American Prisons; A Public Health Crisis

prison hosp

update 9/8/15 > Regarding Mumia Abu-Jamal: In August of this year Mumia learned that he has active Hepatitis C…he also discovered that unbeknownst to him he has been Positive with HepC  since 2012. It is very likely that Mumia’s continued severe health crisis is due to HepC. The Pennsylvania Dept of Corrections is refusing to treat Mumia. There are reportedly over 10,000 inmates in Pennsylvania with HepC that are also being refused treatment. HepC Treatment that brings a high rate of cure is available but costly. However treating Prisoners will reduce the incidence of HepC  not only within Prisons but also throughout  the Country. > http://fivethirtyeight.com/features/eliminating-hepatitis-c-means-treating-prisoners/
update 6/6/2015 > Regarding Mumia Abu-Jamal, his health has improved, however both his Constitutional and Human Rights continue to be violated as do the rights of another Inmate who asked prison officials to help Mumia during his health crisis. Very sadly ALL Lives do NOT matter in America!  > http://wp.me/pTjOC-6SL

“We are all potential criminals, and those who we put in prison are no worse, deep down, than any of us. They have succumbed to ignorance, desire and anger, ailments that we all suffer from, but to different degrees. Our duty is to help them recover.”… The Dalai Lama

The current abysmal medical/healthcare neglect of Political Prisoner Mumia Abu-Jamal housed within the Pennsylvania State Penal System brings to light the torturous conditions that are in place within all forms of Prisons in the Untied States, be they Municipal, State, Federal, Private, Immigrant Detainment Centers, and others. With an estimate of over 2 million Individuals residing at various prison facilities, this indeed is a Public Health Crisis. To understand this better let’s look at those who are currently housed within the American Prison System. Please be aware that actual Guilt or Innocence of an individual does not contribute to making this Crisis of Healthcare worse. EveryONE in Prison is treated Guilty no matter what the crime or circumstance. Please also keep in mind that those who are on probation, parole, house arrest or other community surveillance programs are under duress and due to repeated criminal activity OR at the whim of policing officials may become re-incarcerated thus increasing the in-prison population. In many States ex-prisoners are denied public assistance in the way of medical care, food stamps, housing, and employment opportunities thus making a return to prison a more likely possibility. This alarming statistic really brings home the potential of a worsening threat to Public Health >*An estimated 6,899,000 persons were under the supervision of adult correctional systems at yearend 2013 http://www.bjs.gov/index.cfm?ty=pbdetail&iid=5177. ***this does NOT include those (under the age of 21 & not tried as an adult) in Juvenile Detention Centers.

  • Trying to get accurate statistics is nearly impossible on age and race of prison inmates. Ages within adult facilities range from 18 (and below) to 80+ (and above) years old. Non-statistical sources suggest that spending time in prison ages an individual by at least 10 years. As far as race goes White, Black, Hispanic, and Other are used on government sites. Native Americans and Asian Americans are not specifically noted but a part of “Other”. By the nature of the beast…accuracy and accountability are not treated as important.

  • Prisons are a hotbed for any type of Contagious/Infectious Disease. Again statistics are not accurate or current. For those with *HIV/AIDS all that can be accurately said is that the rate of infection in Prison is higher than in the general population. *Hepatitis C is also at a higher rate in prison populations than in the general populace. Here statistics are a bit more timely and this rate is said to be 1 in every 3 individuals within the prison population are infected > http://www.cdc.gov/hepatitis/HCV/PDFs/HepCIncarcerationFactSheet-BW.pdf. *Tuberculosis once almost totally eliminated in America has been making a steady rise due to increased poverty and homelessness. This will of course prove to be seen in higher numbers within the prison population at some point in the future. Other “everyday” contagious illnesses such as flu, pneumonia, etc also run rampant within prisons across America. The bottom line here is that any contagious/infectious disease seen within communities is also seen in prisons and due to overcrowding conditions the impact is far worse.

