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For Immediate Release
Contact: Media Relations, (202) 777-2509

New Manual Provides Guidelines on Prison Health Care

Standards for Health Services in Correctional Institutions, 3rd edition

By APHA Task Force on Correctional Health

Washington, DC, April 16, 2003 - The American Public Health Association has just released the much-anticipated new edition of its standard-setting book on prison health. Standards for Health Services in Correctional Institutions, 3rd edition provides a model for quality prison health care based on fundamental principles in public health and legal guidelines set forth in the U.S. Constitution, international treaties and court rulings.

"This important book contains rigorously prepared community standards, reflecting a health environment to which any community, but particularly a jail or prison community, is entitled," leading health advocate and former APHA President Quentin Young, MD, writes in the preface.

Prisoners disproportionately suffer from substance abuse problems, mental illnesses, chronic diseases and communicable diseases such as HIV/AIDS, hepatitis B, hepatitis C and tuberculosis. Within prisons the rate of hepatitis C ranges from 15 percent to 40 percent, while the rate is 2 percent in the general population. The rate of confirmed AIDS cases in the prison population is four times that of the overall population, according to a Bureau of Justice Statistics report.

This high-risk population requires quality medical attention. Prisons provide an ideal location for the spread of infectious diseases due to the density of individuals confined in the building and the insufficient management of interactions between inmates. Inadequate health care leads to infectious disease outbreaks within prisons. Prisoners with communicable diseases who receive inferior health care not only put other prisoners at risk, but also place the public at risk when they are released into the community.

The manual includes health promotion as a necessary component of prison health care. Although the prison environment rarely supports the rehabilitation of prisoners, the standards' manual emphasizes that quality health care can be provided to prisoners if health care providers view themselves as independent of the prison administration.

The third edition of this manual has an expanded mental disorders section to focus on the high prevalence of mental illness in prisons, where 16 percent of prisoners suffer from psychological problems. Research has shown that the harsh environment within prisons exacerbates psychological disorders. The children and adolescents section of the manual has also been extended to address the special health needs of these age groups.

"(The latest manual is) the most comprehensive and inclusive set of standards for health services in correctional institutions," Young said. "It is an essential reference for anyone working or teaching in any capacity in the field of corrections."

Chapters in the manual include:

  • Organizing Principles of Care
  • Specific Clinical Issues and Services
  • Specific Populations
  • Wellness Promotion and Health Education

Standards for Health Services in Correctional Institutions, 3rd edition was developed by the APHA task force on correctional health. Members are listed below.

Maddy deLone, MS, JD, is chair of the task force and an attorney at the Prisoners' Rights Project of the Legal Aid Society of New York.

Michael D. Cohen, MD, FAAP, is medical director for the New York State Office of Children and Family Services.

Robert Cohen, MD, is currently appointed by the federal courts in Connecticut, New York and Ohio to review and monitor health care services in jails and prisons.

Ward Duel, RS, MPH, is an environmental expert and compliance consultant on the health risks associated with overcrowding and the impact of environmental conditions on inmates in correctional institutions.

Linda Frank, PhD, MSN, ACRN, CS, is assistant professor at the University of Pittsburgh, Graduate School of Public Health, Department of Infectious Disease; director of the Pennsylvania/Mid Atlantic AIDS Education and Training Center; and chair of the Jail and Prison Health Committee of APHA.

Lambert King, MD, PhD, served as a medical director and clinician at the Cermak Health Service at Cook County Jail.

Michael Puisis, DO, was the statewide medical director of the New Mexico prison system for Correctional Medical Service.

Ronald Shansky, MD, MPH, served as medical director of the Illinois Department of Corrections.

Nancy E. Stoller, PhD, is professor of Community Studies at the University of California, Santa Cruz.

Kim Thorburn, MD, FACP, MPH, served as a prison and jail doctor for 17 years.

Corey Weinstein, MD, CCHP, is a founder and coordinator of California Prisons Focus.

The manual reflects APHA's principles recognizing the prisoner's right to quality health care and the impact of prison health on public health.


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