Why The Prison Health Care System Is Also A Danger To The Public

In a new report by The Atlantic, mass incarceration is cited as aiding in the spread of infectious diseases. “The penal system,” writes James Hamblin, “remains a source of diseases that spread among prisoners at rates far exceeding those in the communities from which they came. Of more than 10 million incarcerated people in the U.S. alone, 4 percent have HIV, 15 percent have hepatitis C, and 3 percent have active tuberculosis. These diseases are part of our criminal justice system, then, metered out and sanctioned implicitly by the state.”

According to The Lancet, a UK medical journal, prisoners facing stigma and discrimination within the institution’s health care system is an all-too common occurrence:

“Worldwide, a disproportionate burden of HIV, tuberculosis, and hepatitis is present among current and former prisoners. This problem results from laws, policies, and policing practices that unjustly and discriminatorily detain individuals and fail to ensure continuity of prevention, care, and treatment upon detention, throughout imprisonment, and upon release. These government actions, and the failure to ensure humane prison conditions, constitute violations of human rights to be free of discrimination and cruel and inhuman treatment, to due process of law, and to health. Although interventions to prevent and treat HIV, tuberculosis, hepatitis, and drug dependence have proven successful in prisons and are required by international law, they commonly are not available.”

The Lancet also stated that “prison officials are often unwilling to implement effective prevention measures such as needle exchange, condom distribution, and opioid substitution therapy in custodial settings, often based on mistaken ideas about their incompatibility with prison security.” Currently, California and Vermont are the only states in America to require that condoms be available to inmates, while some countries prohibit sex and condom distribution.

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While the public presumes that the prison health care system exists to aid prisoners to re-enter society, it fails to do so, particularly for people of color and other marginalized populations. It’s not uncommon for prison health care authorities to “cut off basic treatments” before they’re released. “As black men are disproportionately incarcerated, infectious disease spreads disproportionally in black communities,” Hamblin continues. “Among transgender women of color in the U.S., the rate of HIV infection is 27 percent, inextricably linked to the incarceration rate, and some 35 percent of transgender prisoners in the U.S. report sexual victimization while incarcerated.”

While Lancet argues for prison reform measures, community activists have long been seeking other avenues. Justice Now, a prison abolition group created by Cynthia Chandler and Cassandra Shaylor work with incarcerated women in California, pushing for alternatives to “challenge inadequate health care and abusive conditions” within the penal system. “We were feeling like a lot of the work we were doing was reformist,” says Shaylor, “and was about making conditions better, but in a roundabout way was really functioning to strengthen the current system. We wanted to be very clear that was something we weren’t interested in doing.” The group has argued for hospices outside of prison walls for terminally ill inmates–a turn that directly put them in contrast with prison reformers. The two have built underground, in-prison, peer education programs focused on health care and organized legislative hearings.

As the cracks within prison health care become widely known to the public, further community activists advocating reform, and those for abolition, will be at the forefront of the urging question of the health of those behind bars.

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