Prison Health Care
Key points
- The provision of health care in prisons has mushroomed into a large, often ignored, global issue of concern.
- The poor conditions in California state prisons have come under intense scrutiny the past few years.
- The spectrum of health problems in correctional facilities is significant.
- While prisoners are secured behind high fences wired with electronic sensors and cameras or brick or stone barriers, locked doors and barred windows, and cells encased in thick concrete, the probability of developing an illness or disease while incarcerated is quite high.
The provision of health care in prisons has mushroomed into a large, often ignored, global issue of concern. While prisoners are secured behind high fences wired with electronic sensors and cameras or brick or stone barriers, locked doors and barred windows, and cells encased in thick concrete, the probability of developing an illness or disease while incarcerated is quite high. Prison overcrowding, a universal problem, is an instant recipe for spread of disease both within the confines of the prison as well as to the outside population. For example, in New York City in 1989, an outbreak of multidrug-resistant tuberculosis (MDR-TB) was later linked to prisons that had given inadequate treatment. Indeed, the public health implications of the provision of inadequate health and medical care in prisons are potentially serious; inmates released back to the community more often than not have communicable diseases such as TB, HIV/AIDS, and hepatitis C that could be spread to the general population.
The spectrum of health problems in correctional facilities is significant. Inmate health and medical conditions range the gamut from minor (colds or viruses) to the significant (HIV/AIDS and TB). In addition to the communicable diseases, the prevalence of mental health and psychiatric diseases and substance abuse is higher among the prison population than the general population. The scope of this chapter is to provide an overview of the state of health among prisoners, to assess the provision of health care to those incarcerated, to examine the policies regulating care of prisoners including the challenges governments face in their ability to provide health and medical care to inmates, and to discuss the pros and cons of having the private sector (privatization) involved in prison health care delivery.
Problems persist in prison health care system
The poor conditions in California state prisons have come under intense scrutiny the past few years. In fact, a federal receiver had to be appointed to make sure that health care for inmates improves to meet even the minimal standards. But, the problems persist.
Teddie Rowe is 48 years old. Doctors have given him just weeks, perhaps days, to live.
"There's times I'm afraid to go to sleep because I don't know if I'm going to wake up," Rowe said.
Rowe's heart is operating at just 14 percent. He has a Comfort Pak in the fridge for when the pain gets to be too much.
Rowe: "And it's got stuff in it to make my dying a little more easier."
Dan Noyes: "Is it to make it easier or to speed it, as well?"
Rowe: "Both."
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Prison activists point to Rowe as a prime example of the lack of health care behind bars.
"Access to care, access to medications in the prison system is very poor," Prison Law Office spokesperson Don Specter said.
Written and revised by
David Cohen, M.D.
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