Racial Healthcare Disparities free essay sample

Incarceration Disparities that Create Health Problems Name Course Institution Instructor’s name Date due Abstract Shocking disparities in population wellness and health in the United States of America have led to multidisciplinary study efforts to help build health equity. Identifying disparities, clarifying the etiological bases of disparities as well as adopting solutions to get rid of health disparities are part of the United States national health program. Ethnic and racial disparities have been acknowledged throughout the cancer prevention continuum in cardiovascular diseases, diabetes as well as other diseases. The causes of these ethnic and racial disparities are multifaceted, condition specific as well as assumed to result from combinations of socio-behavioral and biological factors. Ethnic and racial health disparities in the immense imprisoned communities have been barred from studies, yet are of significant fiscal and ethical concerns to prisoners, governing bodies as well as non-imprisoned communities into which the prisoners return. Considerably research on ethnic and racial disparities in this distinctive population may help explain the comparative etiologies of health disparities as well as the solutions for developing health equity throughout the entire American population. This study particularly focuses on African Americans who are disproportionately affected by the penal system. Even though prisoners generally suffer from poor health than similar, non-institutionalized adults, it has also been noted that some of the negative effects arise after inmates are released. This clearly shows that the challenges of reintegration into the society are as significant as the conditions of imprisonment. Imprisonment- health relationship is reviewed at an individual as well as at an aggregate level. Keywords: Health, Incarceration, Racial, Ethnic Disparities, Infectious Disease and Stigma Introduction Incarceration and Racial Health Disparities Overview There has been a speedy expansion of the correctional scheme which has been viewed as one of the important and remarkable trends in modern American society. By the year 2004, there were an estimated six times more ex-inmates and inmates than in the 1970s. According to Uggen, Manza and Thomson (2006), currently there more than 16 million felons as well as ex-felons in America. Although every racial group in the United States is affected, the rapid expansion has unreasonably affected a variety of subgroups of the population particularly African American males. In 2002, an estimated 12 percent of African American males were in correctional facilities across the United States (Harrison Karberg, 2003). The lifetime cumulative peril of incarceration of all African American males is more than 20%. Among black males with no high school diploma, the lifetime peril is 58. 9%. While stunningly high, these projections are five times higher than that of the Caucasians. In light of this fast expansion, some observers have reflected on the impacts of increasing size as well as ethnic composition of the correctional facilities. There is a broad as well as increasing literature on how felony and reprimand impact later life outcomes and chances. Research has constantly shown that incarceration significantly lowers the possibility of getting gainful employment, lowers wages in the case of employment and interrupts marital stability (Thomas, James Elizabeth, 2006). It is quite apparent that the rapid expansion of correctional facilities excessively affects minorities. According to Pager (2003), criminal record is more injurious to the employment prospects of African American than whites. Numerous studies reach comparable conclusions that correctional facility unreasonably impacts on the marriage in African-American communities. Problem Statement According to Roberts (2004), although the African American male population comprises only 13% of the entire United States male population, out of the 2. 6 million Americans who are imprisoned, 43% (one million) are African American males. In other words 90 out of every 1000 males in America will be imprisoned in their lifetimes. If this data is broken down by race, only 4%, that is 44 white males will be incarcerated while 28. 5% (285) African American males will be imprisoned. According to Harrison and Paige (2003), one in every three African American male will be incarcerated during their life. Incarcerated African-American males suffer from health issues worse than other incarcerated individuals. When released, these men meet struggles that other ethnic groups don’t have to face. Since African Americans are imprisoned at rates higher than any other ethnic or racial group, the collateral effects of incarcerations heavily affects them, their families and children. The impact of imprisonment on African American men has stigmatizing collateral effects that restrict their capacity to get medical care, proper housing, financial assistance, employment and even participate in political process. Not only do these difficulties have a direct implication on their socioeconomic and health status of their families, children as well as communities but also aggravate the repercussion of health disparities already apparent in the society and undoubtedly have serious effect on the well-being and health of the criminal, their family and the society at large. Black males who are incarcerated or are ex-inmates suffer from mental illness, substance abuse, chronic and infectious diseases more than any other race. These problems add a financial damage to the family of the ex-inmate as they are in poor health and may not be in a position to seek employment therefore perpetuating a cycle of poverty in the family. Importance of the Proposed Study Although there has been a lot of research that has examined numerous consequences of imprisonment, there has been very little attempt to evaluate the health impacts of incarceration or the likely contribution of imprisonment to racial disparities in health. The existing research on this subject has been limited to the implications of prisons on health outcomes for instance depression, suicide and coping (Maruna 2005). Other studies have considered the association between health and more short-lived contact with the justice structure for example arrests. To the degree that some of the health effects are apparent among these all-encompassing types of criminal behavior as well as functions, there is a justification to examine the relationship between more challenging forms of correctional intervention as well as