Kang Yena, Barnard Payge, VanAken Gabriella, Pandian Vinciya, Brenner Michael
School of Medicine, University of Michigan-Ann Arbor.
School of Nursing, Johns Hopkins University.
ORL Head Neck Nurs. 2023;41(4):14-22.
Mass incarceration in the United States presents major healthcare challenges, and otorhinolaryngology-related needs within carceral settings are underrecognized. Public health crises, as exemplified by the COVID-19 pandemic which led to over 3,000 deaths among incarcerated individuals, can intensify disparities. Both acute otorhinolaryngology conditions, such as craniomaxillofacial trauma, impending airway compromise, and life-threatening infection, as well as more chronic conditions such as cancer, sinusitis, or ear infections can lead to impaired quality of life, disability, or preventable mortality. Incarcerated individuals experience substantial healthcare disparities, which are driven by intrinsic individual and carceral facility factors such as resource scarcity, structural barriers, limited self-advocacy, and social determinants of health, as well as extrinsic factors related to societal misconceptions, inadequate education of healthcare providers on carceral healthcare, and underdeveloped care systems. To address these issues, a comprehensive approach is needed, incorporating experiential learning, bias reduction, and trust building. Early clinical exposure, enhanced public health education, and community outreach efforts are conducive to cultivating structural competence and relevant skills. Carceral health initiatives can thus raise awareness and enhance the healthcare of incarcerated individuals. Healthcare professionals can expand their roles to advocate for equitable care, prioritize rehabilitation over punishment, and support individuals upon reentry into society. Healthcare professionals in otorhinolaryngology, play a pivotal role in addressing the needs of incarcerated individuals, with nurses, physicians, and allied health stakeholders working together. Education, advocacy, and compassionate care provide the basis for a more equitable and humane carceral healthcare system that upholds the dignity and well-being of all individuals.
美国的大规模监禁带来了重大的医疗挑战，而监禁环境中与耳鼻咽喉科相关的需求未得到充分认识。公共卫生危机，如导致被监禁者死亡超过3000人的新冠疫情，会加剧不平等现象。急性耳鼻咽喉科疾病，如颅颌面创伤、即将出现的气道阻塞和危及生命的感染，以及癌症、鼻窦炎或耳部感染等更慢性的疾病，都可能导致生活质量下降、残疾或可预防的死亡。被监禁者面临着巨大的医疗不平等，这是由内在的个人和监禁设施因素驱动的，如资源稀缺、结构性障碍、自我维权有限以及健康的社会决定因素，还有与社会误解、医疗保健提供者对监禁医疗保健教育不足以及不完善的护理系统相关的外在因素。为了解决这些问题，需要一种综合方法，包括体验式学习、减少偏见和建立信任。早期临床接触、加强公共卫生教育和社区外展努力有助于培养结构能力和相关技能。监禁健康倡议因此可以提高认识并改善被监禁者的医疗保健。医疗保健专业人员可以扩大其作用，倡导公平护理，将康复置于惩罚之上，并在个人重新融入社会时提供支持。耳鼻咽喉科的医疗保健专业人员在满足被监禁者的需求方面发挥着关键作用，护士、医生和相关健康利益相关者共同努力。教育、倡导和富有同情心的护理为建立一个更公平、人道的监禁医疗保健系统奠定了基础，该系统维护所有人的尊严和福祉。
