500%. That is the increase of prisoners in the US prison system over the last 40 years, totaling two million people (The Sentencing Project). The US prison system has a sordid history of prejudice since the founding of the nation. The war on drugs, prison labor, and systemic injustice all contribute to the unfair punishment and treatment of prisoners today. This article specifically focuses on the injustices within the healthcare system provided for prisoners and how they parallel the U.S. healthcare system.
Illness is more prevalent in the prison population than illness in the average population, thus requiring more medical attention than the average population. 40% of prisoners have a chronic illness (Ahebee) and a significant portion suffer from mental illness. In addition to these illnesses, many inmates suffer with past or current alcohol and substance abuse, thus further worsening their conditions. According to the Prison Policy Initiative, prison healthcare is “low-quality and difficult to access” to the point that mass incarceration has decreased an inmate’s lifespan by 5 years (PPI).
The systemic injustices and medical biases of the healthcare field also manage to permeate through. This is seen by all women who interact with the prison healthcare system. A study by the Office of Justice Department found that male inmates were four times as likely to be seen by a physician and twice as likely to receive treatment than their female counterparts.
The most stark issue that women face in prison in regards to healthcare is quality reproductive healthcare. A recent report by the Correctional Association of New York stated that “reproductive health care for women in New York State prisons is woefully substandard, with women routinely facing poor-quality care and assaults on their basic human dignity and reproductive rights.” The studies mentioned only pertain to New York, however there are many other claims and accounts from across the country that corroborate this finding. An extreme example of this miscare can be found in California, where hundreds of women were tricked into some form of sterilization from 2006 to 2010 (Law). While this is a particularly egregious example, it parallels what we see in the US healthcare system. In many cases, women will present the same cases as men yet receive different or less comprehensive care, thus leading to poorer outcomes. One of the largest contributors to this bias, aside from disbelief of symptoms, is a lack of research.
Even outside of the prison system, there is a clear racial bias in medicine. 20% of Black adults and 35% of Latinx adults can’t access healthcare, while that statistic is only 10% for their white counterparts (MNT). This inequity stretches further than access as 73% of all white medical students held a false belief about the biological differences between races- specifically white and black patients. Race inequality and the prison system itself are heavily intertwined and this permeated into the healthcare system. This lack of information and understanding of a certain race or sex creates a harmful environment for women of color.
Women of color make-up approximately 50% of the female prison population yet they still do not have adequate access to healthcare. This is an account of a female inmate of color’s first experience with prison medical care,
“We were brought down three or five at a time,” she told Truthout. “It’s like an assembly line. They rush you in and rush you out. That in itself is degrading.”
To add to that feeling, the gynecologist did not explain what he was doing or why. … ‘however, he commented, “You have a very nice aroma.’”
Not only do these women not have access to basic healthcare, they often have to face sexual harrassment or worse to get it. Moving on the final intersectionality, we must discuss LBGTQ+ women and their access to healthcare. Nine out of ten transgender women face sexual extortion in prison and out of the 54% who contacted the police, 22% were harassed by officers with 6% being physically assaulted, and 2% being sexually assaulted (Brock). The numbers are even worse for women of color as out of the ones who contacted the police, 29%-38% were harassed by officers, 15% being physically assaulted, and 7% were sexually assaulted (Brock).
There has always been a hostility towards LGBTQ+ inmates and that hostility is amplified for those who are also women of color.
Once again, this hostility parallels that of the current healthcare system.An article by American Progress details the discrimination LGBTQ+ face in the medical setting. 8% are refused service on the basis of sexual orientation and 29% on the basis of gender orientation (CAP). These statistics are startling as they don’t even go into the quality of care these individuals receive, which is generally inadequate. Given the ‘newness’ of extensive procedures for the LGBTQ+ community, there is not much data about the healthcare they receive aside from the fact they simply don’t get any.
Overall, although these discrepancies are not surprising, they are unfair and undeserved. Every issue seen in the medical field has been amplified in prison, and inmates cannot choose to remove themselves from that situation or see a different physician. Inmates deserve respect and quality care and it is ironic that the source of these blatant injustices come from the justice system itself.
References
1. Ahébée, S. (2021, April 9). Why good health care in U.S. prisons may be hard to come by. WHYY. Retrieved March 21, 2022, from https://whyy.org/segments/why-good-health-care-in-u-s-prisons-may-behard-to-come-by/
2. Author(s) S B Sobel. (n.d.). Women in prison - sexism behind bars. Women in Prison - Sexism Behind Bars | Office of Justice Programs. Retrieved March 21, 2022, from https://www.ojp.gov/ncjrs/virtual-library/abstracts/women-prisonsexism-behind-bars
3.Blakinger, K. (2021, July 1). Prisons have a health care issue - and it starts at the top, critics say. The Marshall Project. Retrieved March 21, 2022, from https://www.themarshallproject.org/2021/07/01/prisons-have-a-health-careissue-and-it-starts-at-the-top-critics-say
4. Criminal justice facts. The Sentencing Project. (2021, June 3). Retrieved March 21, 2022, from https://www.sentencingproject.org/criminal-justicefacts/#:~:text=There%20are%202%20million%20people,explain%20most%20of% 20this%20increase
5. Initiative, P. P. (n.d.). Public health. Public health | Prison Policy Initiative. Retrieved March 21, 2022, from https://www.prisonpolicy.org/health.html#:~:text=People%20in%20prisons%20 and%20jails,quality%20and%20difficult%20to%20access.
6. LGBTQ Prison Life. Zoukis Consulting Group. (2022, March 9). Retrieved March 21, 2022, from https://prisonerresource.com/prison-life/specialtactics/lgbtq-prison-life/ Loaded on Feb. 29, 2016 by V. L. published in P. L. N. M. (n.d.). . Reproductive Health Care in Women's Prisons "Painful" and "Traumatic" | Prison Legal News. Retrieved March 21, 2022, from https://www.prisonlegalnews.org/news/2016/feb/29/reproductive-health-carewomens-prisons-painful-andtraumatic/#:~:text=A%20recent%20report%20by%20the,basic%20human%20di gnity%20and%20reproductive
7. MediLexicon International. (n.d.). Gender bias in healthcare: Examples and consequences. Medical News Today. Retrieved March 21, 2022, from https://www.medicalnewstoday.com/articles/gender-bias-inhealthcare#ending-gender-bias
8. Paulsen, E., & Paulsen, E. (n.d.). Recognizing, addressing unintended gender bias in patient care. Duke Health Referring Physicians. Retrieved March 21, 2022, from https://physicians.dukehealth.org/articles/recognizing-addressingunintended-gender-bias-patient-care
9. The truth about women of color behind bars. RSS. (n.d.). Retrieved March 21, 2022, from https://www.logikcull.com/blog/women-color-behind-bars