Inadequate Health Care: A Significant Problem Affecting Incarcerated Women
BS ‘19, Public Health Sciences
May 30, 2019, Alumni, BS, Undergraduate, Advocacy, Child Health, Health Care Access, Health Disparities, Maternal Health, Pregnancy, Reproductive Health, Women's Health
The United States prison system is generally built on a male-specific model, leaving many correctional facilities significantly unprepared to meet the unique biological, psychological, and social health needs of women. This has a negative impact on the health of female inmate populations and presents a challenge that must be addressed.
Currently, there are approximately 219,000 women incarcerated in the United States (Kajstura, 2018b). This group represents the fastest growing inmate population in the US federal prison system and accounts for over 30% of the world’s incarcerated women (Kajstura, 2018a).
"A focus on trauma care, rehabilitation, comprehensive pre-release planning, and effective post-release case management may positively influence health outcomes and ultimately lead to decreased female prison populations and lower rates of recidivism."
Poor infrastructure, unsatisfactory prison living conditions, the possibility of physical or sexual abuse, solitary confinement, intimidation and harassment by correctional officers, inadequate trauma care, and restricted access to counseling services and social support are conditions that build upon one another and exacerbate negative health outcomes for female inmates. However, a focus on trauma care, rehabilitation, comprehensive pre-release planning, and effective post-release case management may positively influence health outcomes and ultimately lead to decreased female prison populations and lower rates of recidivism.
The Public Health Problem
The lack of access to quality health care for female inmates remains a serious issue as countless individuals continue to die or see their health status deteriorate while in prison.
For example, many federal prisons do not secure health care providers who are properly trained in obstetrics and gynecology, leading to decreased rates of screenings and erroneous interpretation of test results. Women who are at higher risk for preventable diseases such as breast and ovarian cancers are often not screened or have abnormal screening results that may go undetected (Weatherhead, 2003). Former inmates from the Women's Huron Valley Correctional Facility, the only prison in Michigan that houses women, confirm the claims that their health care needs were unmet by the prison system. They noted that access to health care was so nonexistent that it was known as “deathcare” among the inmates (Prison Birth Project at the University of Michigan, 2018).
Adequate family planning services and reproductive health care also remain significant issues within the federal prison system.
About 6 to 10% of female inmates in US correctional facilities are pregnant and many lack access to the necessary prenatal care, screenings, and social support required for a safe, healthy, and comfortable pregnancy and delivery (American College of Obstetricians and Gynecologists, 2011).
Data has demonstrated the importance of mother-infant attachment for infant development and maternal well-being (Goshin, Byrne, & Henninger, 2013). However, mothers who give birth while serving time are separated from their infants almost immediately following birth, leading to higher rates of postpartum depression and emotional trauma. This separation takes an emotional toll on the wellbeing of many women who are incarcerated and has been found to increase rates of re-entry into the prison system (Goshin et al., 2013).
Further, due to the fact that women are often the primary caregivers of their children, they are faced with the difficult task of maintaining and caring for their families during their imprisonment (Kajstura, 2018b). For individuals who do not have a spouse or relatives nearby, this often leads to the displacement of their children. This situation adds to the stress that many of the women already battle, not only while they are in prison, but also when they return to their communities.
Looking Toward the Future
Currently, the most basic health needs and human rights of women prisoners are not being met. This violation of rights, coupled with inhumane prison conditions, makes an already vulnerable population even more at risk for poor health outcomes. Providing a nurturing and rehabilitative environment is essential for female inmates and their long-term health. Prison reform that transforms a punitive-based system into one that focuses on trauma care, social support, counseling, educational opportunities, increased familial-bonding time, a greater allowance for early release, and meaningful post-release services, will significantly impact the wellbeing of many women, ultimately leading to better health outcomes, a decreased prison population, and lower rates of recidivism.
- American College of Obstetricians and Gynecologists. (2011). Health care for pregnant and postpartum incarcerated women and adolescent females. Committee Opinion No. 511. Obstetrics and Gynecology, 118, 1198-1202.
- Goshin, L. S., Byrne, M. W., & Henninger, A. M. (2013). Recidivism after release from a prison nursery program. Public Health Nursing, 31, 109-117.
- Kajstura, A. (2018a). States of Women's Incarceration: The Global Context 2018. Retrieved from https://www.prisonpolicy.org/global/women/2018.html
- Kajstura, A. (2018b). Women's Mass Incarceration: The Whole Pie 2018. Retrieved from https://www.prisonpolicy.org/reports/pie2018women.html
- Prison Birth Project. (2018, December 3). Panel hosted at The Intersections of Reproductive Justice and Mass Incarceration at the University of Michigan, School of Public Health, Ann Arbor, Michigan.
- Weatherhead, K. (2003). Cruel but not unusual punishment: The failure to provide adequate medical treatment to female prisoners in the United States. Health Matrix: Journal of Law and Medicine, 13, 429-472.
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ABOUT THE AUTHOR
Danya Ziazadeh is a 2019 graduate of the University of Michigan School of Public Health where she received a Bachelor of Science degree in Public Health Sciences. She is passionate about the field of global health and is interested in pursuing an MD/MPH. Danya is committed to improving access to quality health care, as well as reducing ethnic and racial health disparities as they relate to cancer outcomes.