Running head: Health Care Disparities 1

Ferris State University

Danielle Bular
Health Care Disparities
Health Care Disparities 2
Abstract
This paper discusses health care disparities among ex-convicts. It outlines the barriers
of employment after incarceration. It identifies policies that negatively affect the hiring of
this population and explains programs are in place to help with the process.
Health Care Disparities 3
Healthcare disparities experienced by former inmates can range from unavailability of
food to reduce access of housing. In this paper, I will focus on the disparity of the challenge
of an ex-inmates to find employment. According to Rakis, research has shown that two thirds
of inmates will be in reincarnated within three years of their initial release (Rakis, 2005).
With this being known employers may be less likely to hire a person that has recently been
released from prison.
According to the Bureau of Justice statistics, roughly 38% of state and federal
inmates do not have a high school or general equivalent diploma, a rate more than twice that
is found in the general population(Bureau of Justice statistics, 2000). With the lack of
educational skills they will be less likely to be hired causing this to be one of the many
factors that can influence the rate of employment after release. Another barrier is a lack of
marketable work skills and a poor employment history (Rakis, 2005). These factors
combined with the time of incarceration can lead to a stigma that everyone with a criminal
record has poor work ethic.
Mental health can play a role in ex-prisoners not been able to find a suitable job. It is
estimated that 283,000 persons with mental health are incarcerated in county jails and prisons
(Rakis,2005). During their incarceration, they may not have suitable treatment for their
mental illnesses which will make it harder for them to adjust to life after their release.
Substance abuse can be in another barrier for obtaining employment after on incarceration.
More than 80% of state prisoners report past drug use and more than half indicate that their
offense was committed under the influence of alcohol or drugs (Bureau of Justice Statistics).
Drug addiction can continue after their release, which can cause them to not be able to find
or hold a job.
Health Care Disparities 4
According to healthy people 2020, some examples of social determinants include
availability of resources to meet daily needs, access to educational, economic and job
opportunities, quality of education and job training (Healthypeople2020, 2013). Many ex-
inmates have one or many of these determinants. They may not have access to resources that
provide basic needs. According to Haney, the adaptation to imprisonment is most always
difficult and, at times, creates habits of thinking and acting that can be dysfunctional in
periods of post prison adjustment(Haney, 2001). If a ex-inmate is unable to find a job to
provide basic needs they may become violent and resort to stealing or becoming involved in
illegal behavior to survive (Haney, 2001).
According to Maslow's hierarchy, one must be able satisfy lower levels such as basic
needs before progressing on to meet higher levels of growth needs (Burton, 2007). Higher
growth needs can include self-esteem, love and belonging and self-actualization. If an ex-
inmate does not fulfill the needs of a job to provide food, housing and clean water than they
will not be able to have self-confidence in what they are doing or to pursue education or job
training classes.
Employers have policies in place that makes them unable to hire anybody with a
criminal record can negatively affect ex-inmates. There are programs that can be set in place
to assist with employment assessments and career guidance. This can be an individualized
plan that can promote successful job placement and retention efforts (Rakis, 2005). The
assessment should start while the inmate is still incarcerated and could continue after release
to help prepare the inmate for a job (Rakis, 2005). The individualized plan can incorporate
pre-employment structure that will include skills needed to find and keep a job. These can
include problem-solving skills, oral communication skills, personal qualities and work ethic
Health Care Disparities 5
(Rakis, 2005). Having life skills can help promote an understanding of the life outside of
prison.
Employers can be held back from hiring ex-inmates for many reasons. Some
companies have policies in place that prevent the hiring of anybody with a criminal record.
Some companies are able to hire ex-convict, but it depends on the severity of their crime.
Research shows that 90% of employers were doing more thoroughly background check if a
person has a criminal record. (Holmes, 2011). Employers seem to be more relax when they
were incarcerated for charges related to drug or property (Holmes, 2011). Researchers state
that 70% of employers do a routine background check before hiring, in doing so that ex-
inmates may not have a chance to demonstrate their abilities to be successful at the job
before getting turned down for it (Holmes, 2011).
These are only some of the policies that are in place that can play a role in ex-inmates
finding a job. If they are not able to find a job then they may not be able to provide basic
needs for themselves, which in turn could cause them, to revert back to behaviors that put
them in prison. If a person's basic needs are not being provided it can drive them to any
behavior to survive.
I think some beliefs that might contribute to this healthcare disparity are people
believing that all people who are imprisoned are evil. A person may believe that everyone in
prison is a murderer or likes to harm people. People could assume that inmates are not hard
workers or do not have any sense of responsibility. I do not think that people consider why
somebody is imprisoned; they just believe that every inmate is bad. The person might believe
that one bad decision made by a person means that they could never make any good
decisions. There are many underlying beliefs that can influence a person's view on ex-
Health Care Disparities 6
inmates. People need to recognize that with help and given the opportunity, ex-inmates can
be hard workers. Employers can be examples by hiring ex-inmates; this can influence more
employers to give them a chance to prove themselves. Every person has made mistakes,
some are more obvious then others but I believe everyone deserves a second chance.
Health Care Disparities 7
Resources
Burton (2012) Our hierarchy of needs. Retrieved from
http://www.psychologytoday.com/blog/hide-and-seek/201205/our-hierarchy-needs

Haney (2001) The psychological impact of incarcerations for post prison adjustment.
Retrieved from http://aspe.hhs.gov/hsp/prison2home02/haney.htm
Healthlypeople2020 (2013) social determinants of health. Retrieved from
http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=39
Holmes (2011) Majority of employers willing to hire ex-offenders. Retrieved from
http://www.personneltoday.com/majority-of-employers-willing-to-hire-ex-offenders/
Rakis (2005) Improving the employment rates of ex-prisoners under parole. Retrieved from
federal probation journal of correctional volume 69-1.
http://www.uscourts.gov/uscourts/FederalCourts/PPS/Fedprob/2005-06/employment.html