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Health Implications of Incarceration and Reentry on Returning Citizens: A Qualitative Examination of Black Men's Experiences in a Northeastern City.

ABSTRACT: While a great deal of research captures the lived experiences of Black men as they navigate through the criminal legal system and onto reentry, very little research is grounded in how those processes are directly connected to their health. Although some research argues that mass incarceration is a determinant of poor health, there is a lack of qualitative analyses from the perspective of Black men. Black men face distinct pathways that lead them into the criminal legal system, and these same pathways await them upon reentry. This study aims to examine the health implications associated with incarceration and reentry of Black men. While adopting a phenomenological approach alongside interviews, our findings show both race- and gender-specific outcomes for the men in our sample. For example, health and wellness appears to be a significant theme that governs their (in)ability to matriculate society. Moreover, their contact with the criminal legal system appears to exacerbate health concerns and hindrances toward reentry. Other themes include mental health and the role of masculinity. We conclude with implications on policy and future research.

SUBMITTER: Williams JM

PROVIDER: S-EPMC7412906 | biostudies-literature | 2020 Jul-Aug

REPOSITORIES: biostudies-literature

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Health Implications of Incarceration and Reentry on Returning Citizens: A Qualitative Examination of Black Men's Experiences in a Northeastern City.

Williams Jason M JM Wilson Sean K SK Bergeson Carrie C

American journal of men's health 20200701 4

While a great deal of research captures the lived experiences of Black men as they navigate through the criminal legal system and onto reentry, very little research is grounded in how those processes are directly connected to their health. Although some research argues that mass incarceration is a determinant of poor health, there is a lack of qualitative analyses from the perspective of Black men. Black men face distinct pathways that lead them into the criminal legal system, and these same pat ...[more]

PMID: 32748697

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Project description:BACKGROUND:HIV prevalence in correctional facilities may be 2 to 10 times higher than in the general adult population. Antiretroviral therapy (ART) interruption is frequent after an incarceration. This, in combination with post-release high-risk behaviors, may have detrimental consequences on the epidemic. Although return to care after release from correctional facilities has been described in many North American settings, data from South America seemed scarce. French Guiana is the only French territory located in South America. In 2014, HIV prevalence was estimated at 1.2% among pregnant women and oscillated around 4% in the only correctional facility. METHOD:HIV-infected adults released from the French Guiana correctional facility between 2007 and 2013 were included in a retrospective cohort survey. The first objective was to describe the cascade of care in the 4 years following release. The secondary objectives were to describe contacts with care and to identify factors associated with return to HIV care, 1 year after release. RESULTS:We included 147 people, mostly males (81.6%). The median time before the first ambulatory consultation was 1.8?months. Within 1 year after release, 27.9% came for unscheduled emergency consultations, 22.4% were hospitalized. Within 4 years after release, 40.0-46.5% were in care, 22.4% archieved virological success. Being on ART when incarcerated was associated with HIV care (aIRR: 2.0, CI: 1.2-3.0), whereas being HIV-diagnosed during the last incarceration was associated with poor follow-up (aIRR: 0.3, CI: 0.1-0.9). CONCLUSION:The risk of HIV-follow-up interruption is high, after an incarceration with HIV. ART supply should be sufficient to cover the timespan following release, several months if possible. Those not on ART at the time of incarceration may require special attention, especially those newly HIV-diagnosed while in custody. Comprehensive programs are necessary to support ex-offenders to stay on ART after incarceration.

Project description:IntroductionThe high rate of maternal mortality among Black women in the United States continues to gain attention; yet research has not yet fully illuminated the precursors to these events, most impactful among them being "maternal near misses." A maternal near miss occurs when a woman nearly dies but survives a complication that occurred during pregnancy, childbirth, or within 42 days of termination of pregnancy. Researchers have focused on reviewing patient medical records after sentinel maternal events to help determine major contributors to them; however, qualitative studies with near-miss survivors, especially among Black women, may be a more useful approach.MethodsUsing a qualitative methodology, we conducted semi-structured interviews with 12 Black women to explore how they perceived the care provided to them during their near-miss experiences. Our study also employed a phenomenology framework to understand the lived experience of Black women who had a maternal near miss in the context of a hospital setting.ResultsWe interviewed 12 women between October 2020 and March 2021. All participants had a maternal near miss between the years 2010 and 2020 and were aged between 19 and 41 years when they had their near-miss experience. These women identified communication, patient-provider relationship, skills/competency of staff, provider discrimination, systems issues, and emotional distress as major contributors to their experiences.ConclusionMaternal near misses serve as a precursor to maternal mortality events. By listening to patients and their families recount their perspectives on what leads up to these near misses, we can unearth valuable lessons that can aid in the development of strategies and interventions to decrease the numbers of pregnancy-related deaths; especially among Black women who suffer disproportionately from maternal morbidity and mortality. Based on these findings, we recommend that hospitals and OB-GYN practices consider the unique predispositions of their Black patients; account for their own personal biases, revisit the near-miss experiences of past patients to keep patients central to care and build rapport between patients and hospital birthing support staff; and center discussions about improvements in care around racist structures and systems.

Dataset Information

Health Implications of Incarceration and Reentry on Returning Citizens: A Qualitative Examination of Black Men's Experiences in a Northeastern City.

Publications

Health Implications of Incarceration and Reentry on Returning Citizens: A Qualitative Examination of Black Men's Experiences in a Northeastern City.

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