Health Care in Prisons is Not Equal

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Many lack access to critical and preventive care

A new study by Cleveland State University is challenging the long held assumption that prisoners have easy and inexpensive access to health care resources during incarceration, and highlights the impact lack of medical access has on correctional facilities and the broader community. The findings, published in the peer-reviewed journal Criminology by CSU faculty member Meghan Novisky, indicate that medical services, including critical and preventive care, are widely divergent at different prisons and are based in part on inequalities related to economics, education, and social support. 

“Most prisons charge fees for medical services, offer limited resources to support dietary health and physical fitness and have few educational offerings to assist prisoners in making better health care decisions,” says Novisky, an assistant professor of criminology at CSU. “This leads to a situation where more economically secure and well-networked individuals can gain proper access, while others are left behind.”

Novisky argues the current negative state of health care for prison populations is a significant public policy concern given the increased costs of housing and caring for older and sicker prisoners and the strain that is placed on the broader health care system when these individuals are released, often with increased employment barriers and significant health problems.

“We are now dealing with some of the consequences of four decades of substantial prison population growth in the U.S. Prison overcrowding, in combination with the aging of the prisoner population, has significantly strained correctional budgets, leaving deficiencies in health care and health related resources for correctional populations,” Novisky adds. 

“Policymakers should specifically investigate options to use incarceration more selectively and to improve health care services and access. This will assist in meeting our stated long term goals to rehabilitate individuals, assist them in reentering society and lower risks for public health concerns such as the spread of infectious disease.”

For the study, Novisky spent 13 months conducting interviews focused on health and health‐care experiences with older prisoners residing in minimum, medium and super-maximum security state prisons. She interviewed a total of 279 incarcerated men, all of whom were 50 years of age or older. One finding of the research was that prisoner success with health care access was dependent on access to key prison-specific resources, such as commissary funds and employment opportunities. Ultimately, those without access to such resources during incarceration are at a higher risk for disparate health outcomes. 

Moving forward, she hopes to conduct additional research to expand the size and diversity of interviewees, and provide additional insights on the specific barriers these individuals face. She will also seek to advocate for specific policy reforms that can improve access and preventive care, while ensuring prisoners have the information and resources necessary to make better health care decisions.