School of Medicine and Health Sciences Poster Presentations
Change is Slow, but Apathy is Devastating/Challenging Medical Education in Health Policy & Criminal Justice/Curriculum Development: Incarceration & Health 101
Document Type
Poster
Keywords
Incarceration & Health; Correctional Medicine; Criminal Justice Health; Medical Education in Incarceration; Prison Health Policy
Publication Date
Spring 2017
Abstract
Background
Incarceration rates and health disparities in the U.S. prison population are rising at staggering proportions. As future physicians, it is crucial for medical students to develop a working knowledge of the criminal justice system and the agency of the health care provider working within the backdrop of this system. It is nearly statistically impossible that a current medical student/future physician will not care for a patient affected by a history of incarceration in their lifetime. Combining persons in jail, under parole, and in supervised probation, 1 in every 31 adults, or 3.2% of the U.S. population lives under a form of correctional control. One in three black males can expect to be imprisoned in his lifetime. The number of incarcerated persons in America has more than quadrupled in the past 30 years. Contributing factors to incarceration include a myriad of health-related issues including but not limited to dire rates of mental health illness, substance use disorders, and histories of violence against vulnerable populations. Incarcerated persons are disproportionately vulnerable to contraction of infectious diseases and experience unequal access to quality health care services. This issue cuts across all disciplines - evidence-based medicine is not immune, but rather exceptionally accountable.
The multidisciplinary nature of mapping the criminal justice system as it pertains to health lends itself to utilization of the assets within University communities – where Schools of Medicine, Public Health, Public Policy and Law coexist in natural symbiosis. The objective of this project was to draft a proposed outline of medical school topics that would befit a curriculum to address incarceration and its intersection with medicine, public health, health policy, healthcare delivery and health advocacy.
Methods
The project was divided into a two-part design – theory and practice. First, a compilation of evidence-based research, health policy legislation and community organizations related to criminal justice and health were evaluated. Second, meetings within various University department leaders were scheduled to discuss the feasibility of curriculum implementation as well as to assess service-oriented fieldwork opportunities.
Results
Integrating a two-part design to curriculum adaptation was only partially productive. The use of a conceptual framework to organize evidence-based research and focus on strengthening relationships with local prison health providers in the D.C. community yielded an overwhelmingly positive response. This integrated model of research will serve as a foundation upon which continued support for future endeavors will rest. An online “home” for this information was initiated within the Himmelfarb Library services.
However, implementation of the proposed design was limited by administrative approval and scheduling. Prioritization of pre-clinical curriculum topics that mirror USMLE Step 1 content and an accelerated pre-clinical curriculum restricted the will to integrate this topic into the pre-clinical curriculum hours.
Conclusion
Further research is warranted to evaluate resources vested within the larger University community that would provide support for a multidisciplinary approach to the integration of a criminal justice and health curriculum. In the nation’s Capital of Washington D.C., it is imperative to utilize the abundant resources at our disposal to complement our pre-clinical and clinical education in these formative years with the study of health policy, healthcare delivery, health advocacy and the complex bioethical conundrums ripe within the context of the criminal justice system. Future physicians will undoubtedly face many social, structural, and personal challenges in the care of this vulnerable population. We owe it to our patients to be prepared. Change is slow, but apathy is devastating.
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Open Access
1
Change is Slow, but Apathy is Devastating/Challenging Medical Education in Health Policy & Criminal Justice/Curriculum Development: Incarceration & Health 101
Background
Incarceration rates and health disparities in the U.S. prison population are rising at staggering proportions. As future physicians, it is crucial for medical students to develop a working knowledge of the criminal justice system and the agency of the health care provider working within the backdrop of this system. It is nearly statistically impossible that a current medical student/future physician will not care for a patient affected by a history of incarceration in their lifetime. Combining persons in jail, under parole, and in supervised probation, 1 in every 31 adults, or 3.2% of the U.S. population lives under a form of correctional control. One in three black males can expect to be imprisoned in his lifetime. The number of incarcerated persons in America has more than quadrupled in the past 30 years. Contributing factors to incarceration include a myriad of health-related issues including but not limited to dire rates of mental health illness, substance use disorders, and histories of violence against vulnerable populations. Incarcerated persons are disproportionately vulnerable to contraction of infectious diseases and experience unequal access to quality health care services. This issue cuts across all disciplines - evidence-based medicine is not immune, but rather exceptionally accountable.
The multidisciplinary nature of mapping the criminal justice system as it pertains to health lends itself to utilization of the assets within University communities – where Schools of Medicine, Public Health, Public Policy and Law coexist in natural symbiosis. The objective of this project was to draft a proposed outline of medical school topics that would befit a curriculum to address incarceration and its intersection with medicine, public health, health policy, healthcare delivery and health advocacy.
Methods
The project was divided into a two-part design – theory and practice. First, a compilation of evidence-based research, health policy legislation and community organizations related to criminal justice and health were evaluated. Second, meetings within various University department leaders were scheduled to discuss the feasibility of curriculum implementation as well as to assess service-oriented fieldwork opportunities.
Results
Integrating a two-part design to curriculum adaptation was only partially productive. The use of a conceptual framework to organize evidence-based research and focus on strengthening relationships with local prison health providers in the D.C. community yielded an overwhelmingly positive response. This integrated model of research will serve as a foundation upon which continued support for future endeavors will rest. An online “home” for this information was initiated within the Himmelfarb Library services.
However, implementation of the proposed design was limited by administrative approval and scheduling. Prioritization of pre-clinical curriculum topics that mirror USMLE Step 1 content and an accelerated pre-clinical curriculum restricted the will to integrate this topic into the pre-clinical curriculum hours.
Conclusion
Further research is warranted to evaluate resources vested within the larger University community that would provide support for a multidisciplinary approach to the integration of a criminal justice and health curriculum. In the nation’s Capital of Washington D.C., it is imperative to utilize the abundant resources at our disposal to complement our pre-clinical and clinical education in these formative years with the study of health policy, healthcare delivery, health advocacy and the complex bioethical conundrums ripe within the context of the criminal justice system. Future physicians will undoubtedly face many social, structural, and personal challenges in the care of this vulnerable population. We owe it to our patients to be prepared. Change is slow, but apathy is devastating.
Comments
Poster to be presented at GW Annual Research Days 2017.