Magazine article Newsweek

Doing Double Time: Chronic Diseases a Chronic Problem in Prisons; the Incarcerated Are Aging Rapidly, Which Means Conditions Such as Heart Disease Are Overwhelming the Health Care System Behind Bars

Magazine article Newsweek

Doing Double Time: Chronic Diseases a Chronic Problem in Prisons; the Incarcerated Are Aging Rapidly, Which Means Conditions Such as Heart Disease Are Overwhelming the Health Care System Behind Bars

Article excerpt

Byline: Jessica Firger

Gregory Finney, then 37, felt extremely unlucky but in good physical condition when he arrived at Louisiana State Penitentiary in 2001. He had been shipped to the notorious maximum-security prison in Angola to serve 15 years for drug possession and shoplifting. Up to that point in his life, Finney hadn't worried much about his health, in part because he was too busy scrambling to hold a job and avoid getting arrested.

It turned out his health should have been a main concern. Not long after he got there, the prison clinic informed Finney he was on a fast track to heart disease that could kill him--he was diabetic and had hypertension. Angola is the largest maximum-security prison in the U.S. and one of the most dangerous, so Finney suddenly realized he would now be fighting for his life in more ways than one. "I didn't want to die in Angola," he says.

In the years that followed, Finney struggled to get decent health care. The prison doctors prescribed insulin shots and gave him pills to manage his diabetes and high blood pressure, but two to three months might pass before he was able to see a physician for a follow-up exam. The clinic had too many patients and too many with far more serious illnesses. If Finney's blood pressure happened to be too high on a day when he finally got an exam, the doctor would simply give him more medications instead of conducting further evaluation to determine how best to adjust his treatment. By the time he was released 15 years later, he was taking 13 different medications, and the treatment plan hadn't done much to improve his condition.

The health care system at Angola was tragically slow and mostly useless, says Finney. "In prison, you won't be seen when you have the illness; you get seen when they have the time."

In the U.S., the only citizens constitutionally guaranteed to have access to health care are prisoners, but experts agree that the treatment of serious chronic illnesses in prisons is a disgrace.

The U.S. Centers for Disease Control and Prevention recently released its first-ever national study on the state of prison health systems throughout the U.S. It suggests that most state prisons are well aware that chronic medical conditions are a serious threat to this population, but the care after an inmate is diagnosed is inconsistent and sometimes does more harm than good.

Staffing is a problem. In addition to medical emergencies, health care services in prison tend to focus on conditions that could have an immediate and widespread impact, such as infectious diseases like HIV and tuberculosis that could affect the larger population--both in prison and upon release. Psychiatric illness and addiction are also top priorities, since these disorders can result in suicide or even homicide.

Halting the slow killers that afflict the general U.S. population in epic numbers is usually at the bottom of a prison clinic's to-do list. According to a study published in the American Journal of Public Health, 43 percent of inmates in federal prisons and 39 percent of those in state prisons suffer from chronic medical conditions, such as hypertension, high cholesterol, diabetes and obesity, all of which contribute to cardiovascular disease--the leading cause of death in the U.S. One study by Harvard Medical School and the Cambridge Health Alliance suggests prisoners are 55 percent more likely than the general population to have diabetes and 90 percent more likely to have suffered a heart attack.

Chronic health conditions like cardiovascular disease have become a more significant problem in correctional facilities in part because the prison population is rapidly aging. The number of inmates in state prisons aged 55 serving more than a year increased from 26,300 to 131,500 from 1993 and 2013, according the Bureau of Justice Statistics .

The incarcerated are thrown into an inherently stressful, blood pressure-raising environment. …

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