摘要：Persons processed into and through jail facilities in the United States may be particularly vulnerable during an influenza pandemic. Among other concerns, public health and corrections officials need to consider flow issues, the high turnover and transitions between jails and the community, and the decentralized organization of jails. In this article, we examine some of the unique challenges jail facilities may face during an influenza pandemic and discuss issues that should be addressed to reduce the spread of illness and lessen the impact of an influenza pandemic on the jail population and their surrounding communities. AT YEAREND 2007, MORE than 7.3 million adults were under correctional supervision in prison, in jail, on probation, or on parole, accounting for about 3.2% of the adult population in the United States. 1 Prisons are confinement facilities run by state or federal correctional authorities and typically house sentenced felons. Jails are confinement facilities usually administered by local law enforcement agencies and typically house persons awaiting trial or sentencing or who have been convicted and sentenced to terms of less than one year. Probation is a nonconfinement sanction involving supervision in the community. Parole is supervision of offenders after release from prison. Of the adults under correctional supervision, thirty percent—or about 2.3 million—were held in prisons or jail facilities throughout the country. About 800 000 of the 2.3 million were held in the more than 3000 jail facilities nationwide. Although jails held fewer inmates than prisons at yearend 2007, over the course of the year jails had more than an estimated 13 million bookings. 2 Persons held in correctional facilities in the United States have higher rates of infectious and chronic diseases, mental illness, substance dependency, and homelessness prior to jail booking, than the general public. 3 During an influenza pandemic, these health and socioeconomic issues would likely make jail inmates particularly vulnerable because of their compromised immune systems and possible diminished capacity to understand the importance of taking medication. In addition, the large number of jail facilities and high turnover of jail inmate populations would likely present challenges for managing the spread of infection into jails from surrounding communities and, equally important, from jails into communities. Such possibilities suggest the need for jail facilities and public health officials to work together during the pandemic influenza planning process. However, the decentralized nature of the jail system in the United States complicates the planning process. In this article, we address characteristics of jails that public health officials need to be aware of when planning for an influenza pandemic. These characteristics include the number and varying size of jail facilities in United States, the high turnover of jail populations, the connection between jail facilities and their surrounding communities, the capacity of jails as it pertains to the ability to handle infected inmates, and the prevalence of and capacity to provide services for physical health, mental health, and substance abuse problems of inmates. We used data and reports collected and compiled by the United States Bureau of Justice Statistics (BJS), a component of the United States Department of Justice that is dedicated to collecting, analyzing, publishing, and disseminating data on crime, criminal offenders, victims of crime, and the operations of justice systems at all levels of government. The BJS data provide the only nationally representative data on jails and jail inmates. Because of the number and variety of jail systems in the nation, this is an important issue, though often overlooked. We focused on those data relevant to pandemic planning, such as population characteristics, turnover, and comorbid medical conditions. In addition, we reviewed 2005–2009 pandemic influenza planning literature posted by the government (available at http://www.pandemicflu.gov ).
