chapter  1
The need for correctional public health and health promotion
Pages 9

Prisons, jails and other correctional settings are a part of the community. They also serve to focus risk for many diseases, either by concentrating people with elevated risks, or by providing the conditions for exacerbation or transmission of some diseases. And, as part of the community, they return the vast majority of inmates back into the community. Thus, correctional public health and health promotion is arguably of as much, if not more, signi cance than “free world” community health. In correctional settings, people with actual or potentially elevated risks are concentrated and probably easier to screen, treat and educate than those in the community. This introduction is not intended to be an exhaustive review of health in prisons: for that, there are excellent texts available (for example, Grei nger, 2010). Its purpose is to introduce the signi cance of health and disease in prisons and the opportunities it provides for interventions. I have chosen to emphasize data for one US state, Texas, as an example, in addition to wider US data, simply to make the point that even in a single statewide community, there are major issues with prison and jail health and major opportunities to address them. If, as former Speaker of the US House of Representatives Tip O’Neill once said, “All politics is local,” then ultimately all health is local – and personal – too.