Flu Season in Correctional Facilities: Why Everyone Should Care
By Jay Piland, M.D., Founder and President, IMS Correctional Healthcare
As we enter the holiday season, most of us are thinking about family gatherings, travel plans and hopefully getting their annual flu shot. But there’s a population in our state whose healthcare needs often go unseen by the broader public — the thousands of individuals housed in county jails and detention centers across the country.
I’ve been providing healthcare in North Carolina correctional facilities since 1994, and every flu season reminds me why this work matters not just for inmates, but for our entire community.
An Invisible Health Crisis
When flu spreads through a jail or detention center, it doesn’t stay behind the walls of the facility. Inmates are released back to our neighborhoods. Staff members go home to their families every night. And when someone in custody needs hospital care, they’re transported to the same emergency rooms where you and I would be treated.
The congregate nature of jails creates a perfect environment for respiratory illness to spread rapidly. Unlike you or me, an inmate can’t isolate at home when they start feeling symptoms. They live in shared housing units, eat in common areas and have limited ability to practice social distancing. Add the emotional stress of being separated from loved ones during the holidays, and you have a population particularly vulnerable to illness at flu season’s peak.
The Challenge of Prevention
Vaccination is our best tool against flu, but implementing vaccination programs in jails comes with unique challenges. Many people who end up in custody have had inconsistent healthcare access throughout their lives. Others carry deep mistrust of medical systems, often for valid historical reasons.
Getting someone to accept a flu shot when they’ve never trusted doctors requires more than just showing up with needles. It requires conversation, education and relationship-building — a commodity in short supply when the average jail stay might be just a few weeks. But the effort matters. In a congregate setting, one person might be the difference between isolated cases and a full-blown outbreak.
What We Owe
There’s a broader question we need to grapple with: What do we owe people who are incarcerated?
I’ve heard the argument that inmates don’t deserve quality healthcare. But disease doesn’t make moral judgments. More practically, inadequate healthcare in jails creates problems for everyone. Outbreaks strain facility resources, create security challenges, put correctional officers at risk and increase healthcare costs for counties already working with tight budgets.
During my three decades doing this work, I’ve cared for fathers worried about missing their children’s birthdays, young people struggling with addiction and individuals who made mistakes they deeply regret. They’re still people. And in a moment of vulnerability — sick with flu, scared, separated from family during the holidays — they deserve basic human dignity.
Looking Ahead
As we head deeper into flu season, facilities nationwide are navigating these challenges. Some have robust vaccination programs and clear protocols. Others are struggling with limited resources and competing priorities.
The public health lesson from correctional settings applies everywhere: prevention is always cheaper and more effective than response. But prevention requires investment — in vaccines, in staff training, in the kind of relationship-building that makes healthcare effective rather than just available.
It also requires us to remember that those who are incarcerated are still part of our community. Their health is connected to our health. And the choices we make about their care reflect our values as a society.
This flu season, hundreds of thousands of Americans — including thousands of North Carolinians in the state where I live and practice — will cycle through our county jails. Some will be there for a few hours, others for months. All of them will eventually return to our communities — to their families, their jobs, their lives.
The question isn’t whether we can afford to provide them with quality healthcare. The question is whether we can afford not to. Because in the end, their health is our health. Their flu season is our flu season. And the walls that separate them from us are a lot more porous than we’d like to think.
Dr. Jay Piland has practiced correctional medicine in North Carolina since 1994 and serves as Founder and President of IMS Correctional Healthcare.