Background
Over 20 million Americans
are currently incarcerated or have been in the past. Most are from medically
underserved populations; one in three African American men and one in six
Latino men born in 2001 are projected to go to prison during their lifetimes. The
amount of funding from the National Institutes of Health (NIH) to understand
and improve the health of criminal justice-involved persons is unknown.
Results
Of more than 250,000 NIH
funded grants, 180 (less than 0.1%) focused on criminal justice health
research. The three most common foci of criminal justice health research grants
were substance use and/or HIV (64%), mental health (11%), and juvenile health
(8%). Two institutes, the National Institute on Drug Abuse and the National
Institute of Mental Health, funded 78% of all grants. In 2012, the NIH invested
$40.9 million in criminal justice health research, or 1.5% of the $2.7 billion
health disparities budget for that year.
Limitations
NIH-supported research that
did not explicitly include current or former prisoners but may have relevance
to criminal justice health was not included.
Conclusions
Federal funding for research
focused on understanding and improving the health of criminal justice-involved
persons is small, even when compared to the NIH’s overall investment in health
disparities research. The NIH is well-positioned to transform the care of
current and former prisoners by investing in this critical yet overlooked
research area.
Table 3
NIH funding for criminal justice health research by Institute
| Institute | Grants Awarded 2008–2012 no. (%) | Training/CDAa Grants no. (%) | Investigator-Initiated Research no. (%) | Other Researche no. (%) | 2012 Funding Awarded $ (%) | ||
|---|---|---|---|---|---|---|---|
| Juniorb | Otherc | Pilotd | R01 | ||||
| NIDAf | 107 (59) | 21 (66) | 4 (100) | 18 (45) | 48 (69) | 16 (47) | 29.44m (72) |
| NIMH | 34 (19) | 5 (16) | 0 | 13 (32) | 11 (16) | 5 (14) | 4.91m (12) |
| NICHD | 8 (5) | 1 (3) | 0 | 5 (12) | 1 (1) | 1 (3) | 1.14m (3) |
| NIAAA | 7 (4) | 0 | 0 | 2 (5) | 5 (7) | 0 | 1.38m (3) |
| NINR | 5 (3) | 2 (6) | 0 | 0 | 2 (3) | 1 (3) | 0.04m (0) |
| NIAID | 4 (2) | 0 | 0 | 0 | 1 (1) | 3 (9) | 1.22m (3) |
| NCI | 3 (2) | 1 (3) | 0 | 1 (3) | 1 (1) | 0 | 0.43m (1) |
| NCHHSTP | 3 (2) | 0 | 0 | 0 | 0 | 3 (9) | 0 |
| NIMHD | 3 (2) | 0 | 0 | 0 | 0 | 3 (9) | 0.99m (2) |
| NCIPC | 2 (1) | 0 | 0 | 0 | 0 | 2 (6) | 1.07m (3) |
| NIA | 2 (1) | 1 (3) | 0 | 1 (3) | 0 | 0 | 0.15m (0) |
| NHLBI | 1 (1) | 1 (3) | 0 | 0 | 0 | 0 | 0.14m (0) |
| CDC | 1 (1) | 0 | 0 | 0 | 1 (1) | 0 | 0 |
| Total | 180 | 32 | 4 | 40 | 70 | 34 | 40.91m |
NIDA, National Institute on Drug Abuse; NIMH, National Institute of Mental Health; NICHD, Eunice Kennedy Shriver National Institute of Child Health and Human Development; NIAAA, National Institute on Alcohol Abuse and Alcoholism; NINR, National Institute of Nursing Research; NIAID, National Institute of Allergy and Infectious Disease; NCI, National Cancer Institute; NCHHSTP, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention; NIMHD, National Institute on Minority Health and Health Disparities; NCIPC, National Center for Injury Prevention and Control; NIA, National Institute on Aging; NHLBI, National Heart, Lung, and Blood Institute; CDC, Centers for Disease Control and Prevention
aCareer Development Award.
bF30, F31, F32, K01, K08, K23, R36, T32
cK02, K05, K24
dR03, R21, R34
eP20, P30, R00, R15, R24, R43, RC1, RC2, RC4, U01, U49, UR6
fIncludes four grants jointly administered with another institute (NIAAA, NIAAA, NIAID, NIMH)
Table 4
Recommendations for immediate action to increase NIH support of criminal justice health research
| Recommendation | Targeted Outcome |
|---|---|
| Call for and fund efforts to identify current and former prisoners in existing national health data sets | Use existing nationally representative data sources, many of which include current and/or former prisoners but do not code incarceration status or history, to better understand the relationships between exposure to incarceration and numerous health factors |
| Include correctional healthcare settings in solicitations for investigator-initiated research across the 28 centers and institutes included in the health disparities research strategic plan | (a) Incentivize the medical research community to consider how incarceration may factor in health disparities in their primary area of research (e.g. disproportionately high rates of cardiovascular disease among African-American prisoners) (b) Generate new partnerships between universities and criminal justice health systems (e.g. jails, prison, local departments of public health, and state departments of correction) focused on improving the care of prisoners in-custody and post-release |
| Include IOM guidelines for the safe and ethical conduct of criminal justice health research in all relevant funding solicitations | Reduce barriers to criminal justice health research by dispelling the misconception among medical researchers that research with current and former prisoners is necessarily high risk, administratively daunting, or ethically challenging |
| Establish training and career development awards to support health researchers interested in the roles that incarceration and criminal justice policy play in health and health disparities | Leverage growing interest in the public health implications of U.S. criminal justice policy to develop a new generation of healthcare leaders working at the intersection of health and criminal justice |
| Highlight existing efforts and innovation in criminal justice health research | Draw attention to the important work healthcare researchers are doing to address policy challenges and improve care in the field of criminal justice health |
Full article at:
By:
1Division of Geriatrics, University of
California, San Francisco
2School of Medicine, University of
California, Davis
3Section of General Internal Medicine, Yale
University School of Medicine
4San Francisco VA Medical Center
Corresponding Author: Cyrus Ahalt, MPP, University of
California, San Francisco, 3333 California Street, Suite 380, Email:moc.liamg@tlahasuryc,
415-547-9152 or ; Email: ude.fscu@smailliw.eirb
Current Mailing Addresses for all authors
Cyrus Ahalt, 294 Carl St, San Francisco, CA 94117
Marielle Bolano, 2625 54th Street, Sacramento, CA 95817
Emily Wang, Internal Medicine, PO Box 208056, 333
Cedar Street, New Haven, CT 06520-8056
Brie Williams, 3333 California Street, Suite 380,
San Francisco, CA 94118
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