Of significant importance are Individuals within Prisons who have chronic illnesses and those who are Aging. With the population boom in prisons within the past few decades many individuals entered into the Penal System with existing chronic physical and mental health issues. Others due to the prison environment (poor nutrition, unsanitary surroundings, isolation/solitary confinement, stress and more) developed their chronic illnesses while inside. As stated previously inmates in prison age quicker than persons in the general populace thereby making their chronic health issues more intense. Intrinsic to many forms of chronic health conditions is the fact that there will be acute episodes of prevalent illnesses and often the establishment of other chronic health concerns; very few chronic illnesses exist alone, they become entwined with others. Medical/Healthcare within Prisons is not a Public Health Priority and thereby makes the problem even worse. This apathy is born in part due to the lack of current information on the subject. One such Survey on the subject was done in 2002 and 2004 and published in 2009 > http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2661478/ (please note here that “jails” are separate from prisons). In another survey based on stated incomplete data, what medical conditions rank the most prevalent falls into question but still it acquiesces to the fact that prison populations do indeed suffer from [some] chronic medical/health conditions at a higher rate than the general population. http://societyofcorrectionalphysicians.org/corrdocs/corrdocs-archives/winter-2010/chronic-medical-diseases-among-jail-and-prison-inmates In one other survey published in 2015 from findings a few years previous it is obvious that the medical/health problems of Prisoners continue. http://www.bjs.gov/index.cfm?ty=pbdetail&iid=5219  Particularly of interest in this survey is that it states More than half of prisoners (56%) and jail inmates (51%) said that they were either very satisfied or somewhat satisfied with the health care services received since admission.” In non-survey situations Inmates along with their family, friends, and supporters speak more to the dissatisfaction with medical/health treatment. *Please note while surveys can give a glance of what is seen within the Prison population, they do not convey the true story; no type of survey does this for whatever subject it examines. What is glaringly obvious with or without surveys is that as in the general populace, chronic physical conditions that plague inmates for which medications and other interventions are of necessity include diabetes, hypertension, asthma, and virtually any chronic illness that affects the rest of the population — medical/healthcare treatment for these conditions is lacking. *Although not a chronic illness, pregnancy exists within the female prison population and appropriate care is also lacking and should be of the utmost necessity.

Under the 8th amendment of the United States Constitution, Prisoners, regardless of where they are detained are mandated to receive adequate Medical/Healthcare with access to accessible treatment. https://www.aclu.org/files/assets/know_your_rights_–_medical_mental_health_and_dental_july_2012.pdf  Additionally each State has their own laws and regulations regarding their State Prison Systems.

Although legal mandates for adequate medical/healthcare exist within Federal and State Constitutions that does not mean that these mandates are followed. Over population, budget constraints, cost containment, reduction in staff along with apathy, prejudice, and politics all contribute to a lack of appropriate compassionate medical/healthcare for Inmates. Within the 2012 Federal Bureau of Prisons Clinical Practice Guidelines for Management of Diabetes it states, “Clinical guidelines are made available to the public for informational purposes only. The Federal Bureau of Prisons (BOP) does not warrant these guidelines for any other purpose, and assumes no responsibility for any injury or damage resulting from the reliance thereof. Proper medical practice necessitates that all cases are evaluated on an individual basis and that treatment decisions are patient specific. http://www.bop.gov/resources/pdfs/diabetes.pdf. Guidelines not withstanding no matter what type of Prison or Detainment Center, time and again reports from Inmates to family, friends, supporters (and integrity-driven Internet media) along with the infamous Prison Grapevine paint a picture of medical negligence, abuse and indifference. Those who have had or currently have a Loved one in Prison understand all-too-well.

For those with Chronic Mental Health Issues (including substance abuse, various psychiatric illnesses, developmental disabilities and physical illnesses with varying mood-altering behaviors, etc) medical/healthcare within prisons is virtually non-existent. Very sadly and disturbingly so as Community resources for Mental Health are cut from budgets those with mental health issues fall between the cracks and far too often end up within Federal and State Penal Systems — prisons have become the “new” (non)treatment centers for Mental Illness. The following gives a fairly in-depth discussion on Mental illness and the Prison System > http://tacreports.org/storage/documents/treatment-behind-bars/treatment-behind-bars.pdf.  Although outdated the following looks at the cost of incarcerating those with Mental Illness. > http://www2.nami.org/Content/NavigationMenu/Inform_Yourself/About_Public_Policy/Policy_Research_Institute/Policymakers_Toolkit/Spending_Money_in_all_the_Wrong_Places_Jails.pdf

