An estimated 250 offenders are released from the Suffolk County House of Corrections in Massachusetts each month. Eighty percent are men, many are men of color, and close to none enter the Boston community with health insurance.

Yet, the overall rate of confirmed AIDS cases among inmates is five times the rate found among the general population, according to a report by the Urban Institute. The rate of hepatitis C among inmates is even higher-nine times the rate of the general population. And correctional facilities account for almost 40 percent of the nation's tuberculosis cases.

Ironically, these ex-offenders join a population of young men already in the community who are least likely to seek medical assistance, even while they claim the highest mortality and morbidity rates in the nation, according to the Whittier Street Health Center in Boston, Mass.

"They don't access care and they don't utilize health services, even when they have it," said Whittier Street's President and CEO, Frederica Williams. "Because of this, our clinic must bring awareness on the health disparity among young men of color."

Whittier's new men's evening clinic, which was named after the city's long-time men's health advocate Edward Harris, accommodates the specific health concerns of urban-centered adult males, providing services from primary care, eye care and a dental clinic to more preventive measures, such as prostate cancer screenings, HIV counseling and testing and a diabetes clinic.

Joe Rowell, the clinic's post-prison release Program Coordinator, said sky-high medical bills and overconfidence are what prevent Boston's men of color, including ex-offenders, from paying regular visits to the doctor.

"I hope that the program will be able to reach out to a minimum of 500 men by the end of the year," Williams said. "We are targeting all kinds of male populations, including ex-offenders and victims of AIDS and hepatitis C."

The Edward Harris Men's Health Clinic, which opened its doors to prospective clients on January 15, is largely funded by a $150,000 grant from the state Department of Public Health and a $40,000 grant from Blue Cross Blue Shield of Massachusetts Foundation.

A Work in Progress

Now that the clinic has the funding it needs, Rowell is beginning to focus on recruiting ex-offenders for healthcare and treatment.

He is working with the Suffolk County House of Corrections to gain clearance to the prison. After submitting some final paperwork, he is hoping to make his first trip there early next month to pre-screen inmates for the clinic.

Nicholas Lahage, Suffolk County House of Corrections' Discharge Planner, said he is very much aware of the importance of immediate health care for ex-offenders.

"Coming to prison is a traumatic experience for both the body and the mind, so it is sensible for health care to be available," Lahage said. "It's a lot of stress, and while in prison, [inmates] are locked up in extremely close quarters, which makes them vulnerable to mental and physical illnesses."

Lahage said that he hopes the clinic will also help ex-offenders to become "law-abiding citizens of the community." He hopes they will achieve this goal through the Whittier Post-Prison Release Collaborative, which the health center began last May. The collaborative provides ex-offenders with social services, such as employment and education.

"[The collaborative] never touched upon one of the most obvious and important aspect of their reentry, physical health," Rowell said. "So now, we must put on a strong campaign for them."

The clinic has yet to establish how many ex-offenders can be accommodated, but Rowell hopes to service as many as possible, starting with those released from Suffolk County.

During his visits to the prison, Rowell will pre-screen men who are planning to be released in the next 90 days, regardless of race. The only other criterion is that an ex-offender must meet is "a willingness to come."

"There is no other specification, no other exclusion," Rowell said. "And we will not forget the men who were in prison years ago and never received the healthcare they should have."

The Challenge

As simple as it sounds, the clinic's director, John O'Neal, said finding ex-offenders with a willingness to come could turn out to be difficult.
 
As it is, African American and Hispanic men have higher rates of death and injury than any other race, with a homicide rate that is 15 times higher than it is for white males, O'Neal said. Still, they are less likely to possess or use health insurance than any other racial group of men in Boston.

"If it's difficult for men who have not had the experience of incarceration to come and deal with their health, then it's going to be even more of a difficulty for men who are coming straight from prison," Rowell said.

With an effective outreach program, largely based on referrals, Rowell hopes the clinic will attract an increasing number of ex-offenders.

"It is too important that we focus on them," he said. "We're hoping that they will become more productive in the community."

Ultimately, Rowell said, "We want them to come in when nothing's wrong, just to make sure everything's right."

Looking into the Future

After the $40,000-grant that Whittier Street Health Center received from the Blue Cross Blue Shield of Massachusetts Foundation has run out, the clinic will need to look toward fundraising.

The Department of Public Health has made a commitment to work with Whittier, but Williams said the clinic's operating costs far exceed the Department's contributions.

The center, however, will not quit easily, Williams said.

"We're going to keep looking for fundraising opportunities because these men need to be educated about prevention and wellness and provided with access to care," she said. "If we can just teach them about the importance of being healthy, I'm hoping they'll have a positive impact on the high rates of mortality and morbidity rates."

Resources:

For more information about the Whittier Street Health Center, go to http://www.bu.edu/familymed/patient/whittier.htm