The UnSeen,

     The UnCounted,

          The Undiagnosed Network

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ADAM II continues as a critical source of data for estimating trends in drug use in local areas, understanding the relationship between drugs and crime, and describing drug market activity in the adult male arrestee population. Data are collected within 48 hours of the respondent’s arrest in face-to-face interviews in booking facilities during two 14-day periods (two back to back calendar quarters from April 1 to September 30) each year, weighted appropriately to represent the county in which the primary city sits and annualized to reflect the year’s arrests. The program offers a unique advantage over many traditional surveys of drug use through its collection and testing1 of a urine sample from respondents to verify answers about recent drug use.

While the 1 in 100 statistic has seeped into the national consciousness, many Americans remain unaware that a much large number of offenders are not behind bars at all but receive their punishment in the community.

California Prisoners and Parolees, 2008, is a presentation of statistical data about the adult felons, civil narcotic addicts and other populations under the jurisdiction of the California Department of Corrections and Rehabilitation (CDCR). Statistical data on felons in CDCR have been published since 1950 when the first issue of California Prisoners, covering the years 1945 through 1949, was released. Statistical data on civil narcotic addicts have been published since1967 when the first issue of Summary Statistics, Civil Commitment Program for Narcotic Addicts, covering the years 1961 through 1966, was published. Beginning in 1981, the two were combined into one publication. In 2008, CDCR’s publication Historical Trends was incorporated into this publication. Historical Trends described changes to CDCR’s population over a 20 year time period.

Children whose parents have been arrested and incarcerated face unique difficulties.  Many have experienced the trauma of sudden separation from their sole caregiver, and most are vulnerable to feelings of fear, anxiety, anger, sadness, depression and guilt.  They may be moved from caretaker to caretaker. The behavioral consequences can be severe, absent positive intervention—emotional withdrawal, failure in school, delinquency and risk of intergenerational incarceration. Yet these children seem to fall through the cracks. Police do not routinely ask at the time of arrest whether their prisoners have children, nor do sentencing judges or correctional agencies regularly raise this question. Since no agency collects data about these children, “…it is unclear how many are affected, who they are, or where they live.

To our knowledge, only one estimate of the annual costs of HCV in the 1990s has appeared in the literature, $0.6 billion. However, that estimate was not supported by an explanation of the methods. Our estimate, which relies on detailed methods, is nearly 10 times the original estimate. Our estimate of $5.46 billion is on a par with the cost of asthma ($5.8 billion

The Texas Department of Criminal Justice (TDCJ) operates one of the largest correctional systems in the Western world. The challenge of ensuring that TDCJ prisoners continue to receive constitutionally mandated medical care is becoming increasingly difficult as the number of offenders with mental illness and chronic and infectious diseases continues to grow and treatment standards become more sophisticated and expensive.

Prisons in the twenty first century certainly are not proving to be an exception to this because there are various sociopolitical perspectives on incarceration, and, therefore, it has its share of controversy. Nevertheless, regardless of one’s point of view, the health of the nation’s inmates, and the racial composition of prisons, cannot be overlooked or ignored by prison administrators, elected officials, and those who ultimately elect officials and pay the costs, the taxpayer. There is little disputing that the nature and quality of, and extent of access to, health care prior to incarceration have significant effects on health care needs within prisons. The social and economic costs to society cannot be measured easily or overlooked. There is no question that this area of corrections is one of the most important topics facing this country in the early part of this century and millennium.

     Incarceration affects more lives than just those of the inmates, and it seems as if no aspect of society escapes its grasp or influence. There are far reaching consequences for those who are imprisoned, and no correctional outcome is as severe, except for capital punishment. Imprisonment affects taxpayers as well as the lives of the families and the communities in which the inmates lived before imprisonment, and in the case of those fortunate enough to experience freedom, communities to which they return

Many State prison systems cannot report detailed, accurate data on the prevalence of medical problems or mental disorders within their inmate populations. It would appear that State systems have not integrated their inmate databases. Administrative databases that contain information on the demographic profile of the inmate population are not “connected” to databases that contain medical data on diagnosed conditions or medication usage from the pharmacy. Concerns regarding confidentiality of inmates’ health conditions undoubtedly contribute to the lack of linkage between these databases.

Since approximately 50 percent of men who have been incarcerated or have passed through the correctional system consider themselves to be in committed heterosexual relationships and intend to return to their partners upon release from custody, as many as 6.5 million women each year will experience the risk of having a partner who has been incarcerated. Given the disproportionate number of low-income men of color in correctional settings, low-income African-American and Latina women are more likely to have intimate sexual or needle-sharing relationships with recently imprisoned men.

