Health Care In Prison Essay

Many people believe that prisoner’s do not deserve proper health care simply because they are criminals. That thought can be very damaging to not only the prisoners but also members of society. What people with that mindset fail to realize, is that most prisoners will eventually be released from jail and once again be a part of the community. In fact, in 2012 alone, a total of 637,411 inmates were released from U.S prisons (Carson, Golinelli & BJS Statisticians, 2014). If ex-convicts do not receive proper care while they’re serving their sentence, their issues will continue to follow them as they try to become an active member of society. It is difficult enough to try and better oneself in today’s world, let alone if you’re an ex-convict with

health issues. The health care system in prison needs to be reshaped in order to help prisoners live a better life inside and outside of prison. The lack of resources also comes from the lack of funding. As a solution, there should either be more funds being put towards prisoner health care or the spending of funds needs to be revaluated. Reshaping the system does not only include better resources and more funding but also finding more health professionals that are willing to work in the prison environment. It is clear that adequate health care services are not always available inside of a prison, which is starting to become detrimental to prisoners. Despite whatever their actions may have been, prisoners are still people who deserve equal and reliable health care services.
The life of inmates before incarceration
A vast majority of prisoners either lack income, are homeless or have some sort of illness. The John Howard Society of Toronto (2010) did a report based on the lives of male inmates serving jail time in Toronto and found that “Prior to their incarceration, more than one-third of the respondents, 35.3 percent, relied on welfare benefits from Ontario Works (OW). A smaller proportion, 13.8 percent, received benefits from the Ontario Disability Support Program (ODSP)” (p. 13). As shown in Figure 1 below, out of the 83 homeless prisoners, a little over half were staying in some type of shelter or facility, 37.3% lived in what is considered an unfit environment, and 10.8% were temporarily staying at places without making any type of payment (The John Howard Society of Toronto, 2010, p.17).

Figure 1. Forms of homelessness expressed by adult male inmates in Toronto jails.
Note. Reprinted from Homeless and Jailed (p. 18), The John Howard Society of Toronto, 2010, Toronto: Canadian Observatory on Homelessness.
According to the Public Health Agency of Canada (2015), a mental illness is described as “alterations in thinking, mood or behaviour associated with significant distress and impaired functioning”. In the past 20 years, there has been an 85% increase in the number of convicts identified with having some sort of mental health issue at the time of their intake (Government of Canada, 2013). Not that any of these conditions are an excuse for their behaviour however, it can most definitely play a part in the reasoning behind their actions. Putting someone with any sort of illness into a facility where there are little to no resources/help being provided to treat them, could potentially only make things worse.
Resources for inmates
Due to their environment, prisoners are more likely to have health issues and due to the lack of resources available, those health issues are more likely to go untreated. Different illnesses and conditions require different treatments. Not all problems are treated the same way, therefore there should be multiple pathways that one has the option to take in order to better themselves. Medications should be provided and prescribed to those who need it and at no cost to the prescribed and therapeutic programs for inside prison should be available and very much encouraged to all inmates; the continuation of these types of programs should also be offered to former inmates once they are released from prison. A possible solution that prisons should consider is operating a treatment wing for heavy drug users. Inmates who fall under this category are placed in these separate wings which aim to educate the inmates about abstinence from drugs and reducing harm (Kolind, Asmussen, Dahl, & Birk, 2012). People in prison are more likely to contract diseases such as HIV/AIDS due to the sharing of drug instruments, unprotected sex, and homemade tattoos. According to the research found by the Centers for Disease Control and Prevention (2017), in 2010 there were over 20,000 inmates who had HIV/AIDS in both state and federal prisons. These inmates who have contracted these diseases are usually embarrassed and fear the stigma surrounding these diseases, therefore do not seek help. A solution to this would be to have programs and therapy options where prisoners can feel as though they have full confidentiality with a professional. These professionals should be able to provide those who are suffering with proper resources such as Antiretroviral Therapy (ART). According to the International Association of Providers of AIDS Care (2014), ART is described as medications that help treat the prevention of growth for HIV. Sadly, resources such as ART are not available in most prisons.
Funding for health care in prison
The lack of funding for health care in prison leads to the lack of tools and supplies required to treat patients. The professionals that work in the prison environment, cannot adequately perform their job if they lack the basic supplies to treat their patients. The Government of Canada (2014), reports that the total funds spent on health services in 2012-13 for prisons were only $216.7 million. That is a very low amount compared to the $62.5 billion that was spent on hospital care in Canada, in 2013 (The University of British Columbia, 2014). Between the years of 2007-2011, only 37% of prison health care spending was spent on general medical care. (See Figure 2.)

Figure 2. Prison health care expenditures from 2007-2011.
Note. Reprinted from State prison health care spending, The Pew Charitable Trusts., & the John D. and Catherine T. MacArthur Foundation, 2014.
In most situations, inmates are required to pay fees for basic amenities including medical care. As of now, a total of 35 states allows correctional facilities to charge inmates medical fees for procedures (Eisen, 2015). These fees are possible deterrents for prisoners when it comes to seeking medical attention because they lack the funds to do or because it will come from their commissary accounts, leaving them with no money for basic things such as soap or even food.
Health care professionals in prison
It is difficult to find staff for these prisons because the institutions are usually located in remote parts of the country, on the contrary, without proper staffing, it can be dangerous to the inmates, the medical staff and also nearby civilians, to remove the prisoners from their environment and bring them to nearby hospitals. A good solution to this problem is that “many of our prisons are located near medical schools and their research institutes provides an opportunity to challenge universities and professional colleges to develop and offer a curriculum focused on prison health” (Flegel & Bouchard, 2013). In addition, the number of prisoners outweighs the amount of health care professionals being staffed by these penitentiaries, which makes access to proper health care that much more difficult for these inmates (Miller, 2013). It is very important to have properly trained staff who know how to deal with these common issues facing inmates so that the prisoners have hope that they are still cared for, even while they are serving their sentences. The opinions of convicts are rarely taken into consideration and if medical staff were willing to advocate and support the inmates with these known health issues, it would greatly increase the awareness of the level of care being provided to the prisoners, or the lack thereof (MacDonald, Hucker, & Hébert, 2010). Health professionals working in prison are crucial in attaining the goal of providing equal health services for prisoners.
The next step for improving prisoner health
According to the Public Health Agency of Canada (2011), the 12 determinants of health are: income and social status, social support networks, education and literacy, employment/working conditions, social environments, physical environments, personal health practices and coping skills, healthy child development, biology and genetic endowment, health services, gender and culture.

It goes against multiple determinants of health if prisons are not receiving sufficient funds to provide the level of care required by the prisoners. Inmates are lacking education and literacy about possible diseases, they lack coping skills to deal with their poor health, and they most definitely lack the opportunity to receive proper health services. The wellbeing of prisoners is often overlooked or ignored, and it is time that the health care system in prison is

reshaped.

References
Carson, A. E., Golinelli, D., & BJS Statisticians. (2014). Prisoners in 2012: Trends in admissions and releases, 1991–2012. Retrieved from https://www.bjs.gov/content/pub/pdf/p12tar9112.pdf
Centers for Disease Control and Prevention. (2017). HIV among incarcerated populations. Retrieved from https://www.cdc.gov/hiv/group/correctional.html
Eisen, L.B. (2015). Charging inmates perpetuates mass incarceration. Retrieved from http://www.brennancenter.org/sites/default/files/blog/Charging_Inmates_Mass_Incarceration.pdf
Flegel, K., & Bouchard, F. (2013). Let us get prison health care out of jail. Canadian Medical Association Journal, 185(4), 281. Retrieved from http://www.cmaj.ca/
Government of Canada. (2014). Annual report of the office of the correctional investigator 2013-2014. In Office of the Correctional Investigator. Retrieved from http://www.oci-bec.gc.ca/cnt/rpt/annrpt/annrpt20132014-eng.aspx#sI
Government of Canada. (2013). Community mental health initiative. In Correctional Service Canada. Retrieved from http://www.csc-scc.gc.ca/publications/005007-3010-eng.shtml
International Association of Providers of AIDS Care. (2014). What is antiretroviral therapy. Retrieved from http://www.aidsinfonet.org/fact_sheets/view/403
Kolind, T., Asmussen, V. F., Dahl, H., & Birk, M. H. (2012). Prison drug treatment in denmark: A historical outline and an analysis of the political debate. Nordic Studies on Alcohol and Drugs, 29(6). http://dx.doi.org/10.2478/v10199-012-0046-3
MacDonald, N., Hucker, S. J., & Hébert, P. C. (2010). The crime of mental illness. Canadian Medical Association Journal, 182(13), 1399. Retrieved from http://www.cmaj.ca/
Miller, A.

(2013). Health and hard time. Canadian Medical Association Journal, 185. Retrieved from http://www.cmaj.ca/

Public Health Agency of Canada. (2011). What determines health? Retrieved from http://www.phac-aspc.gc.ca/ph-sp/determinants/index-eng.php

Public Health Agency of Canada. (2015). Mental illness. Retrieved from http://www.phac-aspc.gc.ca/cd-mc/mi-mm/index-eng.php#tphp

The John Howard Society of Toronto. (2010). [Graph illustration forms of homelessness expressed by adult male inmates in Toronto jails]. Homeless and jailed. Retrieved from http://www.johnhoward.ca/document/JHS-Toronto%20Report%20Homeless%20and%20Jailed.pdf

The John Howard Society of Toronto. (2010). Homeless and jailed. Retrieved from http://www.johnhoward.ca/document/JHS-Toronto%20Report%20Homeless%20and%20Jailed.pdf

The Pew Charitable Trusts., & the John D. and Catherine T. MacArthur Foundation. (2014). [Graph illustration prison health care expenditures from 2007-2011]. State prison health care spending. Retrieved from http://www.pewtrusts.org/~/media/assets/2014/07/stateprisonhealthcarespendingreport.pdf?la=en

The University of British Columbia. (2014). Current hospital funding in Canada. Retrieved from

http://healthcarefunding2.sites.olt.ubc.ca/files/2014/02/White-Paper-Current-Funding-2.pdf