Editor’s note: This post is coauthored by Mary Darby, vice president for health policy at Burness Communications, working on issues related to health care and jails.
In the Narrative Matters essay, “To Improve Public Health And Safety, One Sheriff Looks Beyond The Jail Walls,” published in the March issue of Health Affairs, Michael Ashe, sheriff of Hampden County in Massachusetts, describes the county’s efforts to help break the cycle of reincarceration by ensuring inmates get quality health care in and out of jail. Here, Jeffrey Brenner reflects on efforts to bring jails in Camden, N.J., into a health information exchange.
Camden, N.J., is one of the nation’s poorest cities, with 38.6 percent of the population below the poverty line in 2010, according to Census Data. With profound poverty comes a host of other problems, including high levels of crime, violence, pollution, and illness. People here struggle to maintain decent health, and often it is a losing battle.
One day in 2002, at the family medicine practice in Camden where I worked, I opened an envelope from the Camden County jail. It contained a letter from a patient, “James,” who told me he’d wound up in jail, a result of some bad choices on his part. I knew James and his family quite well. I’d seen his wife for prenatal care when she was pregnant and given his kids their routine well-child checkups. James himself was a poorly controlled asthmatic with seizure disorder, so I had seen him pretty regularly in the clinic.
James’ letter distressed me. He said that his asthma and allergies, already severe, were getting worse. In addition to being sick, he felt overwhelmed, depressed, and afraid. After reading his letter, I called the jail to find out what was happening.
Although the staff people with whom I spoke were very nice, I found it difficult to get the information I needed – and to share the important information I had concerning James’ medical history with the appropriate personnel. After all, James had two potentially serious chronic conditions, and he took several medications. The health care providers in the jail didn’t know James’ medical history and they didn’t know what medications he was taking. They also had no connection to the primary care provider who knew him best: me.
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