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Article

Health Effects of Incarceration  

Justin Berk, Ann Ding, and Josiah Rich

Since 1976, incarcerated individuals in the United States have an established right to healthcare. This has created a national system charged with addressing the unique challenges of healthcare delivery in jails and prisons. As incarcerated populations are often excluded from large research studies, evidence-based practices must often be extrapolated from community data. There is a wide variation in care delivery across institutions nationwide. Challenges in correctional settings include a “dual loyalty” to patients’ health and facility security and the toxic effects of disciplinary practices including solitary confinement, violence, communicable disease control, an aging population, discharge planning for community reentry, and a high prevalence of substance use disorder and mental health disease. Although incarceration may offer a unique opportunity to address chronic health issues of a difficult-to-reach population, the net health effects in the United States seem to be mostly negative. Mass incarceration in the United States has led to significant health consequences at the individual, family, and community levels and has exacerbated health, socioeconomic, and racial disparities. As most incarcerated individuals return to the community, healthcare delivery during incarceration plays a substantial role in the health of communities at all levels.

Article

Law Enforcement and Public Health  

Isabelle Bartkowiak-Théron

The law enforcement and public health (LEPH) movement is an emerging area of practice and scholarship that aims to consolidate responses and research addressing a range of complex issues relating to areas of crime and deviance that are deeply rooted in public ill-health. Despite recent growth in political, professional, and academic interest, LEPH collaborations are not new. However, LEPH collaborative problem-solving and the associated delivery of support services to the communityremain difficult to implement, sustain, and evaluate. LEPH is a promising platform from which to view systemic change unfold, and its future appears to be increasingly important given the current calls for the abolishment or defunding of the police, with the accompanying recommendation to re-fund public health services. The opportunities for shared practices and language, as well as the debates around disciplinary remits (particularly how these remits necessarily overlap in practice), focus on how vulnerable people can benefit from the articulation or integration of joined support services in health and criminal justice. Collaborative endeavors in LEPH are not only desirable but also necessary to effectively address the significant overlapping issues presented to police and public health agencies. In a context of global public dissatisfaction with the public sector and the entrenchment of inequality and deprivation, LEPH efforts may offer the next best step to address the ways in which communities have been disadvantaged by inflexibly siloed areas of government.

Article

Epidemiological Criminology  

Ali Rowhani-Rahbar and Haylea Hannah

Health and crime are interrelated in numerous ways. Criminal offending can influence health outcomes, while health and well-being can change the likelihood of criminal offending. In addition, tools of the criminal justice system can affect health, while health policy may influence criminal offending. Notably, the tools of the public health and criminal justice system can work synergistically or antagonistically to impact both health and crime outcomes. Epidemiological criminology (EpiCrim) has been viewed as a paradigm linking the methods of public health with those of the criminal justice system and integrating epidemiological theories and practices with their corresponding theories and tools in criminology. The specific contribution of this framework is toward the development of strategies and interventions that address multiple factors underlying health and criminal behavior at different biopsychosocial levels. The overarching premise of this paradigm is that sustained and intentional efforts toward applying the principles of EpiCrim could improve health and well-being and reduce criminal behavior in manners that exceed the contribution of each field separately.

Article

Countering Violent Extremism: A Framework for Comparative Analysis  

Keiran Hardy

Countering violent extremism (CVE) has become a core component of counterterrorism strategies. As a concept and field of research, the CVE label lacks clarity, but it refers to policy and programs designed to prevent violent extremism and radicalization. The major components of CVE include community engagement, interventions for vulnerable youth, efforts to counter online extremism, and attempts to deradicalize terrorist offenders through psychological and religious counseling. Evidence about the effectiveness of these programs remains limited, but empirical research in the field is growing. CVE is commonly understood through a public-health framework that focuses on program targets: communities, at-risk individuals, and convicted offenders. A more thorough comparative approach would also consider governance, definitions of key concepts, aims, actors, targets, activities, and context.