A Plague of Prisons: The Epidemiology of Mass Incarceration in America by Ernest Drucker

Author:Ernest Drucker [Drucker, Ernest]
Language: eng
Format: mobi
ISBN: 9781595586056
Publisher: New Press, The
Published: 2011-08-08T16:00:00+00:00

• Inadequate examinations by nurses and physicians

• Failures to treat chronic medical problems expeditiously

• Delays in access to specialists and inadequate follow-up by prison providers on specialists’ recommendations

• Problems with receiving medications and the health education needed to comply with complex medication regimens

In addition to the neglect of preexisting medical conditions and major lapses in consistent medical care, the deprivations and stresses of prison life and the poor quality of prison diet increase the severity of chronic diseases.14

The care of HIV-infected inmates is a major issue (and expense) in the prisons of states with high rates of AIDS. Thus New York State (with over 53,000 prisoners in 2010) has about 1,700 HIV-infected inmates receiving medical care using antiretroviral drugs, at an annual cost of more than $25 million. But best estimates are that these 1,700 are only about one-third of New York State prisoners infected with HIV—most of whom do not know they are infected (there is no routine testing of inmates). These HIV-positive individuals have a great need for testing programs to identify them and to initiate their treatment as early as possible—both for their own benefit and for reducing transmission risk in the prison and, on reentry, in their communities.

Women’s health care needs, always more prominent than those of young males, are also inadequately addressed in prisons. In addition to facing all the routine gynecological, reproductive, and nutritional issues of women who are not incarcerated, the overwhelming majority of women in prisons are survivors of violence and trauma.15 And more than 60 percent of incarcerated women are parents, who must deal as best they can with separation from their children and families, along with the depression, anxiety, and low self-esteem that this entails. Not surprisingly, incarcerated women suffer from serious mental illnesses at much higher rates than male inmates. 16

Increased potential for contracting an infectious disease such as AIDS, hepatitis, TB, or a sexually transmitted disease (STD) is another feature of prison life. Inmates face a heightened risk of acquiring bloodborne infectious diseases, due in large part to the sharing of contraband drug injecting equipment with others in prison. The risk of acquiring STDs is increased through consensual but unprotected sex, and by rape in prison. An estimated 60,500 inmates—4.5 percent of the nation’s prisoners—report experiencing sexual violence ranging from unwanted touching to nonconsensual sex, according to a recent Bureau of Justice Statistics survey of federal and state inmates.17

Yet few inmates see any point in seeking the protection of prison authorities; a separate Bureau of Justice Statistics survey found that only about 6,500 official allegations of prison sexual violence (by staff or inmates) were reported to correctional officials in 2006—about 11 percent of the cases. The report found that “low response rates from victims are due to embarrassment or fear of reprisal, challenges in verifying victims’ self-reports, and lack of common terminology to describe sexual abuse.” 18 Recent reports of sexual offenses by staff in juvenile detention centers have launched a new federal investigation of sexual violence faced by close to 3 million juveniles arrested each year.

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