How to Talk with Patients about Incarceration and Health

AMA J Ethics. 2017 Sep 1;19(9):885-893. doi: 10.1001/journalofethics.2017.19.9.ecas2-1709.


The United States has the highest incarceration rate of any nation in the world-more than 700 people per 100,000. For this reason alone, clinicians practicing in the US should be aware of the numerous ways in which incarceration adversely affects the health of individuals, their families, and communities. While we clinicians are taught how to discuss ways that culture, religion, or sexuality can affect health outcomes, we are not instructed on how to talk about incarceration history with patients when it might be affecting their health, as highlighted in the case scenario. Here I present a "structural vulnerability" screen, a theoretical approach that clinics or individuals can take to better understand how structures of power (i.e., mass incarceration) directly and indirectly affect our patients. I also offer practical tips on how to talk to patients about incarceration history and why it matters for good health.

MeSH terms

  • Health Status Disparities*
  • Humans
  • Patients / psychology*
  • Prisoners*
  • Prisons
  • United States