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“The mood and temper of the public with regard to the treatment of crime and criminals is one of the most unfailing tests of the civilization of any country.”

-Sir Winston Churchill


  • Jails, prisons, and correctional institutions as an integral component of the community represent a public health opportunity.

  • More than 10 million men and women are imprisoned around the globe; most will return to the community.

  • Nurses practicing in penal institutions recognize that in their professional roles, prisoners (and ex-offenders) are viewed and treated as patients.

  • Nurses are faced with challenges unique to their roles, the patient population for whom they provide care, the correctional environments in which they practice, and the laws that govern their administration.

  • In order to provide competent nursing care, it is imperative that nurses understand the healthcare needs that prisoners experience while incarcerated and bring to the community upon their release.


Jails, correctional facilities, and prisons are often thought of as being separate from the community when, in fact, these penal institutions are an integral part of the community. Distinct in their own culture and providing a unique healthcare environment, secure settings nevertheless are reflective of the broader community and cultures from which they receive prisoners. An understanding of the experience of incarceration and its impact on the health of individuals and populations is critical to the assessment and delivery of population-based healthcare, and it is a critical component of successful integration of offenders back into the community. This chapter defines the offender population and explores the factors affecting health and healthcare during incarceration and upon re-entry, providing a framework for the assessment and care of offenders in community settings.

From a public health perspective, the health of the incarcerated population is a direct reflection of the state of health of the community at large. In his remarks to the National Conference of the National Commission on Correctional Health Care (NCCHC) in 2003, Vice Admiral Carmona, the United States Surgeon General, remarked: “Correctional health is a key to public health…tremendously important, not just to the individuals [served], but to the health of the families and communities they come from and to which they will return” (Carmona, 2003, para. 10-12). Increasingly, secure penal institutions are identified as a public health opportunity (Correctional Service Canada, 2003; Herbert, Plugge, Foster, & Doll, 2012; Williams, 2007).


Nurses practicing at the interface of the health and criminal justice systems, regardless of where they are located in the world, are faced with daily challenges unique to their roles, the individuals for whom they provide care, the secure environments in which they practice (including prisons, jails, correctional facilities, and a variety of community-based environments), and the laws ...

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