More than 20,000 justice-involved people are released from Indiana state prisons every year, and many leave with chronic health conditions and little access to medical care or health insurance.

Research from the American Public Health Association showed formerly incarcerated people over age 50 live six years less on average than those who have never served time.

Wanda Bertram, communications strategist for the Prison Policy Initiative, said the prison environment takes a mental and physical toll.

“Lack of exercise, outdoor time, the isolation from your loved ones, obviously the trauma that can happen in the prison environment, poor dietary options, and really notoriously terrible healthcare,” Bertram outlined.

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Mental health disorders, including depression and anxiety, can arise during and after incarceration. The study supported abolishing carceral systems altogether. It suggested changing the institutions, policies and practices government uses to define, monitor and punish criminal activity could reduce poor health outcomes. Another report from the National Library of Medicine shows life expectancy for men between the ages of 50 and 75 is reduced by eight years.

Bertram argued more programs are needed to connect people to medical care and services when they are released.

“Making sure people do not face any hurdles in getting enrolled in Medicaid or Medicare,” Bertram urged. “A lot of people who go to prison are uninsured or they are on Medicaid when they go in, even though they are eligible when they get out. Typically, their health insurance has been suspended.”

Nearly 11% of previously incarcerated people were uninsured, compared with almost 5% of people who had never been incarcerated, according to the National Library of Medicine data.