Health Care in Prisons: A Human Right or Luxury? - Essay Sample

Introduction

While the disparity in health care exists between different regions, nations or groups, every individual has the right to enjoy the highest attainable standards of mental and physical health. Health care is a part of life and many consider it as something that they are entitled to have access to. However, for many people across the globe, especially prisoners, this is simply not an option. Health care is prisons has become one of the most discussed and ridiculed social issues today. This is because, prisoners, particularly those with existing health conditions continue to have their health care needs neglected or ignored, thereby ending up developing even severe health issues. Many states also continue to ignore the unhygienic and unhealthy prison conditions, as well as the poor control of infectious diseases due to the fact that many of inmates will eventually return to their respective communities at the end of their sentence. As a result, infectious diseases such as tuberculosis, HIV, and other chronic diseases continue to affect the quality of life of many inmates who are in dire need of medical attention and intervention. Ideally, if medical needs of incarcerated individuals are not met, it may affect their quality of life while in prison by increasing their risk of developing mental illness and other specific health conditions, risk of communicable diseases, risk of violent and stressful conditions of detention, and poor personal interventions to control detrimental health habits.

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Background

Overall, inmates represent one of the groups with increased social and health care needs. Different studies indicate that the prison population is often more vulnerable to various health problems compared to the general population since prisons themselves are settings carrying high risks of disease (Lindquist & Lindquist, 1999). However, in reality, many inmates tend to receive medical interventions of far inferior standards in comparison to those available to the general population, if they receive health care at all. Essentially, many governments recognize the individual medical needs in prisons, and policies are in place aimed at improving the outcomes within the incarcerated population, however, these interventions are often limited due to a large number of sentenced individuals. According to a recent publication on imprisonment, more than four million individuals are incarcerated and the rate continues to rise, with the average prison population rate estimated to range from 15 to 600 inmates per 100, 000 inhabitants (Temin, 2018). The United States, for instance, is considered to have a higher incarceration rate than any other country in the world which continues to wreak havoc in many American prisons. This hyper incarceration in the United States can be attributed to the war on drugs and also the expansion of the criminal justice system which requires mandatory minimum sentencing.

For decades, federal reforms in the United States, as well as grants from the federal government for law enforcement agencies, have reinforced the tough on crime rhetoric which has resulted in increased arrests among drug offenders (Temin, 2018). With continuously rising crime rates and social foment over the years and driven by mandatory minimum sentences, the increased arrests which led to the expanded population of prisoners were conducted with no regard for an objective evaluation of benefits or possible harms to all the stakeholders. Indeed, for a group of people living in a closed environment, incarceration can provide a respite, especially, for individuals who used to live on the edge before imprisonment and a range of benefits including a stable diet, health care, and reduced access to cigarettes, alcohol, or drugs. Even so, the burden of mass imprisonment fell on the backs of those below the social ladder who are the usual victims.

While it is evident that there exist significant socioeconomic disparities between inmates and the non-incarcerated individuals, the health disparities between the two groups is the controversial part. For example, unlike the general population, more than 85 percent of state prisoners encounter various unrelated health problems ranging from drug dependence, Hepatitis C, to chronic health conditions (O'Hara et al., 2016). This is because, in many cases, the health statuses of incarcerated individuals are often considered as insular and a non-issue both by the federal government and prison workers, therefore, much of health concerns are directed towards the general public.

Evidently, an individual's medical needs and the prison environment can significantly affect their quality of life while incarcerated in many ways. For instance, due to the continuously growing incarcerated population and lack of adequate medication, prisons have become a breeding ground for many infectious diseases. According to Bick (2007), infectious diseases such as tuberculosis are more prevalent in prisons than in any other setting. The study found that individuals incarcerated in jails and prisons had up to 18 times and 5 times higher chances of contracting tuberculosis (TB) compared to free folks (Bick, 2007). Generally, the TB virus has been largely controlled over the years in the United States with strategic interventions and policies, however, due to lack of medications and limited attention towards the incarcerated population, the prison inmates continue to suffer from this contagious disease. Prisons and jails are usually crowded and poorly ventilated which provides the ideal environment for such diseases to spread.

