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AJPH First Look, published online ahead of print Apr 16, 2009
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American Journal of Public Health, 10.2105/AJPH.2007.123265


Public Health Then and Now

From Public to Private Care: The Historical Trajectory of Medical Services in a New York City Jail

Noga Shalev 1*

1 New York Presbyterian

* To whom correspondence should be addressed. E-mail: nos9021{at}nyp.org.


   Abstract

Over the past 25 years, incarceration rates in the United States have more than tripled. Providing health care services for this growing number of inmates poses immense medical and public health challenges.

Focusing on the administrative and financial shifts in health care delivery, I examined the history of medical services in one of the nation’s largest correctional facilities, Rikers Island in New York City.

Over time, medical services at Rikers have become increasingly privatized. This trend toward privatization is mirrored nationwide and coincides with the rising prevalence of incarceration.

Key Words: Health Service Delivery, History, Social Science, Urban Health







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