health. This research evaluated the relationship between correctional system and health by intensively testing the long-term impacts of incarceration on health performance. Further, this study merges other studies on the collateral implications of incarceration with work on ethnic health disparities to evaluate if the correctional system adds to inequalities in health. This study details the empirical and theoretical linkages indicative of a relationship between incarceration and health considering factors such as dramatic life events, exposure to stress as well as the neighborhood health practice. The wellness and health of the American community draw out fiscal and multi-tiered concerns and impact multiple communities including criminals themselves as well as the communities into which they are released. Researching the ethnic and health disparities in incarceration facilities will help serve as a model for expounding the determinants of disparities as well as developing results applicable to health impartiality in non-incarcerated settings. Literature Review Patterns of Incarceration The incarceration system has rapidly grown over the last three decades, haracterized by an increasing flow and stock. Before the mid-1970s, the incarceration rate oscillated in a narrow range of about 100 imprisonments in every 100,000 people. However, in 1973, the incarceration rate began to increase sharply at a rate of 6% every year and had passed the 500 incarcerations in every 100,000 in the first decade (Glaze Bonczar, 2007). According to Uggen et al. (2006), by 2004 more than 2. 4 millio n parolees and prisoners were under correction and an extra four million ex-prisoners were in the American population. Combining the current inmates and ex-inmates figures over six million American citizens have served their time in prison which represents approximately 2. 9% of the entire adult population and 5. 5% of the adult male population as well as 17% of the black male population. For anyone concerned about health, the occurrence of racial mass imprisonment has two significant features. One the incarceration system is in fact crowded in the sense that it is currently large enough to affect the whole demographic group not just a small group of people (Garland, 2009). Additionally, the type of current and ex-inmates has attributes of a status group as opposed to a caste or class, meaning that ex-inmates share a negative record that severely affects their lifetime irrespective of their race or ethnicity. These factors are very important in understanding how imprisonment affects the health of the prisoners and society. They propose that the health risks of imprisonment are essential in the sense that they may be associated to health via an array of different mechanisms. The Health of Inmates Statistics reveals that the current inmates undoubtedly have prominent levels of illness, particularly given their fairly young age. Although estimates vary among different studies, it is quite clear that inmates report higher levels of chronic illness. According to a report by the National Commission on Correctional Health Care (2002), an estimated 18% of prisons have hepatitis C, while 7% suffer from tuberculosis. These rates are generally higher than in the entire United States population. Likewise, approximately 15% of the prisoners have HIV although this percentage is declining just like in the entire American population. Other common health problems include asthma at 8. 5%, hypertension at 18. 3%, and diabetes at 4. 8%. Other reports have disclosed that prisoners have a lower level of obesity. It is also noted that ethnic and racial disparities are lesser in jails and prisons than in the general American population. However, chronic diseases are in general quite common among inmates; approximately 44% have a chronic medical condition of some kind. Inmates also suffer higher levels of mental illness; federal inmates for instance have a higher level of schizophrenia, bipolar disorder and dysthymia. Given the fact that most of the prisoners are from poor backgrounds, the quality of service availed to them before imprisonment was low which is probably reflected on their mortality rate. According to Patterson (2010), the mortality of the African American men is lower than that of those outside the incarceration facilities. He further argues that incarceration facilities play some role in provision of health care, he adds that inmates recommence treatments while in the incarceration facility that may have earlier failed before imprisonment. Moreover at least 70% of the inmates with a medical condition report seeing a health professional while in prison (Smedle, et al. , 2003). Methodology The main objective of this study is to investigate racial incarceration disparities that create health problems. Both qualitative and quantitative research methods will be used as they allow accurate analysis and prediction, quantitative method is more suitable when the issues being investigated are known. The main advantages of using quantitative and qualitative research methods are that findings are statistically reliable and the findings are projectable to the population. While selecting an appropriate methodology for this study, the pros and cons of different methodologies were considered. Data Collection The researcher intends to employ both primary and secondary methods of data collection. Secondary data will be collected from journals, books and other publications on this subject while primary data will majorly be collected through closed questionnaires and interviews. A questionnaire is a self-report form of data collection instrument whereby each respondent fills it out as part of the study. Researchers commonly use questionnaires to measure certain characteristics such as beliefs, values, perceptions attitudes and behavioral intentions of the research participants. The questions, whether verbal or non-verbal, communicate inquiry. A closed ended questionnaire is one in which the participants are offered pre-designed replies such as true or false, yes or no, multiple choice or given a chance to choose from choice of numbers representing attitude or strength of feeling. Closed questionnaires are most likely the most popular data collection tools. Their popularity is as a result of: data analysis of closed questions is simple because questions can be coded fast, the inflow of data is fast and from several people, they are cheaper and are also easy for respondents to fill out and the participants anonymity is assured. Sample Population and Data Analysis The sample population is basically inmates in the