Much has been written about bulging jail and prison populations of the last 30 years, especially in the U.S.
But little has been written on the fact that major health epidemics such as HIV/AIDS and Hepatitis C have hit those who have lacked or, in most instances have never had quality health care: prisoners.
Carceral institutions in the U.S. have aggressively turned to for-profit prison health care providers to manage these populations. This endeavor has, in a word, not been particularly successful.
First, prisons and jails lack both the financial resources and institutional imperatives to address major health care problems behind bars. Bulging carceral institutions has meant that the majority of U.S. states and municipalities have had to do prisoner health care on the cheap; outside prison health care contractors have been a convenient way to do this.
These companies focus on cutting costs by ensuring that legal liabilities are met at the absolute minimum of standards imposed by courts. Jails and prisons are first and foremost organized to manage and control risk. In this way, regardless of health status all incarcerated individuals are prisoners first and patients an often distant second (Report on New York Prisoners).
The result has been a deadly human rights crisis not at the hands of villains and bad apples working inside carceral institutions. But at a more systemic level. Prisons and jails today are overwhelmed by prisoners with multiple illnesses who need comprehensive care. They routinely lack sufficient record keeping on prisoner medical histories and a stable health care workforce (i.e., the turnover rate for prison health employees in, for example, the state of New York is very high). The result is the creation of catastrophic institutions in which exorbitant numbers of chronically ill prisoners needlessly die in secret.
This site will serve as place to break the silence of a crisis that has gone on far too long.
It is a problem that is not easily addressed in age of ‘tough on crime’ posturing by politicians and free market profiteering run amok.
The focus on cost savings and profit over care that characterizes much of the U.S.’s health care system is mirrored in the nation’s carceral institutions and is thus a problem of both prisons and society.
Dramatic reductions in incarceration rates and the creation of a system of comprehensive health care in the U.S. for both privileged and poor alike will go a long way in helping the nation and, increasingly, other countries in the world turn the corner to a more humane and democratic future.
In addition to serving as a repository for carceral health care crises in the U.S. and around the world, the site will also continuously build a bibliography on the most up to date scholarly and social justice reports on issues relevant to carceral health care.
“I would argue that a social justice approach should be central to medicine and utilized to be central to public health. This could be very simple: the well should take care of the sick.“
-Paul Farmer (celebrated human rights physician and author of the outstanding book, Pathologies of Power)