Medical legal partnerships’ role in improving health among people released from incarceration

Of the more than 600,000 people released from US prisons each year, a large proportion—perhaps more than half—have chronic health conditions. The process of returning from incarceration to the community, commonly termed “reentry,” is often characterized by an array of challenges accessing necessities such as food, housing, and employment. For many, these challenges must be navigated while also managing substance use disorders. During this difficult transitional period, access to and use of routine health care can be limited: A consistent literature demonstrates that the reentry population often goes without primary medical care and relies heavily on emergency departments to address non-emergent health conditions.

Further complicating reentry, people returning from prison face a wide range of post-release civil penalties and restrictions known as the “collateral consequences” of conviction. These legal restrictions can affect many aspects of life by, for example, limiting access to social services and benefits; restricting occupational licensure; impeding custody and visitation of children; and limiting one’s right to vote. Beyond these restrictions, recently released persons can face other impediments related to the legal system such as the accumulation of court fees and fines, and they may also be vulnerable to violations of their civil rights (for example, unlawful evictions) yet lack legal representation.

In this post, we explain how collateral consequences of conviction and other legal issues can be viewed as a manifestation of social determinants that can be detrimental to health. We characterize the burden of such legal challenges among a population of released persons with chronic health conditions; describe the structure of Medical Legal Partnerships (MLPs) and their role in addressing these challenges as a key social determinant of health; and advocate for the inclusion of MLPs in reentry services as a means to improve the health of released persons.