American jails and prisons who are over 18 years. The researcher intends to sample a population of 500 inmates across the United States in both federal and state incarceration facilities. The independent variables in the study will include race, gender, educational level, family status and parents. Rigorous analysis will be conducted to ascertain the incarceration-health relationship. Regression data analysis method will be used to determine the correlation between health and incarceration. Demographic data will be presented graphically in pie charts and bar graphs. Descriptive statistics for instance standard deviations and mean will be used try and understand the incarceration and racial health disparities. Proposal Review Research Strengths and Limitations Numerous characteristics of penal settings provide methodological strengths as well as limitations that should be taken into account when designing disparities studies in the penal system. One of the advantages of this research is that the corrections departments use surveys to help meet the daily needs of the prisoners. The record includes work history, health situation, education, addresses as well as the felony committed. These records may offer useful contextual information linked to health disparities, prisoners’ health as well as health etiologies. Health care information includes laboratory tests, process and results are outlined in medical reports in the incarceration facilities. As opposed to the non-imprisoned individuals, the records of prisoners are maintained as single, all-inclusive records stored in a single place. This provides a methodological strength in case finding the occurrences and likely health and wellness disparities. Correctional facilities keep dietary logs of all its inmates which provide another key strength for his study. All the meals provided to the prisoners are documented thus self-reported dietary intake can be dependably supported by the correctional facilities menus as well as canteens report. Inmates exercises are monitored by the correctional facilities staff, hence self-reported physical fitness level can be easily compared to the general population. Lastly follow up studies as well as interventions are viable and practical in a penal system setting. As opposed to non-incarcerated settings, the duration of study of an inmate can be speculated and the location noted Despite the numerous advantages of the questionnaire methodology, it still has certain shortcomings in data collections. To start with, there is little chance for the researcher to check the truthfulness of the answers given by the participants. Another limitation is that pre-coding questions could bias the results towards the researcher as opposed to the participant’s perspective. Pre-coding questions can be frustrating and restricting for the participants and therefore deterring them answering. Other limitations that the researcher faces include resources such as time and money required carrying out the research. Time and money limitations could results to poor research as the required data may not be collected. Other limitations to the use of incarcerated population in this type of study include reading level of inmates, facility restrictions as well as health care variability. These limitations can however, be addressed via thorough studies and understanding of the identified correctional facilities. Security restrictions vary from one correctional facility to the other, thus the researcher must be familiar with the resources and tools such as writing materials and computers that are permitted within the facilities the researcher intends to conduct this study. The ability to accommodate researchers also varies from one institution to the other as some institution may not allow the researcher to conduct interviews. Correctional facilities services such as exercises and dietary provision must be taken into account when considering the usability of lifestyle surveys. Most of these services are limited and may not be relevant to the lives of prisoners, lifestyle surveys tools specific to inmates have not been used or validated. Prisoners’ educational level varies from one facility to the other and in most cases is only assessed at admission. If the prisoners’ reading level is lower that of the intended survey tool, this may pose a serious challenge to the researcher. Although prisoners in all correctional facilities have the right to all-inclusive health care, facilities vary in scope of health services and standard of health care provided to the inmates. Clinical procedures including testing, screening and examination for chronic health conditions and treatment procedures vary among correctional facilities and should be taken into account when examining and extrapolating inmates’ health information. Penal systems provide numerous methodological strengths and limitations that can be overcome in the study design. Studies within penal facilities should be carried out in a manner thoughtful of the challenges prisons staff undergo and more so via partnership and collaboration with correctional facilities department. References Glaze, Lauren E. and Thomas P. Bonczar (2007). Probation and Parole in the United States,2006. Washington, DC: Bureau of Justice Statistics. Harrison, Paige, Jennifer Karberg (2003) ‘‘Prison and Jail Inmates at Midyear 2002. ’’ Bureau of Justice Statistics Bulletin, NCJ 198877. Washington, DC: U. S. Department of Justice. National Commission on Correctional Health Care (2002). The Health Status of Soon-To-Be Released Inmates. Washington, DC: National Commission on Correctional Health Care. Pager, Devah (2003). The Mark of a Criminal Record. American Journal of Sociology, 108: 937–75. Patterson, Evelyn (2010). An Analysis of Mortality in United States’ State Correctional Facilities, 1985–98. Unpublished Manuscript, Department of Sociology, The Pennsylvania State University. Robert, Stephanie (1999) ‘‘Socioeconomic Position and Health: The Independent Contribution of Community Socioeconomic Context,’’ 25 Annual Rev. of Sociology, 489–516. Smedley, Brian D. , Adienne Y. Stith, and Alan R. Nelson (2003). Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington, DC: The National Academies Press. Thomas, James C. and Elizabeth Torrone (2006). Incarceration As Forced Migration: Effects on Selected Community Health Outcomes. American Journal of Public Health, 96: 1762–65. Uggen, Christopher, Jeff Manza, and Melissa Thompson (2006). Citizenship, Democracy, and the Civic Reintegration of Criminal Offenders. The Annals of the American Academy of Political and Social Science, 605: 281–310.