Locked Up and Left Behind: Health Inequities in Prison

Authored by: Sawandi DeSilva

Art by: Rachel Jacob

When we picture people in prison, it’s rare that we think of their needs or struggles. Most of us fail to see the disparities that exist within these communities, as we feel they may not be worthy of receiving basic welfare. This negative lens on prisoners reflects on our desire to make a difference in the environments they occupy. Prisons are a hotspot for infectious diseases, and specifically, many women, who have no access to the resources every human should have a right to, criminal or not. This neglect also directly impacts a detainee’s mental health, as they may feel as if they don’t matter enough to be cared for. Our society’s perception of prisoners as undeserving directly impacts the quality and accessibility of their medical care. 

Two million people in the United States currently live behind bars, a great percentage of them denied access to healthcare. Each year that someone spends in prison cuts their life expectancy by two years [1]. Medical neglect kills hundreds of incarcerated individuals yearly, highlighting how basic care is stripped away from jails and prisons countrywide. At the center of medicine lies ethics. While this is commonly ignored, it’s vital that everyone is granted the same resources and attention, especially when the living conditions are worse in comparison to the average person. When an individual is labeled as a criminal, society often views them as inferior, justifying the poor conditions that they continue to live in. 

There are currently no federal standards in place for governing productive health for the incarcerated, and more importantly, no guidelines for what can be considered as the legal minimum standard of care [2]. The number of people going without care continues to go up while no changes to health equity in these communities are taking place. Being in prison can take a serious toll on an individual’s psychological well-being. For most of these detainees, mental illness already exists within them. Without any attention for treatment, pre-existing conditions just worsen. The response of the issues to the prison system however are often taken as a “normal” reaction to being in an institutionalized setting. Recent research has found that 38.4% of people living in prison received some type of behavioral treatment while only 7.1% received any type of treatment for substance use and mental health problems [3]. Treatments are commonly reserved for diagnoses that are considered fatal in comparison to an everyday issue. In fact, incarcerated individuals' aren’t even granted the opportunity to be assessed by a mental health profession, and or instead given unproductive simple screening questionnaires. Neglected mental health awareness increases the risk of recidivism for many of these convicts as well. Statistics reveal that about 29.7% of justice-involved people who have serious mental health issues are likely to return to prison at least once [4]. 

Prevalence of disease and health conditions in prisons worldwide is also an ongoing matter that needs to be addressed. Many women specifically in custody suffer from a history of trauma and abuse and are commonly mistreated as they are a minority within a justice system designed for men. There is a high burden for HCV infection with limited access to health care [5]. Many women here fail to get their hands on menstrual hygiene products, reproductive care, and even prenatal services. Additionally, these spaces are a hub for infectious diseases such as HIV, Hepatitis C, Tuberculosis, and so much more. The poor and obscene living circumstances contribute greatly to this, making outbreaks inevitable. With all of this happening in front of our eyes, it is not difficult to realize that prison healthcare is not just a matter of ethics, but a matter of public health. 

References:

1. Borysova, M. E., Schlosser, J., & Herget, S. (2012). Racial and ethnic health disparities in incarcerated populations. Journal of Health Disparities Research and Practice, 5(2), 92–100. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3546523

2. Nowotny, K. M., Bailey, Z., & Brinkley-Rubinstein, L. (2017). Racial disparities in health conditions among prisoners compared with the general population. SSM - Population Health, 3, 487–496. https://doi.org/10.1016/j.ssmph.2017.05.011 

3. Morin, A., & Swaim, E. (2025, April 16). The mental health effects of being in prison. Verywell Mind. https://www.verywellmind.com/mental-health-effects-of-prison-5071300

4. Vera Institute of Justice. (n.d.). Health care behind bars: Missed appointments, no standards, and high costs. https://www.vera.org/news/health-care-behind-bars-missed-appointments-no-standards-and-high-costs

5. McLeod, K. E., Cooper, A. B., & Brinkley-Rubinstein, L. (2025). Health conditions among women in prisons: A systematic review. The Lancet Public Health, 10(7), e609–e624. https://doi.org/10.1016/S2468-2667(25)00092-1