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June 2014
Resources on Women, Incarceration, and Public Health 
Below are resources, books, and articles on standards, norms, and advocacy issues related to women and incarceration.

Health Issues among Incarcerated Women


A Plague of Prisons: the Epidemiology of Mass Incarceration in America


this illustrated guide  covers the profile of women prisoners and why standards are needed.    
provides guidance on the components of a gender-sensitive approach to prison management.

Mothers Behind Bars
profiles state by state policies and practices of confining pregnant & parenting women, and the impact on their families.

Immigrant Women's Rights
Esperanza is the Southern Poverty Law Center's initiative to give women immigrants voice and help protect their rights.

Advocacy Groups

The Center for Prison Health and Human Rights: offers advice and resources for getting medical care for prisoners.

Women's Prison Association: WPA offers free online toolkits for providers and public officials.


The Sentencing Project:

is the leading research and advocacy group dedicated to criminal justice system reform and alternative sentencing. Click here to view their infographic on U.S. Trends in Corrections.
Aid to Inmate Mothers (AIM) is an Alabama nonprofit organization serving a critical role in helping families of women in prison.
Little Children, Big Challenges in partnership with Sesame Street provides much-needed resources for families with young children as they encounter the difficult changes and transitions that come with a parent's incarceration.

Women At Risk advocates for treatment  as an alternative to jail and prison, providing clinical outpatient substance abuse and mental health treatment that helps women overcome self-destructive and abusive behaviors.
ACA News  
The Kaiser Family Foundation produced the  Visualizing Health Policy infographic which takes a look at preventive health services for women, including missed opportunities for preventive counseling on risk factors and sexual health issues.
Updates from the Coalition
Megan Fazekas-King
Our volunteers help to move  forward a lot of our initiatives and activities.

Have you noticed our blog upgrades?
The graphics, social media sharing capabilities, and the addition of widgets to display videos, our latest newsletter were all made possible by the volunteer work of Megan Fazekas-King. Here is what she had to say about her experience. Our involvement with Megan has been rewarding and we appreciate all of her contributions. She currently does freelance work for public health programs and nonprofits. Click here to review her profile and exceptional skills.

Our graduate interns worked with the March of Dimes for the 2014 Advocacy Day activities at the North Carolina Statehouse. Click here to get an insight of their experience.     
The YouQuitTwoQuit program which is coordinated out of the Center for Maternal and Infant Health at UNC, Chapel Hill was featured in an article in the newsobserver.com. The article highlights the successes of the program, calls for it to be disseminated statewide,  and states how funding for this program can show a return on investment, given the impact on reducing the health costs associated with tobacco usage during pregnancy. Click here for the article..  
Women and Incarceration
The United States incarcerates more people than any other country. Since 1972, the number of people incarcerated in prisons and jails increased by 500%, with a total current population of 2.2 million. Women are the fastest growing segment of the prison population. Between the years 2000 and 2009, the number of women in U.S. prisons rose by 21.6%, while the number of men rose by 15.6%. The seven states with the highest incarceration rates are all in the south. Poverty, sexual violence, domestic violence, and substance abuse are only a few of the systemic problems associated with women's involvement in criminal activity. Two thirds of women are incarcerated for nonviolent offenses, and roughly 80% of women in prison are estimated to struggle with addiction. An estimated 85-90% of these women have experienced violence and abuse in their lives prior to coming to prison, such as child abuse, sexual violence, or domestic violence. Upon release these women are typically barred from assistance programs to help with housing and education, and most struggle to find work with a criminal record. About 75% of women who are incarcerated report having a child under the age of 18 at home, with an estimated 200,000 children whose mothers were incarcerated in the US.  The children, family members, and communities these women are removed from all bear the burden of incarceration. 

