The prison population in the United States is overwhelmingly the most worldwide, and the health care system available for prisoners is a common concern. The prison’s population makes up to one percent of the general US population, and the capacities of the prison facilities are overstretched to accommodate them. There are reports of overcrowding in many state and federal incarceration facilities.
Inmates in these prisons are more vulnerable to diseases than the general US population. Reports have shown that about 40% of offenders serve time with chronic medical conditions. This is a result of correctional facilities often lacking adequate healthcare treatments which manifest in severe healthcare conditions for inmates. Apart from this, the healthcare system in the prisons also fails to cater adequately to mental health illnesses and drug addiction/use of illegal substances.
Reports also concluded that compared to the general population, inmates are more vulnerable to having HIV/AIDS, tuberculosis, and hepatitis C. Cases of sexually transmitted diseases, especially among female inmates, are also higher than in the general population. Moreover, in outbreaks that can be easily gotten (such as COVID 19), prisoners are not prioritized to be given vaccinations. It consequently results in the faster spread of such diseases among the prison population.
Overcrowding is a serious concern to the healthcare of prisoners. The growth in the US prison population over the past decades is disproportionately high and some prisons are operating at 100% capacity or more. However, the budget allocated to the prison system is not enough to cater to its population, and most states are cutting it, resulting in low-quality resources provided to inmates.
The privatization of prison health services has further contributed to the decline of prison health care. Some states hire private organizations to carry out prison services, including health care services. There are reports of poor quality health care services provided in prisons operated privately nationwide. The delay in providing medical care, negligence, and overall poor conditions increases the health risks of inmates.
An example is the Arizona prison health care services run by a private company, Centurion. The organization carries out the medical services in the state including mental health and dental health services.
Although the Arizona Department of Corrections, Rehabilitation & Reentry has the Health Services Technical Manual guiding the medical care process and treatment of inmates, the private organization provides such services with little supervision by the department.
There have been multiple concerns and reports about the inadequacy of the Arizona prisons’ health care system. Over the years, there have been lawsuits against the state regarding the poor healthcare system for prisoners. The situation is linked to the privatization and outsourcing of healthcare services to save costs for the state.
Recently, an Arizona judge terminated a settlement resolving the case initiated in 2014. A trial over the health care system in the state-run prison facilities ensued from it.
The legal representatives of inmates describe the medical system as lacking adequate health personnel and poorly supervised. Inmates were also denied access to medical care, and terminal diseases were managed poorly.
As a resolution, the legal representatives of the inmates suggest that the court should take over the health care operations of the Department of Corrections, Rehabilitation & Reentry. They are persuading the court to appoint an official in charge of the operations to ensure a better health care system for inmates in Arizona.
Similarly, the health care services rendered in detention centers that house immigrants apprehended by the Immigration and Customs Enforcement (ICE) have been criticized by human rights advocates. The ICE detains up to 350,000 immigrants annually across county jails and prisons nationwide.
The conditions of these detention centers may deteriorate the physical and mental health of these detainees that mostly flee from similar conditions in their home country. There are growing concerns about the separation of family units, especially minors from their parents or guardians. The enforcement agency rarely allows contact between split family members, which has caused anxiety, depression, and generally affects their mental wellbeing.
Pregnant detainees also lack access to the prenatal medical care they require and this can cause complications or miscarriages. Similar concerns have been raised by advocates for women detainees who face risks of sexual assault in prisons.
Improving the Health Care in US Prisons
The implications of poor health care in prisons can linger in inmates after their release. It can frustrate efforts to reintegrate them back into society. Ex-prisoners are more susceptible to illnesses and have a higher mortality rate compared to the general United States population. They struggle more with mental health issues, substance abuse, and physical health, making reintegration harder. Former inmates are also less likely to have access to medical care. Financial barriers can restrain them from healthcare insurance, hiring a physician, or purchasing medications they require.
The federal government and states need to provide comprehensive health care services to prisons, including physical health care, mental health care, and reproductive health care. Policies and legislation must also be created and implemented to this effect.
Prison medical services must also include counseling and rehabilitation programs for inmates that need them. Prisoners should be able to conveniently test for sexually transmitted diseases and other infectious diseases, and adequate treatments administered to the infected inmates.
It is also helpful to ease the reentry process of released inmates. The barriers faced by ex-prisoners to access quality medical services must be eliminated to provide more befitting reintegration.