Diversity of Release Patterns for Jail Detainees: Implications for Public Health Interventions

摘要

Objectives. We sought to develop a detailed description of the variety of jail release patterns and to learn what factors affect the length of stay (LOS). Methods. The main data set for the study came from a biennial Bureau of Justice Statistics survey on felony defendants in large urban counties. Results. The median LOS for the felony defendants was 7 days. One quarter of the jails had a median LOS of less than 2 days; median LOS for 75% of the jails was less than 15 days. Median regression showed that male gender, previous arrests, and violent charges were predictive of longer LOS. Conclusions. The diversity in release patterns among jails has not been previously described. A public health intervention feasible in one jail may not be feasible in another because of the heterogeneity of release patterns. Individual inmate characteristics could predict a slower rate of release. Currently, the fact that 50% of jail inmates leave jail by 48 hours is so ingrained in the correctional health literature that it has been stated without citation. 1 Original sources of this data included a survey by the Centers for Disease Control (CDC) of large jails in a study of sexually transmitted diseases (STDs) screening practices 2 and a 1992 United States Bureau of Justice Statistics (BJS) study of felony defendants. 3 Although the median length of stay (LOS) may be 2 days, more precise information on both the median and the range of discharge patterns could assist those planning many potential public health interventions in the jail setting. Jails receive persons with compromised health because certain illegal behaviors have adverse health consequences. The prototype behavior in this category is abuse of illicit drugs. Both jails (facilities taking in persons short term) and prisons (institutions housing convicted felons long term) are environments holding a high concentration of persons with a history of drug use, and consequently, with human immunodeficiency virus (HIV) and STDs, or at risk for HIV and STDs. Approximately 80% of inmates have a history of use or abuse of mind-altering substances, 4 , 5 and 1 in 6 persons with HIV in the United States is incarcerated at some point during a calendar year. 6 Intervening in a jail represents a public health opportunity. A number of public health interventions, from improving the continuity in care for HIV-positive prisoners transitioning to the community, 7 to lowering the drug and sexual risk behavior among persons leaving prisons, 8 – 11 were successful in the slow-moving prison setting. Among persons who spent time in a correctional setting over a 1-year period, 85% were solely in jails. 6 Fewer studies have been published about how to conduct brief interventions, such as in the areas of HIV prevention, STD screening, or assessment of readiness for drug treatment, that would assist those detainees with short stays in jails. Interventions in jail settings must be tailored to the patterns of the specific jail in which they are introduced. How fast jail detainees leave varies between individual jails. We have been unable to locate detailed, published analyses of the diversity of release patterns experienced by detainees from jails that would assist those in public health and addiction services. To describe the variation both over time and geographically in patterns of releasing detainees from jails, we wanted to analyze a longitudinal and nationally representative dataset. Our goal was partially met in examining results of a biennial BJS survey of felony defendants in the 75 largest counties in the United States. We were unable to locate similar individual level data on either nonfelony defendants or defendants in small jails. We sought to describe the range of patterns of releasing felony defendants among these large jails around the country. Also, we explored if certain detainee characteristics were associated with the release patterns in the jail system.