This somewhat lengthily dissertation brings us back to the grave situation of Mumia Abu-Jamal. His current well-publicized medical/healthcare crisis has provided a closer look at the inequities of medical/health treatment for Prisoners. After reading a description of Mumia’s symptoms from a number of reliable sources and connecting with a friend of his family, it is unfathomable that appropriate lab work did not reveal his onset of diabetes. Then again, perhaps appropriate labs were obtained but their results may have been discounted or ignored. Lab work aside just physically looking at his skin condition, noting changes in body weight and demeanor, acknowledging his vital signs, reported levels of pain and other symptoms, it should have been clear that he was in serious physical distress. The following are a more in-depth report on Mumia’s Health Crisis > http://www.democracynow.org/2015/3/31/mumia_abu_jamal_moved_from_prison?autostart=true&get_clicky_key=suggested_related & http://thiscantbehappening.net/print/2716 & http://www.bringmumiahome.com/  Obviously SomeONE or SomeONES were not doing their jobs either because of their own ineptitude or because of political pressure from the State of Pennsylvania and others. Because of Mumia’s high profile as a Political Prisoner (which the United States Government does not acknowledge), his life while in Prison has been an open book. For those unfamiliar with his case please go to > http://www.freemumia.com/who-is-mumia-abu-jamal/ (site under construction at present). Is the life of Mumia Abu-Jamal worthy of appropriate medical/healthcare? Most definitely YES; this is his Constitutional, Legal, Civil and Human Right! It is also the right of EVERY other incarcerated individual within the borders of the United Sates of America and its Territories (including Guantanamo Bay and other US Military Prisons).

The current discussions of Prison Reform center on cost reductions and the over-burden of Prisoners incarcerated due to America’s failed “war on drugs”. There has been some mention of the Aging prison population, but then again this is in reference to non-violent “drug crimes”. Reducing sentences and Pardoning/Commuting Sentences has been a well-received way to reduce prison populations and reduce cost. However it is very disturbing that there is no mention of those wrongfully imprisoned such as Mumia Abu-Jamal (due to bias/prejudice/racism and malfeasance by Police, Public Defenders & Prosecuting Attorneys, Judges, Juries, Politicians and Agents within both Federal and State Justice Systems) who have not been incarcerated under the “drug war” umbrella. Within the past few years we have seen innocent men released from prison….but this has been after they have spent 20+ years of their lives as virtual “dead men walking” inside prison walls. Why has the discussion of Prison Reform ignored this? Why has the discussion of Prison Reform ignored the plight of EVERY Prisoner’s Medical/Healthcare needs? In every way shape and form the United States of America’s Prison Systems constitute a Public Health Crisis that MUST be addressed at multiple levels.          

In Closing….. “to willfully neglect, refuse to administer or procrastinate giving humane medical treatment and healthcare to prisoners is torture. So too is withholding needed treatment and care for political and bureaucratic reasons. I refer you to the United States Constitution, the United Nations Declaration of Human Rights, the United Nations Declaration on the Rights of Indigenous Peoples, the United Nations Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment and to the Geneva Convention; although the Geneva Convention refers to War, prison in my mind is War (BFW)”.

Respectfully I thank you for your time and consideration.

In Peace.

Bonnie F. Walker, RN, BS, LNC  

With appreciation to Annette Howell & Moorbey for their constructive feedback.

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9 thoughts on “American Prisons; A Public Health Crisis

    • Thank You so much Moorbey. In the medical profession both abiding by a moral code of ethics and accountability are essential in the practice of GOOD Medicine. Respect & Love

      • What are u thanking me 4, I did not do anything. And besidez the ‘Code of Ethicz” and accountability there iz 1 important thing to know right from wrong which we were all taught az children and then reinforced az young adultz.

  1. Pingback: Slow Genocide in American Prisons thru Medical Neglect & Indifference | Speaking With A True Heart

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