Examining American Prisoners and their health Essay Example

restraint as a fundamental principle. Through case studies involving interviews with two local men, I explored their experiences, beliefs, and health in relation to the intersection of male gender, poverty, and health. These case studies shed light on how the prison system affects individuals' wellbeing, opportunities in life, and overall health. It is widely acknowledged that our prison systems have significant flaws; inadequate healthcare further worsens the issue within a culture of abuse, hatred, and violence (Dyer, p.13). Life as an inmate is arduous by design; however it is essential to recognize that every individual deserves equal human rights and dignity.The American Justice system does not accurately represent fair treatment and often involves mistreatment and violence, leading to resentment. These negative aspects have serious consequences when combined with inadequate health conditions in prisons, as it increases the risk of new medical issues and worsens existing ones. Additionally, inmates are more vulnerable to life-threatening illnesses. It is crucial that inmates, who are human beings, are treated fairly and have their basic needs, including proper protection, fulfilled. However, the management of health and healthcare within the American prison system is insufficient and often lacking. The reasons behind this confusion in medical intervention inside prison walls may be influenced by the environment or the isolated society within American Prisons (Dyer, p.13, 2000). Moreover, our legislators' positions on these matters may also play a role. Various factors contribute to these disparities and it is important to consider if these problems can be resolved. Looking back at history reveals how our lawmakers' stances have shaped laws during significant changes like the Civil Rights Movement in the 1960s. The subsequent decades

saw prison expansion and the War on Drugs in the 1980s followed by private prisons emerging in the 1990s which created profit-making opportunities. Transformative changes have occurred in the American Criminal Justice system due to harsher sentencing laws such as three-strikes and truth-in-sentencing (Reiman P., 140, 1995).According to Samuel Walker's book Sense and Non Sense about Crime and Drugs, the justice system often makes decisions that lack sensibility. These decisions have resulted in a decrease in community service and substance abuse programs for nonviolent offenders, which has contributed to a larger prison population. As a result, private prisons have seen an increase in construction, now owned by shareholders who profit from incarcerating minorities and the poor (Dyer, p.4, 2000). Despite crime rates not significantly increasing, more individuals are being imprisoned due to their perceived criminal status creating unfounded fear of crime (Dyer, p.88., 2000). This false fear of crime has led to the passing of legislation aimed at increasing incarceration rates. Involvement with private prisons began in the early 1990s driven primarily by financial motives, with various corporations profiting from supplying products to prisons while treating inmates as captive consumers (Dyer, p.14.,2000). The false fear of crime discussed in Mander's Four Arguments for the Elimination of Television (1978) has caused America to rely on mediated experiences rather than direct experiences which leads to support for tough crime legislation even without an actual increase in crime rates. Furthermore, prisoners face unhealthy conditions that contribute to mental health issues such as depression and PTSD according to the World Health Organization (WHO).The prison population consists mainly of marginalized individuals, including those with poor health and untreated chronic conditions,

drug users, vulnerable individuals, and individuals engaged in hazardous activities such as drug use and sex work. These disparities in health are a result of societal inequalities like poverty, discrimination, and limited access to healthcare. Additionally, unstable communities and living conditions exacerbate these disparities. Overcrowding in prisons also increases the risk of infectious diseases like tuberculosis (TB). The lack of ventilation and prolonged incarceration further contribute to the spread of TB within prisons. Furthermore, delayed diagnosis, difficulties in identifying cases, and isolating inmates for treatment worsen the situation. In addition to these challenges, prisoners are more susceptible to population-based risks such as poverty, substance abuse, and past lifestyle choices (Stuckler et al., 2008). This issue is not limited to American prisons; according to the WHO, inmates in certain parts of Europe were found to be 84 times more likely than free civilians to have TB. Moreover, there is a common problem of failing to provide follow-up care for infected inmates after their release from prison. Stuckler et al.(2008) state that incarceration is likely contributing to the spread of TB epidemics. Mycobacterium TB bacteria cause TB primarily affecting the lungs.Transmission of pulmonary TB occurs when an individual with the disease coughs, sneezes, or speaks. Overcrowding and poor conditions in prisons can contribute to the spread of infectious diseases, as well as foster the development of various illnesses. These unfavorable conditions within prisons worsen health conditions and promote disease transmission (Stuckler et al., 2008). According to the World Medical Association (2000), inadequate sanitation, unequal nutrition, limited access to quality healthcare, and the prison environment itself pose a significant public health concern. This environment can have a profound

impact on individuals' perception of their future prospects. Two case studies conducted with African-American men in their mid-thirties who were both convicted of multiple felonies revealed their experiences behind bars. Em described his time in prison as dreadful due to constant noise that disrupted his sleep at night. Being separated from his freedom and family added to his hardship, while hearing about other prisoners being assaulted made him constantly vigilant. Em stressed the importance of caution in prison (Em, November 22, 2010).Despite the challenges he faced throughout his life, Em has shown resilience and intelligence. From a young age, he was raised by a single mother with four children on the Southside of Fort Wayne, Indiana, which meant dealing with limited resources. Surprisingly, Em does not fit the criminal stereotype despite experiencing abuse, hunger, and discrimination. These traumatic experiences have not adequately prepared him for society. Additionally, being born as a black man in 1976 further complicated his situation during a time when racial discrimination was still prevalent in America. Em's life choices have led to anger and frequent illness due to unsanitary conditions while in prison.

