There are 2. 3 million people incarcerated in the United States, a number that dwarfs the prison population of any other country, and one that has grown at a staggering rate since
the Seventies, when there were just over 350,000 inmates. Mass
incarceration is now widely acknowledged as a major problem in
our society—and one that professionals in law enforcement, education, public policy, and government are working to address. In
New York City, where some 10,000 inmates are housed in the city’s
dozen jails on any given day—and 55,000 inmates are admitted
each year—Ross MacDonald ’03, MD ’08, chief of medicine for the
Division of Correctional Health Services, is tackling this issue from
a public health perspective.
On most days, MacDonald drives from his Manhattan home
to his office on Rikers Island, across the East River from LaGuardia
Airport, where nine city jails are grouped in a massive complex.
Tasked with overseeing medical care for inmates in one of the nation’s
biggest municipal jail systems—which provides roughly 800,000
patient appointments per year—MacDonald has a primary goal of
ensuring that detainees receive the care to which the law entitles
them. But on a broader scale, he is part of what he describes as a
complicated, generations-long, multi-disciplinary effort to roll back
mass incarceration—a staggering public health issue in which prisoners and the recently jailed are among the unhealthiest members of
society, dealing with high rates of substance use disorders, mental
illness, and homelessness that are only exacerbated by imprisonment.
“I believe that physicians have a particular role to play in helping
society find alternative ways of dealing with mass incarceration,” says
MacDonald, who notes that contributing to the scientific literature
is part of that role, as is promoting what he calls a human rights
approach to medicine that acknowledges the ethical complexities
Ross MacDonald ’03, MD ’08, promotes a human rights
approach to healthcare in New York City’s jails
‘PHYSICIANS HAVE A PARTICULAR ROLE TO PLAY’: Ross MacDonald ’03, MD ’08, chief of medicine for New York City’s Division of Correctional Health
Services, outside his office in Lower Manhattan; he has another on Rikers Island, home to a massive complex of nine jails.