Magazine article Corrections Forum

JAILS AND PRISONS: Chronic Healthcare Issues

Magazine article Corrections Forum

JAILS AND PRISONS: Chronic Healthcare Issues

Article excerpt

ACCORDING to the International Center for Prison Studies at King's College in London, there are 2.3 million incarcerated people in the United States. That figure is significantly higher than any other nation's. Providing healthcare to all of those inmates is a challenge to say the least. Populations are up. Budgets are down. More and more inmates are coming in or developing multiple conditions. California is under a federal court order to reduce overcrowding based on what was considered to be inadequate and un-Constitutional medical and mental health care.

Numerous experts agree that mandatory sentencing has had an enormous impact on medical requirements in corrections as the population ages and requires more and more resources in environments not designed to provide that type of care. There are the same issues that we all face to consider as well as a host of other conditions that come from being a member of a high-risk population. In general, says Bill Sessa, Information Officer at the California Department of Corrections and Rehabilitation, inmates have many medical conditions caused by their lifestyles before their incarceration. Alcohol and drug abuse, a problem in itself, often adds to conditions they may develop later in life. In many ways, experts say, inmates have bodies that are medically older than their chronological age. On top of that, says Sessa, there are communicable factors to consider. "Having bodies together in an institutional setting can add to the spread of illness, too."

While there are no diseases "unique" to corrections, says Dr. Donald Kern, chief medical officer of NaphCare, a Birmingham, Alabama-based provider of inmate health services, "jails and prisons have to contend with greater numbers of inmates with medical conditions, inmates with multiple medical conditions, and inmates with more advanced and unstable forms of medical conditions when they enter the correctional facility from the community." He furthers that in the past, inmates tended to be healthy, younger males, but for a variety of reasons, jails now receive inmates with a variety of acute and chronic health issues. While females, juveniles and the elderly remain the minority of inmates, the rate of incarceration is increasing, and just as in the community, female and elderly inmates might require more health services than others.

The cost of healthcare has grown enormously over the years, and, Kern notes, inmates often did not have health insurance or did not seek treatment before incarceration. "Jails in this manner may have to substitute for a public health system that the inmates could not or would not access."

One of the primary ailments that affect inmates in jails is viral hepatitis. In fact, says Kern, inmates are about 10 times as likely to have hepatitis than people in the general community are, and while inmates tend to be in jail for short periods of time, those who arrive on medication are likely to remain on medication, and that treatment can cost as much as $50,000 a year per patient.

Another issue is that inmates often arrive at jails suffering from acute or chronic dental issues. Dental insurance in the community is less common than health insurance, and dental problems are further exacerbated by smoking and methamphetamine use: activities that are more likely to occur by those in the jail population.

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