A lack of public health resources combined with mass incarceration hinder people’s abilities to get adequate care and adapt to life outside of imprisonment, according to a Tuesday panel of Yale scholars.

Undergraduates, Yale School of Public Health students and other community members tuned in for a discussion titled “Health and Mass Incarceration: The Impact of Imprisonment on Well-being” earlier this week. The event, which discussed public health disparities in prisons as a product of mass incarceration, is the first installation of a two-part series co-hosted by the Black Pre-Health at Yale and STEM and Health Equity Advocates at Yale. Nearly 55 attendees watched as the panelists — Lecturer in the History of Medicine Dr. Miriam Rich, Associate Professor of Medicine Dr. Emily Wang, and Tino Negron,  a Community Health Worker in the Yale Health Justice Lab and employee at the Yale-New Haven Transitions Clinic — covered the history of U.S. incarceration. Specifically, they spoke to the policing of public health concerns for people in prison as well as actionable tasks for students interested in community-minded abolition.

“I think the biggest component is for some people in faculty, on staff in the university to take an interest and want to go in and have this discussion with these young men and these women [in prisons] and provide them with those services,” Negron said. “This is not just a mere conversation because if it’s just a conversation, we’re still going to have a problem … Through research, we have come to find out that people can change. They just need the proper services to help them do so.”

Behind bars, health care is a two-step process, according to Negron, in that people in prison must notify both the correctional officer and the nurse of medical problems. He said that because of this reliance on self-reporting as well as an insufficient number of available healthcare providers, incarcerated people are often misdiagnosed or undiagnosed.  He added that treatment following diagnosis often lacks supervision, resulting in mistreatment. According to Negron, who spent 30 years incarcerated, a lack of awareness regarding mental health issues further complicates a system that requires individuals to seek care for themselves. 

“The whole practice of medicine is different behind bars: it’s a passive system with lots of barriers to entry,” Wang said. She pointed out that post-release, people have a heightened risk of dying in part due to inadequate care experienced in prison.

Rich began the event by briefly discussing the history of mass incarceration in the United States. She explained to the audience that as of 2018, over 2 million people are incarcerated in the U.S. and statistics have revealed racial disparities in the rates of incarceration. 

Wang said that common mental health issues such as anxiety and depression are treated differently behind bars than they are in the general community. 

Forms of imprisonment, such as solitary confinement, as well as poor healthcare and exposure to violence tend to exacerbate mental health problems. 

“The system itself creates trauma and augments it in a way that makes it harder for people to understand how to intervene and help,” Wang said, adding that the “taboo” of such issues exists both behind the bars as well as in our community. 

Negron encouraged students to collaborate with the Transitions Clinic-New Haven at Yale — a medical home for people in the area who have recently been released from prison and have a chronic medical condition.

Wang said that the topic of prison abolition is often a taboo topic within the medical field, but she added that it is important physicians discuss radical systemic change.

STEM and Health Equity Advocates representative and event facilitator Jeremy Otridge ’22 told attendees they could sign onto two ongoing petitions. The petitions — one addressed to Yale’s Program on the History of Science, Medicine and Public Health and the other to the Yale School of Medicine — each demand curricular changes to address systemic racism as it applies to their disciplines.       

Amma Otchere ’23 — a member of SHEA and attendee — said that she advocates for abolition not through the more typical routes of humanities or social science but through her interest in STEM.  

“To me, abolition is about radical reimagining [of] a lot of the structures and institutions we take for granted as necessary, especially in regard to jails and prisons,” Otchere said. “I think as a STEM student, my perspective is oriented towards the empirical, and research is unequivocal in showing that the carceral system as it exists is not working to address the issues that cause crime. As a pre-med student, I feel like it’s important to address the public health issues that incarceration causes, including, as was mentioned in the workshop,  harm to communities and family members of incarcerated people.”

Otchere also said panels that focus on interdisciplinary discussion are especially important amid a nationwide reckoning regarding race in America. 

 Jaida Morgan, co-president alongside Stephen Martinez-Hamilton ’22 of Black Pre-Health at Yale, wrote in an email to the News that she did not know about “the structural hierarchy of medicine in the prison system” prior to Tuesday’s event. 

“It saddened me to hear that incarcerated people must rely on the people in power to notify various officers and health professionals to even be seen for their initial health concerns, especially since some of these concerns could potentially lead to death,” Morgan said. “With the systemic racism so prevalent in our society, this would further negatively impact Black and brown prisoners, since the officers address prisoners’ medical issues on their own time.”

Ann Greene, a Community Research Liaison at the Yale University School of Medicine told the News in an email that she was “pleased” to see students interested in “building knowledge of structural inequality into their training for their work as health professionals.”

Greene said that during the talk, she learned about the relationship between incarceration and “the painstaking work” needed to create “positive health outcomes” for people who have not sought out medical care.  She sees her role as “helping build bridges between all the disciplines that must address social drivers of health,” such as allied health professionals and criminal justice advocates, because without these interdisciplinary teams, “it will be impossible to provide justice-informed care to all.”

A follow-up event took place on Wednesday, Sept. 16, during which attendees and people who were previously incarcerated could speak with one another.