Rethinking correctional health

Most people think correctional healthcare, if they think about it at all, focuses solely on the day-to-day medical needs of the men and women serving time in prisons and jails.

But according to Olugbenga Ojo, MD, MBA, FACP, SFHM, CCHP, CCHP-CP, executive director of the Center for Correctional Healthcare Excellence at The University of Texas Medical Branch (UTMB), nothing could be further from the truth.

"Correctional health care is public health care," he said.

According to the Bureau of Justice Statistics, about 95% of incarcerated people are released back into their communities. That means the quality of health care they receive while incarcerated affects not only their own futures but also the health of families, neighborhoods, and communities across Texas.

That philosophy is driving the Center for Correctional Healthcare Excellence (CCHE), one of the newest academic initiatives at UTMB.

From provider to pioneer

UTMB has provided correctional healthcare for decades and today manages the largest prison health system in the United States. But something has been missing, Ojo said.

That missing piece, he explained, was a center that could bring together all major stakeholders, including educators, clinicians, policymakers, and health system leaders from Texas and across the country, under a unified mission to improve health outcomes for one of the nation's most medically vulnerable populations.

"There was really no dedicated academic hub focused exclusively on advancing correctional healthcare through research, innovation, clinical excellence, and policy," Ojo said. "None, to my knowledge, does what UTMB does. That means UTMB is in a class by itself."

Established by UTMB President and Health System CEO Jochen Reiser, MD, PhD, in 2025, CCHE is the first center of its kind in the country designed to elevate correctional healthcare as a recognized academic discipline and to serve as a national leader in innovation, research, education, and clinical excellence in carceral medicine.

"UTMB has been a leader in correctional healthcare for decades," Reiser said. "Now, through the work of the Center for Correctional Healthcare Excellence, we are uniquely positioned to take that care into the future.

"Our goal is to change the discussion around correctional healthcare and to drive home the point that the health concerns of incarcerated people do not stay within prison walls and that the quality of carceral care has direct implications for the families and communities that incarcerated patients go home to."

The timing of the center, as well as the UTMB-hosted symposium on correctional healthcare taking place at The San Luis Resort on Friday, Aug. 7, 2026, is particularly important as correctional healthcare increasingly is recognized as an essential component of public health.

"The vision is to make UTMB No. 1 when it comes to correctional healthcare innovation," Ojo said. "The aspiration is to transform correctional medicine through groundbreaking research, evidence-based clinical care, workforce development, ethical leadership, and policy innovation.

"Moving forward, CCHE will provide that missing academic infrastructure needed to create opportunities for multidisciplinary collaboration while generating evidence. It's going to further improve the care that we provide to this vulnerable population. Ultimately, we envision a future where every incarcerated individual gets evidence-based, patient-centered care that is high-value and high-impact."

Research: Building evidence where little exists

Although correctional healthcare has existed for decades, Ojo said surprisingly little research has been focused specifically on improving how it's delivered. CCHE hopes to change that by creating a multidisciplinary research hub focused on the unique health needs of incarcerated populations and generating evidence that can improve care inside and outside correctional settings.

Research priorities span nearly every major health challenge, including infectious diseases, cardiovascular disease, diabetes, hypertension, mental illness, and healthy aging.

The center also hopes to better understand how social determinants of health influence health outcomes before, during, and after incarceration.

One area of growing concern is the aging prison population.

According to Ojo, people who are incarcerated often experience accelerated aging, with a physiological age that may be 10 to 15 years older than their chronological age.

"So, if you're 55 and you're incarcerated, you're behaving physiologically like a 70-year-old," he said.

There are about 24,000 patients 55 and older incarcerated in Texas. They represent only about 16% of the Texas prison population but account for more than half of hospitalizations, creating opportunities to study aging, chronic disease, and geriatric care in ways that could benefit older adults everywhere.

"One of the goals for this research is to inform policymakers in Austin and Washington, D.C., about effective approaches to improving healthcare," Ojo said. "The evidence we generate has the potential to influence healthcare delivery not only within correctional settings but beyond them as well."

Another goal of the center is to dispel the notion that research cannot be conducted within prison populations.

"That's actually not true," Ojo said. "Yes, this is a vulnerable population. Research must be carefully regulated and monitored so no one is taken advantage of. That's where the center can play an important role."

Innovation: Ideas that reach beyond prison walls

Innovation is another cornerstone of the center's mission, Ojo said, and many of those innovations have applications far beyond correctional medicine.

One of the most significant contributions in correctional medicine developed by UTMB began long before COVID-19 made telemedicine a household term.

"We have been doing telemedicine since the early '90s," Ojo said.

The reason was simple: Transporting incarcerated patients to outside hospitals created security risks. Telemedicine allowed specialists to treat patients remotely, reducing movement while expanding access to care.

