Urgent Need to Address the Health Harms of Incarceration, Health Strategy Group Reports

April 11, 2022

The Aspen Health Strategy Group lays out a strategy to reduce the toll that incarceration takes on the health of individuals, families and communities

Contact: Jon Purves
Senior Media Relations Manager
The Aspen Institute

Washington, DC, April 11, 2022 – A new report released by the Aspen Health Strategy Group (AHSG), an Aspen Institute initiative, calls for prompt action to improve the health status of people in prisons and jails, who are disproportionately people of color. “Reducing the Health Harms of Incarceration” is the result of a year-long study involving 18 nationally recognized leaders and experts across sectors, with input from the general public. The group is co-chaired by Kathleen Sebelius, former US Secretary of Health and Human Services and former Governor of Kansas, and William Frist, former US Senator from Tennessee and former Senate majority leader.

The report can be read online here and a list of AHSG participants is available below.

“Despite having the highest incarceration rate in the world, the United States pays little attention to the health of the millions of people directly touched by the criminal justice system. People enter jail and prison with significant unmet health needs, often experience harm and deteriorating health while incarcerated, and face elevated mortality and morbidity rates when they return to the community,” the group states in the summary report. “The poor health of this population harms their families and communities and saps the strength of the nation as a whole.”

The report advances “5 Big Ideas” to address those harms, accompanied by four expert background papers that informed the group’s decisions. Among its key recommendations, the AHSG report urges that the nation:

  • Eliminate the Medicaid exclusion, which denies Medicaid coverage to people in jails and prisons
  • Make health a priority in correctional systems
  • Bring population health and quality standards to carceral health
  • Coordinate care inside and outside carceral settings
  • Dramatically reduce the level and consequence of incarceration

More than 10 million people are incarcerated every year in the United States and an astonishing 45 percent of Americans have a family member who has been jailed or imprisoned. Yet carceral health is invariably secondary to security concerns and lacks the standards, reporting mechanisms, and quality improvement systems that have become the norm elsewhere in the health sector. Incarceration itself is a counterproductive response to the needs of individuals with mental health or substance use disorders and is undeniably an ingredient of the structural racism that characterizes the entire criminal justice system.

“You are not treated as a human being,” said a formerly incarcerated man at the AHSG convening, describing his deteriorating health and the staggering indifference he encountered in the carceral system.

“The issue of health in prison settings has never received the attention it merits,” said AHSG co-chair Kathleen Sebelius. “For far too long, we have allowed it to remain hidden to the American public.”

“The five ideas our group offers can play an important role in reducing the health harms associated with incarceration. It is time to act,” emphasized AHSG co-chair William Frist.

The following members of the Aspen Health Strategy Group participated in this report:



  • Kathleen Sebelius, 21st US Secretary of Health and Human Services (2009-2014); former Governor, State of Kansas (2003-2009)
  • William Frist, former US Senator (TN) (1994-2006); former US Senate Majority Leader (2003-2007)


  • Marcia Angell, Senior Lecturer on Social Medicine, Harvard Medical School; former Editor-in-Chief, New England Journal of Medicine
  • Richard Baron, President and CEO, American Board of Internal Medicine
  • Richard Besser, President and CEO, Robert Wood Johnson Foundation
  • Gail K. Boudreaux, President and CEO, Anthem, Inc.
  • Dena Bravata, Healthcare Entrepreneur
  • Toby Cosgrove, Executive Advisor and Former President and CEO, Cleveland Clinic
  • Deborah DiSanzo, President, Best Buy Health
  • Victor Dzau, President, National Academy of Medicine
  • Judy Faulkner, Founder and CEO, Epic Systems
  • David Feinberg, Vice President Healthcare, Google
  • Harvey Fineberg, President, Gordon and Betty Moore Foundation
  • Helene Gayle, President and CEO, The Chicago Community Trust
  • Ai-Jen Poo, Co-founder and Executive Director, National Domestic Workers Alliance; Co-founder and Director, Caring Across Generations
  • David J. Skorton, President and CEO, Association of American Medical Colleges
  • Jeff Thompson, Executive Advisor and CEO Emeritus, Gundersen Health System
  • Antonia Villarruel, Dean, University of Pennsylvania School of Nursing

This is the sixth annual AHSG publication, following earlier reports on end-of life-care, the opioid epidemic,  chronic disease, antimicrobial resistance and the U.S. maternal mortality crisis. The report was edited by Alan R. Weil, editor-in-chief of Health Affairs, and will be widely distributed to policymakers in health and related fields. AHSG members also commit to sharing the recommendations within their own institutions, organizations, and networks.

The mission of the Aspen Health Strategy Group is to promote improvements in policy and practice by providing leadership on important and complex health issues. AHSG brings together some two dozen senior leaders representing a mix of influential sectors, including health, business, philanthropy, and technology, and is part of the Health, Medicine & Society Program at the Aspen Institute.

The Health, Medicine & Society Program of the Aspen Institute brings together influential groups of thought leaders, decisionmakers, and the informed public to consider health challenges facing the US in the 21st century and to identify practical solutions for addressing them. The rigorously nonpartisan work spans a range of timely topics—from the opioid epidemic, the role of arts in health, and end-of-life care to health systems financing and innovation, public health communication, and much more. At the heart of most of its activities is a package of research, convenings, and publications that supports policymakers, scholars, advocates, and other stakeholders in their drive towards change.

The Aspen Institute is a global nonprofit organization committed to realizing a free, just, and equitable society.  Founded in 1949, the Institute drives change through dialogue, leadership, and action to help solve the most important challenges facing the United States and the world. Headquartered in Washington, DC, the Institute has a campus in Aspen, Colorado and an international network of partners.


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