Dramatic increases in U.S. incarceration rates have led to large concentrations of formerly imprisoned people living in poverty-plagued urban areas. It is therefore important to urban communities -- and to service providers and policymakers concerned about them -- to identify ways of helping inmates who exhibit multiple, serious problems and who are at great risk of experiencing poor postrelease outcomes.

One such strategy, Health Link, recruited adult women and adolescent men during their incarceration in a New York City jail and offered case management services during the particularly challenging first year after release. Over a three-year period, about 1,400 participants were randomly assigned either to a group that was eligible for intensive discharge planning services and community-based case management services or to a group eligible for less-intensive discharge planning and no community-based services. The authors investigated whether the availability of such services reduced rates of HIV risk, drug use, and rearrest.

During a one-year follow-up period after participants' release from jail, interview data and hair analysis showed increased participation in drug treatment programs and weak evidence for reduced drug use. However, reductions in rearrest rates or in activities with high HIV risk were not observed.

The authors concluded that "a well-executed case management program can make modest differences in a few short-term outcomes of former inmates. However, the intervention did not lead to the hoped-for changes across a range of outcomes that would clearly indicate greater success in community reintegration or improved health."

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