Background Throughout the 1990's, an average of 25 new rural prisons per year were opened in the US, compared to 16 per year in the 1980's and 4 per year in the 1970's. In Washington State, most State correctional facilities are located in rural communities and at least two were constructed in the last decade. However, the effects of these facilities on local health care systems and on health of communities had not been examined. We hypothesized that rural health care systems in proximity to correctional facilities must adapt to meet the needs of a changing population and experience both positive and negative effects after placement of a correctional facility.
Study Design and Methods We obtained primarily qualitative information through interviews with key informants in two Washington State rural communities with or near correctional facilities. These informants included Chief Executive Officers and Chief Financial Officers of hospitals, health care managers of correctional facilities, local political leaders and community members.
Results Key informants in both communities discussed the scope of offender health care, the relationship between the health care system and local correctional facilities, the financial impact of the correctional facility and cultural effects on their communities.
Conclusion Placement of a correctional facility in these rural communities has had a positive financial impact on the local hospitals. Hospitals and correctional facilities work closely together to provide quality care for offenders. Negative effects of correctional facilities on the health of these rural communities include: increased stress and/or anxiety on the part of correctional officers, a change in social dynamic due to interactions between correctional officers and ex-offenders and their families and a high degree of economic dependence on the correctional facility.