 Women's Healthcare While Incarcerated
Incarcerated women face restricted access to health care.A 2013 study found that as many as 10% of incarcerated women are pregnant upon intake. Women who are pregnant while incarcerated face particular challenges to care. Although the Supreme Court ruled that refusing to care for a prisoner's serious medical needs was cruel and unusual punishment. However, access to and quality of care varies widely by state, facility, and medical provider, and in 2004 only 54% of incarcerated pregnant women reported receiving any pregnancy care.
Women who give birth while incarcerated are often continuously supervised by a male guard, and many facilities still continue to restrain or shackle women during labor and childbirth to the detriment of the health and safety of both the woman and her baby. The World Health Organization, the United Nations, and the American College of Obstetricians and Gynecologists have all condemned the practice of shackling pregnant women during childbirth, however, many US states continue to allow the practice. Women who are shackled during labor and childbirth face psychological and physical health risks  as shackles around their wrists, ankles, and even belly restrict their ability to move during labor, impede monitoring, delay emergent C-sections, and restrict ability to have skin to skin contact or initiate breastfeeding.


Alternatives to Incarceration 

Alternative sentencing programs offer a different model of  justice and may take different forms. Some examples of alternative sentencing models include community confinement through treatment centers, supervised residential facilities, or probation. Mother and Infant Nurturing Together (MINT) is one model of an alternative sentencing program that has demonstrated marked success, with only 10% of graduates re-offending. Alternative sentencing models of family residential treatment include  more comprehensive substance abuse counseling, which has been found to improve the health of the infant and mother, reduce recidivism rates, and increased employment rates post-treatment.  Rehabilitative programs decrease societal costs, helping to break the costly cycle of recidivism, keep children with their mothers rather than placed into foster care, and decrease stigmatization upon completion, providing women with more opportunity to reintegrate successfully into society.

A new approach to criminal justice is needed, one based on public health and 

prevention: primary prevention, to shrink the system by changing drug laws and stopping mass arrests; secondary prevention, to reduce the harms of imprisonment by building education, job training, and humane treatment into our prisons; and tertiary prevention, restoring life and justice to those needlessly serving long sentences, who pose no threat to public safety and cost us billions annually."

What Can Health Professionals Do?  
A Call to Action!

There is a growing acknowledgement of the need for public health to mobilize to address the root causes of incarceration. The American Public Health Association issued a policy statement condemning the social practice of mass imprisonment, acknowledging the disproportionate negative impact of the system on minority populations, and calling for alternative responses to root causes of criminal activity including poverty, drug addiction, unemployment, homelessness, and illiteracy. Since February, 2013, the Dean of Columbia University's Mailman School of Public Health has hosted a seminar series on public health's opportunity to play a role in the prevention of incarceration. In March of this year, the American Journal of Public Health devoted their journal to focus on incarceration and public health. In Ernest Drucker's editorial, Addressing Mass Incarceration: A Clarion Call for Public Health, he calls on public health professionals to engage new partnerships to enable outreach, health education, and Medicaid enrollment for incarcerated populations, to utilize health information technology systems to improve healthcare for incarcerated people, and to advocate for appropriate alternatives treatment programs. He also proposes utilizing a social epidemiology lens to examine the criminal justice system's response to drug addiction and drug policies, and to advocate for drug law reform. 

 Public health's emphasis on iden
tifying and preventing root causes poises the field well to increase partnerships and advocacy for
 prevention efforts including increasing funding for early childhood education, investing in evidence based juvenile justice interventions
; stopping the school to prison pipeline; advancing alternative treatments programs instead of incarceration; improving healthcare in prisons and jails; promoting innovative programs, such as prison doula and breastfeeding programs; and continuing to develop creative collaborations between those in the field of public health and those already working for criminal justice reform.  Hear from OB/GYN and Medical Anthropologist Dr. Carolyn Sufrin on how she became involved in the state of healthcare in the prison system, and advocating for comprehensive reproductive health for women who are incarcerated.
Incarcerated women and reproductive healthcare: Dr. Caroyln Sufrin at TEDxInnerSunset 
Incarcerated women and reproductive healthcare:
Dr. Caroyln Sufrin at TEDxInnerSunset

Tell Us What YOU Think!  

What are innovative ways that healthcare providers and public health professionals can better support women and families who are court involved or incarcerated? We'd love to share any resources - books, websites, apps, etc - that you find useful!

Read Our Blog! 

This month's newsletter was written by our graduate student intern Hannah Legerton
Click here to read her perspectives on incarceration and public health.  
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