The authors of an article being published in Annals of Internal Medicine (available here) say that physicians are getting a wake-up call about the effects of mass incarceration from an unexpected place: Sesame Street. Currently, more than two million people are incarcerated in the United States – more than any other country in the world. The authors of “Sesame Street Goes to Jail: Physicians Should Follow” argue that while many people need to be in prison for the safety of society, a majority are incarcerated due to behaviors attributable to treatable diseases such as mental illness and addiction. The authors suggest policy changes that would allow doctors to steer eligible defendants into treatment programs rather than correctional facilities, when appropriate. When incarceration is necessary, doctors and correctional medicine should coordinate transfer of patient care upon release so that any gains made during incarceration are not lost. They say that physicians also should be aware of social issues such as education, housing, race, and poverty because they can adversely affect health. These same issues also increase the risk of incarceration.
The authors were inspired to call physicians to action by Sesame Street’s Little Children, Big Challenges: Incarceration initiative. A Muppet named Alex provides support and a voice for young kids, while the online toolkit provides caregivers with a range of materials to help guide children through the challenges associated with the incarceration of a loved one. This is important, say the authors, because incarceration plays a role in health and health disparities for not only the person incarcerated, but also for their families.
Two of the authors, Scott Allen MD and Jody Rich MD, MPH, pictured above, shared their thoughts with us, below.
Scott: What common ground would a couple of doctors writing for an academic medical journal have with Sesame Street? Well, thanks to the groundbreaking work on the impact of incarceration on families and communities done by Lynn Chwatsky and her team at Sesame Workshop, we learned that there’s plenty of common ground.
Dr. Jody Rich and I like to say that we met in prison – which is true – we were both physicians treating patient in the Rhode Island system in the late 1990’s. In prison, the process of seeing patients is often interrupted by the prison routines including an important process called “the count.” The count is the process of literally the counting of the inmates by officers that occurs at multiple times across the day. Anyone working in prison knows when they hear the announcement “Time for the count!” work comes to a stand still. And just as predictably, whenever we’d hear that announcement, Dr. Rich would assume the voice of Sesame Street’s Count von Count. “I count a-one… I count a-two… I count a-three…”
Over the years and through our work with inmate patients and their communities, we grew increasingly concerned about the impact of the widespread use of incarceration in the United States. We co-founded the Center for Prisoner Health and Human Rights at the Miriam Hospital, Brown University in an effort to raise awareness of the impact of incarceration on health. And then one day, our colleague Dora Dumont brought the character of Alex the muppet with an incarcerated father to our attention. Inspired by Sesame Street’s attention, we cited the character of Alex in a paper written for an academic journal, Annals of Internal Medicine arguing for increased attention by physicians to the impact of incarceration on patients and their communities. The good people at Annals loved the paper, and after a few calls to the folks at Sesame Street, we agreed there was great synergy in our efforts. We agreed to collaborate on a short video news release.
Jody and I traveled to New York to Sesame Street, and despite our academic titles and roles as physicians, we were as excited as school kids to meet Alex, our new muppet friend, along with Lynn and the staff behind this terrific outreach effort.
And as a bonus, once we wrapped up the shoot with Alex, out of nowhere appeared the one and only Count to participate in another unrelated shoot.
I looked over at Jody. I knew what was coming.
“It’s time for the Count! I count a-one… I count a-two… I count a-three…”
The Count overheard our conversation. “Ahh! You like to count, too! Let’s count TOGETHER!”
Jody: Dora Dumont came up with the idea and Scott and I immediately jumped on. This work by the Sesame Street team is outstanding and synergistic to our efforts. What is going on in the United States right now with incarceration rates higher than ever before is downright un-American. It is unjust, unfair, wrong and detrimental to the very fabric of our society. Everybody loves Sesame Street and what better way to get our message across.
When the Annals of Internal Medicine agreed to publish our article and mentioned that there could be an accompanying video, we began chanting “We’re going to Sesame Street!”
When we finally went it impressed our friends and families more than anything we’ve done before: instant credibility from our children and their friends.
Scott is accurate in his description of our excitement upon arriving at Sesame Street. We were as excited as school kids getting ice cream.
We were so honored to meet Alex, but also the Count. Over the years, I’ve imitated the Count so many times when explaining the prison “count” to students and visitors. And never in my wildest dreams did I think we would actually get to meet THE Count!