7 April 2011
Issues in the Availability of Health Care for Women Prisoners: Problems in a medical system generally designed for men
If one were to rank population subgroups by the seriousness of their health problems, female prisoners would be located near the top of the totem pole. There is a growing amount of research that shows female inmates are likely to have more serious health problems than both women and men in the general U.S. population, largely because of chronic poverty, lack of access to medical care, and problematic lifestyles in prison. The health difficulties of inmates have long been a challenge. Nineteenth-century inmates in the prisons of the American West, for example, often entered these facilities with chronic health problems and bodies showing evidence of rough lives. Some had substance abuse problems and/or sexually transmitted diseases that were often in advanced stages before incarceration. Tuberculosis was also a considerable problem among prisoners confined in dank, unhygienic conditions and weakened by inadequate diets. Existing physical and emotional problems were aggravated by being incarcerated in prisons unsuited for women. Incarcerated women have more challenging health issues than general population women, due most likely to their increased exposure to poverty, insufficient nutrition, as well as substance abuse histories and a lack of knowledge about health generally.
Another significant factor is that few inmates had access to health care prior to their incarceration. This can be attributed to not being insured or coming from medically underserved areas. This translates into their having had little or no preventive care, and for those who are ill, having received care later in the course of an illness (if care had been received at all). As a result, many women bring untreated health problems with them to correctional facilities, including STDs, high blood pressure, asthma, and diabetes.
A review of existing studies reveals at least three main problems in accessibility to health care services for female prisoners. First, access to treatment for both general and drug related health problems is seriously limited. Today, female prisoners still receive fewer health care services in comparison to their male counterparts (AcocA, 1998). Second, the health care provided to women is often mediocre. It is largely an attempt to "catch up," in that considerable effort is often necessary to raise women's health status to legally acceptable levels (Maeve, 1999). Third, women inmates have reported prison medical professionals are under skilled, often withhold medical care, and show little care or concern for them or their needs (Fletcher, 1993). In fact, most lawsuits filed by women in prison are for complications in receiving medical services (Belknap, 2000). The fact that women constitute a small portion of the correctional population has been used to justify a lack of adequate programming and treatment for them (Belknap, 2000). This is especially true with regard to their health care. Overall, scholars report that effective health care for inmates is insufficient, particularly in preventive care (Belknap, 2000). Experts attribute to the inability to provide sufficient health care to inmates to a “systematic denial to women of parity of services readily and regularly available to incarcerated men”. The differences between men's and women's physical health conditions and needs are considerable, discrepancies observable in both free society and in correctional systems. For instance, Verbrugge and Wingard (Verbrugge & Wingard, 2000) found that women in the general U.S. population have higher morbidity rates from acute conditions, nonfatal chronic disease, and short-term