Improving Medical Care for People Affected by Incarceration (IMPACT)

Local jails are a critical but often overlooked part of the American healthcare system, processing approximately 7.3 million admissions annually and housing more than 600,000 individuals on any given day. Despite this scale, healthcare quality in jails remains highly variable, and mortality rates have increased over time, with drug and alcohol-related deaths increasing as much as four times from 2000 to 2019 and suicide rates remaining approximately twice the national average.

Our research project addresses this challenge by scaling a healthcare accreditation intervention designed to improve healthcare quality, coordination, and oversight in local jails. Building on the first randomized controlled trial of healthcare accreditation in U.S. jails, our team partnered with 46 jails nationwide to evaluate accreditation through the National Commission on Correctional Health Care (NCCHC). We found that accreditation improved compliance with healthcare quality standards, particularly in training and patient care, and reduced 12-month mortality by approximately 60 percent. These improvements happened without increases in staffing or capital investments, suggesting that organizational improvements and better coordination drive impact.

The current phase of the project focuses on scaling implementation and expanding access to accreditation across new sites. Our key partner in this effort is the National Sheriffs’ Association, whose network and relationships with jail leaders nationwide offers an important pathway for implementation and long-term sustainability. Through this partnership, we plan to translate evidence into sustainable improvements in correctional healthcare systems nationwide.