The article by Geronimus et al. appropriately draws attention to disparities in mortality for those living in impoverished regions with even greater disparities documented for Black men who live in urban regions.1 The authors offer their insights into potential factors that may have contributed to these trends. With the US poverty rate exceeding 14%—the highest rate since 1994—the relationship between poverty and mortality cannot be ignored.2 In addition, greater emphasis ought to be placed on addressing the disparities in health care outcomes and mortality rates for those in prisons, particularly for Black men. As the authors mentioned, an alarming 15% of Black men were behind bars in 2000.1 This statistic calls attention to this significant proportion of Black men who could otherwise be among the class of individuals “perform[ing] critical social, economic, reproductive, and caretaking roles,” 1(p728) contributions that could prove to be beneficial to society as a whole.
Research has found that imprisoned Black men carry a high burden of disease, including mental illnesses, chronic diseases, and infectious diseases (e.g., HIV/AIDS, tuberculosis, hepatitis).3 Although there is a move to improve health care quality and accessibility for imprisoned inmates, there is also a compelling need to address health care conditions of ex-prisoners in the communities where they live.4 The continuity of assessment, treatment, and management of health conditions for this population is thus a core public health concern. Approximately 729 295 prisoners were released from federal and state prisons in 2009 alone and even more reentered communities from local jails.5 Many of these prisoners are low-level offenders who will face roadblocks that will make their rehabilitation and reintegration into society exceedingly difficult.6 These penalties last far beyond prison sentences and influence recidivism rates. Challenges in employment acquisition, educational advancement, housing security, and public assistance receipt limit productivity for ex-prisoners once they have returned to their communities.3 These barriers contribute to sustained poor health for ex-prisoners as well as for their families and communities. To improve community health, public health practitioners must make this population a priority, not only by addressing their health needs directly but also by improving societal and political conditions that perpetuate a daunting trend of increased prison populations and disparate negative outcomes in poverty, education, health, and mortality.
Twisted and made useless by a storm surge, oil absorbent booms float along a stretch of oil coated marshland near East Grand Terre Island on June 7, 2010. The booms were part of the effort to clean up the British Petroleum oil spill. Photograph by Benjamin Lowy. Printed with permission of Getty Images.
Acknowledgments
There are no funding disclosures.