Moving forward to our next case study is Dee Felon, an African American who did not expect prison life to turn out as it did. Unlike his childhood dreams of becoming a doctor or firefighter, Dee's life has been challenging and authentic as we discovered in our initial interview. His story reflects both immense pain and happiness, highlighting his optimistic nature that derives strength from faith. Overcoming depression stands as one of Dee's achievements amidst adversity while facing daily struggles caused by limited resources. These two men share many

similar life experiences; they are brothers both in the African American sense and biologically related.One of the individuals admitted to feeling depressed and experiencing multiple cases of food poisoning while being held captive. Both men have memories of hopelessness, which could be attributed to the deteriorating urban areas in the south side of major cities. These areas are similar to war zones and greatly impact people's perception of opportunities, negatively affecting their mental well-being. This influence is comparable to that seen in actual war zones where soldiers face a higher risk of developing PTSD and depression. Additionally, those who have been incarcerated or labeled as criminals continue to carry the burden of stigma even after their release. It is important to note that there are alternatives available outside of prison as evidenced by the significant number of Americans on parole, probation, or behind bars. The culture within American Prisons operates within a dehumanizing system that lacks compassion for individuals solely based on their criminal status. Furthermore, inmates face inhumane treatment and unequal care under harsh conditions due to a lack of proper healthcare within these prisons. There are also individuals infected with AIDS behind bars who have little hope for receiving proper healthcare.In addition, physical abuse in prisons contributes to increased health problems among prisoners and generates significant stress, potentially resulting in psychological disorders. This stress is caused by various factors, including mistreatment similar to slavery that prisoners endure. According to the World Health Organization Europe (2003), being in prison poses substantial health risks, both physically and psychologically. Economic factors also play a role in physical abuse as prisoners are treated as slaves and receive

low wages due to their vulnerable situations. Furthermore, the prison environment fosters psychological abuse, increasing inmates' likelihood of developing post-traumatic stress disorder (PTSD) and depression. Even after completing their sentences, prisoners face societal stigma as criminals.

Upon arrival at the facility, inmates experience violence from unfamiliar guards who handcuff and shackle them while inflicting beatings. Some inmates endure extreme pain from being hog-tied and pepper sprayed, with guards reminding them of their location change from Colorado to Texas. Following this violent introduction, bewildered inmates are transferred to an old warehouse that has been converted into crude cells with bars covering former storage bays. The overcrowded prison cells create an unfavorable rehabilitation environment for all inmates regardless of their criminal classification (Dyer, 2000, p.199).The environment of prisons has led to the emergence of various mental health problems such as depression and PTSD (Dyer, 2000, p.46). These conditions are widespread among many Americans (Centre for Prison Studies, London, 2006; World Prison Brief). The prevalence of sexual abuse and rape within prisons also contributes to these concerns. Those who experience sexual assault are at a greater risk for depression, post-traumatic stress disorder, substance abuse issues, and suicidal thoughts (World Health Organization [WHO], 2002a). These statistics highlight the harsh reality faced by individuals who often enter prison with pre-existing mental illnesses that contribute to their incarceration.

Female prisoners have higher rates of self-harm and suicide compared to male prisoners and the general population (Palmer, 2007). Supporting this data is the WHO guide on health requirements for female inmates in Geneva (WHO, 2007), which provides further evidence. The Prison Reform Trust confirms these findings by stating that incarcerated women have a higher

incidence of mental health issues compared to women in society as a whole (Prison Reform Trust Bromley Briefing London May 2007 p14).

Depression is prevalent among individuals in the prison system. Symptoms include persistent sadness or irritability, changes in sleep and appetite, difficulty concentrating, physical slowing down or agitation, lack of interest or pleasure in activities, feelings of guilt and hopelessness.According to NAMI, individuals may experience recurrent thoughts of death or suicide along with physical symptoms like headaches and digestive disorders that do not respond to treatment. It is worth noting that women have a higher rate of depression than men. Additionally, mental health problems in prisons have significantly increased. Recent US federal statistics from the Bureau of Justice Statistics show that between 2000 and 2006, the number of prisoners with mental illnesses has quadrupled. Over half of all inmates now report mental health issues such as major depression symptoms, aggression, and psychotic disorders. These reported rates among inmates are up to five times higher than those among the general adult population, which can be classified as reaching epidemic levels. One common mental health condition among inmates is Post Traumatic Stress Disorder (PTSD). The symptoms of PTSD vary but generally fall into three categories based on an individual's experiences. The first category involves re-experiencing, where there are recurrent and intrusive memories or nightmares about the traumatic event. This can include flashbacks, hallucinations, and vivid sensations reliving the event. Some individuals may also experience significant psychological or physiological distress when confronted with triggers that remind them of the trauma.The second category of symptoms in individuals with PTSD is avoidance. This involves consistently avoiding anything that reminds them

of the traumatic event, such as thoughts, emotions, discussions, activities, places, or people associated with the incident. It may also result in a general lack of reactivity characterized by an inability to remember certain aspects of the injury and decreased engagement in previously important activities. Individuals may withdraw from others, have a limited range of emotions, and experience feelings of hopelessness about the future.

Increased arousal symptoms can also be present in individuals with PTSD. These include difficulty sleeping, irritability or anger outbursts, trouble concentrating, heightened alertness or vigilance, and being easily startled.

To properly diagnose and treat PTSD, it is necessary to seek medical attention. There are now several steps available for diagnosis. The American Journal of Psychiatry has published a convenient and brief test called the Short screening scale for DSM-IV post-traumatic stress disorder (Breslau et al., 1999) that can aid in this process.The test includes questions like "Did you avoid certain places, people, or activities to avoid being reminded of this experience?" and "Did you have trouble falling asleep or staying asleep after this experience?" Research has shown that PTSD is common in the population, with estimates ranging from 2 percent to 9 percent (Freudenberg, