control of airborneinfections by having protective measures for both the inmates and thestaff. Giving early diagnosis to the various types of TB as well asearly admission of antiretroviral therapy for those inmates with HIVsince they usually have active TB. The intervention will also extendoutside prison by providing continued care for all prisoners who arereleased and who are on TB treatment. By so doing, the families andthe general community is protected.

SLO#4 Advance equitable and efficient prevention services, and promoteeffective population-based health policy through the application ofnursing science and other scientific concepts.

Thedisadvantages that might be encountered when making the changes namedherein for the provision of ideal solutions to the experiencedproblem must be looked into from different angles. This is because astime goes, the inmate populations are aging. This call for the factthat there is a need for them to be reiterated in the profoundlydeveloped infrastructure such as access to toilets to easilyaccessible and toilet seats among others. On the other hand, there isa need for the medical department to considered giving considerableattention to the physically challenged inmates (Marks et al., 2014).The most prevalent challenge that faces the management of thecorrectional facilities today is the cost of providing the desiredservices and provision of healthcare services as well. There is alsoa problem of offering special services for the elderly. Thecorrectional healthcare facilities and the prisons themselves thenstand the threat of becoming breeding areas for the chronic andcommunicable diseases as well.

Accordingto Marks et al. (2014), owing to the physical condition of theelderly inmates, they require properly managed care in attachment tothe fundamental healthcare services. There is a detailed explorationof accommodation of inmates with special needs which includesprograms, treatment, and accommodation. An example of theseexplorations can be able to freely elaborate the frequency and degreeof accuracy in solving the problem. The message passed to patientsis more important as the medicines provided to them. This is becauseencouragements during illness have proven success in many patientsthan the opposite. Contemporary census numbers show that individualsolder than 65years constitute the rapidly growing section of thepopulation of United States. By the time 20th century was beingattained, only four percent of the population was above 65 years, inthe US this number had more than tripled at its close. Estimates forthe year 2050 put the number of Americans above sixty-five years attwenty percent of the population (Degner et al., 2016). There is asimilar observation of trend is witnessed as time continues tounfold. Though the correctional facilities are a minor representationof the whole of the United Sates, inmates aged 40 are the majority inthe prisons with increasing numbers now and then. This is right fortwo reasons: more lawbreakers in this age group are being sentencedto prison and, second, mandatory sentences, longer sentences, andmore restrictive release policies mean that more inmates are growingold behind bars.

SLO#5 Integrate clinical prevention and population health concepts inthe development of culturally relevant and linguistically appropriatehealth education, communication strategies, and interventions

Sincethe technique proposed is education or creation of awareness,communication techniques would be a major factor. According toFrieden (2014), there are various key instruments that communicationshould have when conducting health promotion. On order for any healthintervention to work there would is need for innovation to establishthe basis for action. There is need for developing a few number ofhigh priority interventions that have major impact. Communicationshould be simple, there is no need to use highly technical terms whenexplaining certain principles to the prisoners. Another keyinstrument is the timelines of the communication here, it would benecessary to teach theses prisoners the various ways of preventionbefore actually contracting the disease as opposed to aftercontracting the diseases. The information should be accurate andshould lack any sense of doubt.


Thereis the difficulty of determining a constant number of the elderlyinmates in the United States because there is a constant disagreementin the term elderly. It is not quite precise on who should beconsidered an elderly. With consideration of the Bureau of Prisonsthe term elderly is defined as an individual who has attained fiftyyears of age however, different states use ages 50, 55, 60, or even65 as their lower limit to define elderly inmates. Despite theprecision of the definition of the term elderly, there is a constantagreement that the most effective result is felt among the youngerinmates more. This then means that the state will then have toreconsider its definition. The definition considered by the state ismajorly for a group of inmates who are poor and therefore their agefactor is commanded by their situation of thought – emotionalbreakdown. Most of the individuals smoke and drink or have usedtobacco, alcohol, and illicit drugs.

Itis therefore put into consideration that the most way to be able todelimit ages is through the physical ability of an inmate – the ageat which an inmate will need help to carry out certain tasks. On thesame note, these factors determine the level at which the elderlyengage in social activities and other factors that might need theprovision of the prison. This then means that improvement in theprovision of substances such as books among others might be put intothe consideration. It is the responsibility of every correctionalfacility to make sure that inmates are made alert as possible throughthe possible means available. Prisoners can take advantage of themany available adult education courses and self-help curriculums,particularly the one that will enable them to re-enter the world oncethey leave prison successfully. Ohio Reformatory for Women inMarysville is an example of a facility the gives crucial educationalprogramming for the elderly. The facility has close to twelve diverseeducational and recreational programs that focus on problems andissues relevant to those female inmates who are elderly or havespecial needs.

Theabove factors can be achieved support programs and educativesessions, such as “The Aging Process,” that portray messages onthe kind of expectation to have and the manner in which the agingprocess can be absorbed “Topic Talk,” providing advisory for thewomen to live their lives appropriately as they might desire“Helping Others Together (HOT),” Brotherhood kind of programthat helps inmates support fellow inmates to improve their status ofthought among others who are unable to perform ADLs “Heart toHeart,” specifically for women critically ill and “Topics ofPowerful Significance,” which focuses on health issues, drug andsubstance abuse, and co-dependency issues among other areas. Aspecial refreshment program is best for the delimitation of otherspecial needs prisoners, and a garden club brings about encouragementfor women to take part in agricultural activities through innovationand resource utilization. Inmates are also taught on how to managetheir personal health among the large crowd of inmates and made awarethat it is important to pass information as quick as possible beforeit becomes an outbreak. Besides, through such lessons, inmates can beable to identify signs and symptoms of chronic diseases such ascholera, tuberculosis pneumonia among other diseases.


Centersfor Disease Control and Prevention: (2014) Reported tuberculosis inthe United States, 2013. Atlanta,GA: US Department of Health and Human Services, CDC.

Dara,M., Acosta, C. D., Melchers, N. V. V., Al-Darraji, H. A.,Chorgoliani, D., Reyes, H., … &amp Migliori, G. B. (2015).Tuberculosis control in prisons: current situation and researchgaps.&nbspInternationalJournal of Infectious Disease

Dara,M., Chadha, S. S., Melchers, N. V., van den Hombergh, J., Gurbanova,E., Al-Darraji, H., &amp van der Meer, J. B. W. (2013). Time to actto prevent and control tuberculosis among inmates.&nbspInternationalJournal of Tuberculosis and Lung Disease,&nbsp17(1),4-5.

Degner,N. R., Joshua, A., Padilla, R., Vo, H. H., &amp Vilke, G. M. (2016).Comparison of Digital Chest Radiography to Purified ProteinDerivative for Screening of Tuberculosis in Newly Admitted Inmates.Journalof Correctional Health Care,22(4),322-330.

People,H. (2016). 2020 [h ttps://www. healthypeople. gov/].

Lambert,L. A., Armstrong, L. R., Lobato, M. N., Ho, C., France, A. M., &ampHaddad, M. B. (2016). Tuberculosis in Jails and Prisons: UnitedStates, 2002− 2013. AmericanJournal of Public Health,106(12),2231-2237.

Marks,S. M., Flood, J., Seaworth, B., Hirsch-Moverman, Y., Armstrong, L.,Mase, S., … &amp Armitige, L. (2014): Treatment practices,outcomes, and costs of Multidrug-resistant and extensivelydrug-resistant tuberculosis, United States, 2005–2007. EmergInfect Dis,20(5),812-21.

Miramontes,R., Hill, A. N., Woodruff, R. S. Y., Lambert, L. A., Navin, T. R.,Castro, K. G., &amp LoBue, P. A. (2015). Tuberculosis infection inthe United States: prevalence estimates from the national health andnutrition examination survey, 2011-2012. PloSone,10(11),e0140881.