Infectious disease remains an important cause of morbidity and mortality. The number of new cases of many infectious diseases, such as measles and rubella, has decreased greatly as a result of vaccination and other prevention initiatives. However, incidence rates of some communicable diseases, including chlamydia, have increased. In addition, newly recognized infectious agents have emerged and caused substantial public health concern and investment. These include influenza H1N1, SARS, H5N1 avian influenza, and some particularly virulent or drug-resistant bacterial strains, such as Methicillin-Resistant Staphylococcus aureus (MRSA). Influenza and pneumonia remain major causes of death, particularly among persons 65 years of age and over, and HIV/AIDS continues to spread.

http://www.cdc.gov/nchs/index.htm

http://wonder.cdc.gov/

http://www.mortality.org/

Between 2001 and 2004, State prison authorities nationwide reported a total of 12,129 State prisoner deaths to the Deaths in Custody Reporting Program (DCRP). Nearly 9 in

10 of these deaths (89%) were attributed to medical conditions. Fewer than 1 in 10 were the result of suicide (6%) and homicide (2%), while alcohol/drug intoxication and accidental injury accounted for another 1% each. A definitive cause could not be determined for 1% of these deaths.

The major objectives of the Aging Inmate Population Study were:

• To examine the factors that have accelerated the growth in the elderly inmate population;

• To examine the demographics of the elderly inmates;

• To explore avenues taken by other states in addressing the issues of an aging inmate population;

• To analyze the costs of providing care to an aging inmate population;

• To explore possible resources to help the Division in dealing with the aging inmate population;

• To investigate innovative approaches for dealing with health and mental health issues of the aging inmates;

• To recommend possible solutions to the overwhelming expenses of housing and caring for the elderly inmates; and

• To increase Division knowledge regarding the needs of the aging inmate population.

Prison health care is a public health, public safety, and imposes an enormous financial toll on our entire society. Annually over 10 million adult ex-offenders many undiagnosed and untreated to are return to economic and medically distressed communities many undiagnosed and untreated with hypertension, diabetes and communicable diseases - tuberculosis, HIV/AIDS, and hepatitis C.

This report presents the first information from the 2008 National Survey on Drug Use and

Health (NSDUH), an annual survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). The survey is the primary source of information on the use of illicit drugs, alcohol, and tobacco in the civilian, noninstitutionalized population of the United States aged 12 years old or older. The survey interviews approximately 67,500 persons each year. Unless otherwise noted, all comparisons in this report described using terms such as "increased," "decreased," or "more than" are statistically significant at the .05 level.

Rates of inmate-on-inmate sexual victimization among prison inmates were higher among females (4.7%) than males (1.9%), higher among whites (3.0%) or multi-racial (4.4%) than among blacks (1.3%), higher among inmates with a college degree (3.4%) than among inmates who had not completed high school (2.0%), and lower among currently married inmates (1.3%) than among inmates who never married or who were widowed, divorced, or separated (2.2%)

Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2009

The issue of decriminalizing illicit drugs is hotly debated, but is rarely subject to evidence-based analysis. This paper examines the case of Portugal, a nation that decriminalized the use and possession of all illicit drugs on 1 July 2001. Drawing upon independent evaluations and interviews conducted with 13 key stakeholders in 2007 and 2009, it critically analyses the criminal justice and health impacts against trends from neighbouring Spain and Italy. It concludes that contrary to predictions, the Portuguese decriminalization did not lead to major increases in drug use. Indeed, evidence indicates reductions in problematic use, drug-related harms and criminal justice overcrowding. The article discusses these developments in the context of drug law debates and criminological discussions on late modern governance.

The state prison population has grown three times faster than the general adult population since 1990 and at year-end 2005 stood at 167,698. African Americans have the highest incarceration rates of any group (5,125 per 100,000 adults in the population for men and 346 per 100,000 for women, compared to 1,159 and 62, respectively, for all adults), although Latinos now constitute the largest ethnic group in the prison system, at 38 percent of the total.

The prison population is aging, with adults under age 25 representing a steadily declining share while the number of prisoners in older age groups continues to grow. Currently, the share of prisoners age 50 and older is 11 percent, up from 4 percent in 1990, whereas the share of prisoners under age 25 has declined from 20 percent to 14 percent. This trend bears on the health care problem, as the cost of housing, transporting, and caring for elderly inmates is estimated to be two or three times higher than for other inmates