A broken health system can turn a short prison term into a death sentence.

Kathy was a young woman serving time for drug use at Taconic Correctional Facility in New York when she began to feel sick. Suspecting she had a cold, she went to the prison clinic. The staff gave her a cold pack, which was the common response to such symptoms. Kathy’s body did not respond. Instead, she felt worse.

For over a week, she went to the clinic every day and begged for help. No doctor attended to her needs. Desperate, Kathy called her mom and asked her to convince the superintendent to grant her medical help the next day. But her pleas were futile. Kathy did not see a doctor the next day. She died that night of congestive heart failure before a stethoscope ever touched her chest.

 

The story of Kathy’s death, told by Taconic’s prison chaplain in testimony before the Commission on Safety and Abuse in America’s Prisons, highlights the alarming state of correctional health care in the United States. A host of infectious and chronic diseases fester in our prisons and jails. Hepatitis, Tuberculosis, HIV, and AIDS all infect prisoners at rates much higher than those in the general population. Almost half of state inmates and a little over one third of federal inmates report serious medical problems.

 

Often the medical response to such disease is woefully inadequate. The prison health system in California is so bad that a federal judge removed it from the state’s control in 2006 and appointed a federal receiver to run it. In 2007, 65 inmates in California died for reasons labeled “possibly preventable.” Over a hundred extreme lapses in medical care were identified in these cases.

 

Why Should We Care?

But wait. We’re talking about the Al Capones and the Jesse Jameses of society. Why should we care about the health status of criminals? Don’t they deserve to suffer behind bars?

Ethics, justice, and public welfare demand that we care.

 

Breaking the law does not nullify the sanctity of life. We cannot intentionally inflict cruelty on inmates without trampling on God’s image. In addition, the U.S. Supreme Court has ruled that denying, delaying, or interfering with inmate medical care is a form of cruel and unusual punishment prohibited by the Eightth Amendment.

 

Really, though, we put ourselves in danger when we ignore the health crisis in our prisons and jails. Ninety-five percent of inmates are eventually released. Roughly 700,000 each year walk out of prison and into our neighborhoods. These people bring their diseases with them. Correctional facilities also have thousands of visitors each day and nearly one-half million employees. Because disease does not discriminate, poor inmate health is truly a public health issue.

 

Poor prisoner health also threatens public welfare by hindering offenders from reintegrating into our communities as productive, peaceful citizens. Few things impede stable employment more than bad health. And keeping a steady job not only helps offenders positively contribute to society but also enables them to steer clear of further criminal behavior.

 

How Can We Make Things Better?

To improve the health of our inmates and protect our communities, we must address several specific problems in our correctional health systems.

 

Far too often, a few medical staff are responsible to treat huge prison populations. Many of those who do work in prisons and jails are unqualified for their tasks. Correctional systems should allocate funds for adequate medical facilities fully staffed by licensed professionals. If you are a medical professional, you should consider a job in correctional health care. The need is certainly great, and working to heal inmates physically provides an excellent context to share spiritual healing.

 

Breaking the law does not nullify the sanctity of life.  We cannot intentionally inflict cruelty on inmates without trampling on God's image.

Currently, the U.S. does not have a universal correctional health policy that provides oversight and accountability for all prisons and jails. All facilities should conform to established standards that include health screenings and comprehensive care for pregnant inmates. Facilities should also earn and maintain accreditation from agencies like the National Commission on Correctional Health Care. If you currently work in a prison or jail, check to see if your health system is accredited, and, if not, pressure the leadership to pursue this.

Conflict between custodial staff and medical staff regarding inmate treatment can significantly hinder proper medical attention. When the opinions of these two groups conflict, most facilities subordinate health needs to security needs, placing the final decisions about inmate care in the hands of non-medical supervisors. These two groups should communicate to ensure that inmates receive treatment appropriate to their conditions. If you work as either a medical or custodial staff member, attempt to understand the concerns of the other group. Be innovative to fulfill security and health needs at the same time.

 

As jails and prisons face budget shortfalls and bloated prisoner populations, drawing from the assistance and expertise of the community becomes more and more important to address inmate health needs; failure to do this prevents inmates from accessing the best possible care. Correctional health and public health systems should collaborate both to treat inmates and to provide health education and intervention programs. Perhaps you could encourage your healthcare provider to explore partnerships with prison medical clinics in your area.

 

Collaboration is also essential for effective reentry planning. Some diseases worsen dramatically without consistent treatment. Continuity of care in these situations is critical. Many prisoners have only a couple days of medication and have no plans for further medical help when they are pushed out the door. Reentry preparation should include setting up appointments with community doctors and ensuring that released offenders have sufficient prescription drugs until these appointments occur. If you are a mentor for inmates or plan on becoming a mentor, make sure you talk through these issues with the men and women you counsel.

 

Reentry planning should help offenders find medical insurance as well. Though not required by the federal government, many states terminate rather than suspend offenders’ Medicaid eligibility while they are behind bars. This practice should stop. But until it does, reentry counselors should guide inmates through the process of reapplying for Medicaid benefits.

 

By changing policies and pursuing good practices, we can significantly enhance the health care inmates receive and promote the well-being of our communities. A justice system that focuses on restoring offenders rather than prioritizing punishment and pain cannot neglect the health of inmates—inmates like Kathy. Prisons should be places of healing. No one else should have to share her story.

 

To learn more about inmate health issues, visit Justice Fellowship’s Inmate Health issue page.