"That was the impetus," Ojo said. "If you can deliver guaranteed access to an incarcerated individual without that person having to leave a prison unit, you're impacting public safety."

Today, that innovation benefits not only correctional facilities but also rural communities across Texas, a powerful example of how correctional healthcare strengthens public health.

The success of those early telemedicine efforts reflects a broader philosophy of innovation. During the COVID-19 pandemic, Ojo said, the case fatality rate for COVID-19 in the Texas Department of Criminal Justice was lower than in the general public in Texas.

"Because we're good at what we do," he said.

The center also sees tremendous promise in artificial intelligence to identify patients at higher risk for hospitalization, predict disease progression, improve preventive care, optimize resource allocation, support clinical decision-making, and reduce administrative burdens on physicians and nurses.

"Like in the free world, AI is not going to replace clinicians," Ojo said. "But as long as it's used responsibly it will be a tool that is going to help make life easier for correctional care nurses and physicians."

Education: A classroom unlike any other

Education represents another area where UTMB holds a unique position nationally. Hospital Galveston, located on UTMB's island campus, is the nation's only maximum-security prison hospital located within a major academic medical center. Medical students, residents, fellows, and nursing students rotate through the facility, where they encounter complex illnesses and advanced disease that many physicians might otherwise only read about.

"They get to see this diverse pathology associated with social determinants of health," Ojo said. "For most of these patients, the first time they see a physician, nurse, or other healthcare provider is after they are incarcerated. Their disease is often advanced, creating a learning opportunity for everyone. There are conditions you see here that you've only read about in textbooks."

Beyond clinical knowledge, Ojo believes correctional medicine teaches qualities that benefit physicians throughout their careers, including empathy, compassion, and patient advocacy.

Clinical excellence: Caring for one of medicine's most complex populations

Providing healthcare inside correctional facilities requires the same ethical standards as any other medical setting, Ojo said, while often demanding even greater collaboration among specialists. Patients frequently arrive with multiple chronic illnesses, untreated mental health disorders, trauma histories, and complex social needs that require coordinated care.

"The complexity of correctional medicine often surprises physicians entering the field for the first time," Ojo said. "Caring for these patients requires a high level of clinical judgment and a sophisticated, multidisciplinary health system."

That commitment to clinical excellence extends to advocating for patients when specialized care is needed. Ojo recalls one patient with leukemia whose cancer no longer responded to chemotherapy and who needed a bone marrow transplant unavailable at UTMB. Ojo faced considerable pushback but continued to work tirelessly with colleagues at MD Anderson Cancer Center.

Eventually, the patient received the transplant and recovered. The experience led to more than 100 subsequent patients for bone marrow transplantation at MD Anderson.

For Ojo, the story reflects a simple philosophy: Incarcerated individuals deserve the same evidence-based, patient-centered care as anyone else.

Ethics: The same rights, the same standards

One of the biggest misconceptions about correctional healthcare, Ojo said, is that incarcerated individuals surrender their medical rights along with their freedom. In reality, the same ethical principles that guide healthcare in the community apply behind prison walls.

Patients who are incarcerated have the right to refuse medical treatment, provided they have the capacity to make informed decisions and do not pose a danger to others. They retain medical autonomy, their health information remains confidential, and clinicians are bound by the same obligation to act in their patients' best interests.

"Incarcerated individuals are the only ones who have guaranteed access to healthcare in our country," Ojo said. "According to a 1976 U.S. Supreme Court ruling, deliberate indifference to the serious medical needs of an incarcerated individual is a violation of the individual's Eighth Amendment rights. The cost of care is not a defense for denying access to care."

For physicians, Ojo said, caring for incarcerated patients begins with setting aside assumptions and seeing the person before the circumstances. Empathy and compassion play an important role.

"I always have to remind people that the same ethical principles that apply to community medicine also apply to correctional healthcare delivery," he said. "Never ask them why they are in prison or jail. Ask them why they are in the hospital."

Looking ahead

As CCHE continues to grow, its goals extend well beyond UTMB. Leaders hope to attract research funding, build collaborations with state and federal agencies, influence health policy, and train the next generation of correctional health professionals.

Five or 10 years from now, Ojo said, success will be measured by improved patient outcomes, reduced disparities in care, and an increased ability to attract research funding from state and federal agencies.

"And are we developing future correctional healthcare leaders?" he said. "Are we influencing healthcare policies for this vulnerable population? Have we become the No. 1 resource for correctional healthcare in the United States and beyond?"

As part of developing those future leaders, UTMB is home to the nation's first accredited Carceral Medicine Fellowship, where physicians train in some of the country's most complex correctional healthcare environments.

Ojo also hopes the center will change not only how correctional medicine is practiced but also how it is perceived.

"I'm so excited that we're going to change the discourse," he said.