Overwhelming Need, Insufficient Health Care for Justice-involved North Carolinians.

AJ was a 34-year-old African American male who was incarcerated for eight years for drug-related convictions. He suffered from diabetes, hypertension, chronic kidney failure, depression, and substance use disorder. Upon release from prison he was not connected with health services and he was uninsured, which was an additional barrier to accessing medical care. His own perceived need for care was limited as he had significant cognitive deficits with extremely low health literacy. Two years following his release from prison, an aunt concerned about his health brought him to clinic. His clinical course was fraught with complications that would likely have been preventable if he had been connected to care upon release. With treatment, his depression eventually improved and his substance use disorder was under better control. However, he endured multiple amputations from diabetic foot infections, partial vision loss, severe pain from diabetic neuropathy, temporary dialysis for end stage kidney disease, and two months of a feeding tube for severe gastroparesis. AJ's story is not unique, and it highlights the terrible personal costs of inadequately addressing the health needs of people during periods of incarceration and following their release.