The rates of sexually transmitted infections such as HIV/AIDS and syphilis also continue to affect the correctional populations compared to the general public due to the lack of proper medication and attention. The incidents of sexually transmitted infections that thrive in cramped and overcrowded environments remain high in prisons as there are no adequate testing and diagnosis for such diseases. Some states encourage mandatory testing of the HIV virus among inmates as a way of estimating the prevalence and curbing the disease altogether. However, other states have inadequate personnel and equipment to conduct such an exercise in a prison environment, therefore, inmates are left to suffer on their own (Bick, 2007).

Similarly, due to poor conditions and lack of mental health care, many inmates often suffer from mental health or behavioral problems. Previously in the United States, many prisons were institutionalized together with psychiatric hospitals to take care of inmates exhibiting mental disorders, however, due to insufficient funding for many of these programs, many patients were left without access to adequate care altogether (Reingle Gonzalez & Connell, 2014). According to Sinha (2010), approximately 25 percent of inmates across the globe suffer from certain types of mental disorders that may or may not require immediate attention, and only 5 percent of the non-incarcerated individuals have a serious mental illness.

Although limited attention is often given to the issue of mental illness among the incarcerated population since the closure of mental hospitals, the presence of large concentrations of people with a mental disorder in prisons have been witnessed for decades (Martin et al., 2018). These conditions may be present during the time of imprisonment or emerge after one is incarcerated and become worse as a result of certain conditions of detention and the prison environment in general. Essentially, prison environment is toxic and can negatively impact mentally unstable convicts. The solitary confinement in many jails and prisons are not healthy for incarcerated individuals who are mentally ill since it can affect their mental orientation and change even those who have not never exhibited prior symptoms of mental disorder (Clark, 2018). Consequently, inmates with undiagnosed or untreated mental health disorders continue to suffer without proper medical intervention, leading to high rates of morbidity arising from mental health conditions.

Additionally, in many prisons and jails, there is a significant widespread of drug dependency among inmate which is usually attributed to lack of proper care and medication. With the federal reforms which advocated for the war on drugs and severe mandatory minimum sentences, law enforcement agencies produced an unprecedented increase in incarcerated individuals, majority of whom were addicts. A survey by Bernstein et al. (2015) indicated that about 48 percent of prison inmates and a staggering 55 percent of incarcerated population suffer from alcohol dependence and drug abuse respectively. This data indicates that more half of the inmate population in the United States are simultaneously affected by both drug and alcohol addiction.

Sadly, for many prisoners, addiction is often considered as a mental illness and may be difficult to treat. For example, although many convicts may be willing to undergo treatment, they end up relapsing without proper care in their environments. Also, many people in the United States including incarcerated individuals view substance abuse and addiction as a moral failure rather than a medical issue which may have resulted in lack of availability of addiction treatments within the inmate population (Bernstein et al., 2015). Nevertheless, even though substance abuse is a chronic condition, it is still treatable, therefore, identifying strategies that address the needs of the incarcerated population exhibiting drug problems is important for successful rehabilitation. Since prisons already help such individuals in addressing dependency, it should be accompanied by adequate treatments, to eliminate the problem and to ensure relapses do not occur after release.

Even today, the nutrition value of meals in many prisons is far from ideal, and many incarcerated people continue to suffer from chronic diseases such as diabetes, hypertension, asthma, as well as other health conditions due to lack of medical needs. According to Gates and Bradford (2015), the incarcerated population in America have more cases of chronic diseases compared to the general population. This prevalence in chronic diseases among inmates can be attributed to both the general national obesity epidemic and the fact that most prisons today a large number of aging inmates. Many prisons have failed to eliminate energy-dense meals from the prisoners' meals making them vulnerable to food-related conditions. As a matter of fact, incarcerated individuals are almost four times more likely to develop at least one chronic condition compared to the general public in the same age group (Gates & Bradford, 2015). In many instances, diseases such as hypertension which are usually common among older people continue to affect younger inmates since medical provision in prisons does not include screening for chronic diseases that remain underreported among the incarcerated community.

Special Populations

Lack of medical needs can sometimes make life unbearable for certain populations such as female inmates, juveniles, and the aging population. Despite being the smallest group in the incarcerated community, female inmates are usually affected more due to medical conditions compared to their male counterparts. This is because, women are not only vulnerable to the same diseases that men encounter but also to reproductive health issues (Guthrie, Butler, & Sefton, 2003). Many of them are usually incarcerated while pregnant and are more prone to sexually transmitted infections than men. In addition, women tend have a higher rate of mental illness than men due to post-traumatic stress disorder developed as a result of physical or sexual abuse.

Also, in addition to normal health problems usually de...