Healthcare is a huge issue for people in jail and prison.
There are currently 2.4 million people in American prisons. This number has grown by 500 percent in the past 30 years. While the United States has only 5 percent of the world’s population, it holds 25 percent of the world’s total prisoners. In 2012, one in every 108 adults was in prison or in jail, and one in 28 children in the U.S. had a parent behind bars.
Researchers estimate that 70 percent to 90 percent of the approximately 10 million individuals released from U.S. prisons and jails each year are uninsured, and about 40 percent of incarcerated people have at least one chronic health condition, such as diabetes or hypertension.
Inmates have high rates of chronic medical conditions, especially viral infections. In addition, substance abuse and mental illness are common among inmates. Prisoners with existing healthcare conditions may have their health needs ignored or neglected, and others may develop health problems while in prison thanks to unhealthy and unhygienic prison conditions and poor control of infectious diseases. Prisons can be a breeding ground for HIV/AIDS, tuberculosis (TB) and other infectious diseases.
Women prisoners have particular health needs, which go far beyond their need for reproductive healthcare and pre- and post-natal healthcare. Women in prison are disproportionately likely to be victims of domestic or sexual abuse, to experience poor mental health, and to have alcohol and drug dependency problems. The World Health Organization (WHO) estimates that at least 75 percent of women entering European prisons are estimated to have problems with drug and alcohol use, for example. Women are also more likely to develop mental health problems while in prison and are more likely to self-harm or attempt suicide than male prisoners. Surprisingly to many, HIV and acquired immunodeficiency syndrome (AIDS) are more prevalent among incarcerated women than incarcerated men. With increasing numbers of women entering and exiting the prison system, there is a compelling need to ensure that provisions are in place that can adequately address these health issues.
Providing inmates with health care is politically unpopular. Indeed, during the Bush administration, former Surgeon General Richard H. Carmona stated that the administration had blocked the release of the Surgeon General’s Report, Call to Action on Corrections in Community Health, for fear that the report would increase government spending on inmates. However, the constitutional, public health, and human rights imperatives of improving health care in prisons and jails are clear.
What’s the health care like in prison, anyway? It depends on the state.
At best, it’s about as good as a low-income health plan. At worst, it’s almost nonexistent. In general, when a prisoner gets sick, he tells the on-duty guard. Inmates who become ill typically submit “sick call” slips that are collected at an appointed time each day. If it’s not urgent—a sore throat, say, or an ear infection—the guard will put his name on a list, and an appointment with the prison’s in-house doctor may be set up for as soon as the next day. To handle emergencies, most prisons have a nurse on duty 24 hours a day. Most ailments are treated on-site, but inmates who are gravely ill can be taken to the nearest hospital.
Correctional facilities must provide health services to people who are incarcerated, but that doesn’t mean the care is free of charge. In most states, inmates may be on the hook for copayments ranging from a few dollars to as much as $100 for medical care, a recent study finds. At least 35 states authorize copayments and other fees for medical services at state prisons or county jails.
Sick prisoners must make a nominal co-payment for each visit to the jailhouse doctor — taken from an hourly wage that typically runs between 19 cents and 40 cents an hour. Costs above that are covered by the state.
Prisoners do checkups, but probably not as often as most people. Incoming inmates always get a physical, blood test and all, to check for diseases or drugs. After that, the period between checkups varies. In Pennsylvania, for example, men under 40 are supposed to get physicals every three years, complete with rectal exam, vision screening, and a risk assessment for chronic diseases. Women get pap and pelvic exams every year. Inmates of both genders older than 60 get a yearly electrocardiogram.
At least that’s the theory. In practice, many prison systems are so overcrowded that prisoners have to wait days to see a doctor, even in emergency situations.
If you have a medical question about either yourself or a family member who is in prison, The Center for Prisoner Health and Human Rights suggest the following steps:
1. If you or your loved one has a doctor on the outside, ask if they can communicate directly to his correctional health care providers. In some cases, correctional facilities allow doctors to visit their patients when they need medical attention.
2. You should try contacting the healthcare providers at your/your family member’s prison directly to bring a medical problem to their attention.
3. If you cannot reach the healthcare providers, the medical director’s office will be able to provide the most specific assistance to your health concern.
4. The Department of Corrections website for your state should have appropriate contact information for the medical director’s office.
5. Several states have legal services organizations that represent or otherwise help prisoners. These organizations will sometimes advocate for individual prisoners who are not receiving proper medical and mental health care and treatment. You should contact these organizations, listed here, to see if they can advise you concerning your case.
Each day, men, women, and children behind bars suffer needlessly from lack of access to adequate medical and mental health care. Chronic illnesses go untreated, emergencies are ignored, and patients with serious mental illness fail to receive necessary care. For some patients, poor medical care turns a minor sentence into a death sentence.
Regardless of their offenses, prisoners are human beings and must be treated as such.
Remember, I’m not a doctor. I just sound like one.
Take good care of yourself and live the best life possible!
The information included in this column is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan.