More than 10 million people are incarcerated worldwide. Of these 10 million, the U.S. accounts for 2.3 million, 1.6 in China, and 0.9 in Russia and India, Thailand, Iran, Indonesia, Turkey, Brazil, Mexico, South Africa, and Ukraine with about 100,000 people (Fazel & Baillargeon, 2010). Prisoner populations have many health problems including, but not limited to, high rates of suicide and mental illness, infectious diseases, and chronic diseases. Generally, the rates of these diseases are higher inside prison walls than in the general population. I am interested in finding out if these individuals enter the prison with poor health possibly because of low SES, race, or ethnicity as the social determinants, or if the prison is a contributing factor to poor health.
Several papers that I've read recently discuss the affect of prisoners health on population health. These are related because unhealthy, risky prisoners are released back into the community without being treating for physical or mental illness, and without have going through interventions for drug and/or alcohol abuse. When released from prison, depending our the duration of incarceration, one may have to start from ground zero. They may have no family support, most likely have trouble finding employment, and not have the resources to take care of any physical or mental illness. Because of these factors, they are very likely to go back to risky behaviors. In fact, the death former inmates is over 12 times that of other state residents 2 weeks after release (Binswanger et al., 2007). The most elevated risk (129 times that as state residents) is from drug overdose.
It is clear that prisoners face many challenges, emotionally and physically. Some would argue that prisoners don't deserve equal healthcare and rights, but some would advocate for the opposite. In specific to public health, the health of prisoners is not only detrimental to them, but can also havea negative effect on community members after their release. Just as culture is many times seen as a barrier rather than a strength, high prevalence of physical and mental illness in prisoners present a challenge, but also can be seen as an opportunity. Holding interventions and providing equal healthcare services in prisons can positively affect our society and hopefully reduce the rate of re-incarceration.
Do you guys think that prisons should have these services? Do you think the health and safety of innocent community members is in jeopardy because of lack of treatment and intervention of prisoners? Do you know of any of these services provided in the U.S. or other countries?
References
Binswanger, I.A. (2007) Release from Prison- A high risk of death for former inmates. The New England Journal of Medicine, 356. 157-165.
Fazel, S. & Baillargeon, J. (2010). The Health of Prisoners. The Lancet, 377. 956-965.
Hi Hannah,
ReplyDeleteThank you for raising this topic. I will start from your questions. Yes, I think prisoners MUST have these services not only for the sake of the safety of the innocent community members, which is totally understandable and appreciated, but also for the sake of the prisonors themselves. In my opinion, it is an ethical obligation. We should not punish prisoners twice. They have their punishment by being in prison. We cannot deprive them their right of health. What is the aim of putting a guilty person in prison? Do we intend to ruin his life completely or we give him a lesson to learn from his previous bad deeds to be a productive person in the community after being released?
My home country now is under military coup and it is heartbreaking that many innocent people are being prisoned just because of their political opinions. I,personally, know two innocent persons who died because of lack of medical services and many who are still suffering. In my opinion, it is a crime to deprive them their health rights.
In an undergraduate course I did years ago, we mentioned prisoner health. I believe it is an extremely interesting topic that is often overlooked. The thing I was most shocked about learning with prisoner health was the lack of detoxification programs. The number of prisoners that suffer from withdrawal and die was astounding. The rates have probably changed since the time I studied them, and I hope they have gone down. I think that too often, once a prisoner has be caught and put in jail, they health (at least in the U.S.) is neglected. I know that my father as a judge takes care of cases as soon as he can to prevent the people from sitting in jail without just cause. In other places, in and out of the U.S., who knows what is going on?
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