Medical problems of prisoners

In the United States, the Bureau of Justice surveys inmates in state and federal correctional facilities to quantify the incidence and prevalence of medical problems and conditions. These statistics clearly quantify the substantial burden of illness among those incarcerated.[7] It is no secret that prison inmates face health threats behind bars that equal anything they face in the streets. Violent assault, rape, or the outbreak of highly infectious diseases are much more common in correctional facilities than in the general population. Prison conditions can easily fan the spread of disease through overcrowding, poor ventilation, and late or inadequate medical care.

Not surprisingly, communicable diseases among prison inmates, including TB, HIV/AIDS, and hepatitis C, are an international problem. Studies document that prisons are conducive to the spread of TB; it is well known that TB in prisons poses a threat to the general population.[8] For example, globally, the level of TB among those incarcerated is significantly higher than that of the civilian population and may account for up to 25 percent of a country's burden of TB.[9] TB among foreign-born inmates is particularly alarming in the United States. Furthermore, the World Health Organization (WHO) reports that high levels of MDR-TB have been reported from some prisons with up to 24 percent of TB cases being classified as MDR-TB.[9]

Clearly, the unregulated, untreated, or erratic treatment of TB in prisons is a huge issue not only for those incarcerated, but also for the general population.

That being said, in the United States, most state and federal inmates receive some type of medical service (medical exam, blood test, TB test) either at admission or while incarcerated. Perhaps as an acknowledgment of the high prevalence of HIV and AIDS among prisoners, the Bureau of Justice survey data show that almost three-quarters of inmates get tested for HIV at or after admission. In California, for example, within two weeks after incarceration in a state prison, an inmate will receive full dental and physical examinations, which include testing for TB and HIV.[10] Given California's serious financial crisis, however, cuts in prison health care could be expected.

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Inmate health and medial problems vary by nature of disease, age, gender, and ethnicity of the prisoner. In 2004, an estimated 44 percent of state inmates and 39 percent of federal inmates reported a current medical problem other than a cold or virus.

More than one-third of state inmates and nearly a quarter of federal inmates reported having an impairment (learning was the most commonly reported impairment, with many reported to have multiple impairments including speech, hearing, vision, mobility, or mental impairment). Impairments were most commonly reported among inmates who were homeless or who injected drugs in the year before arrest.[7]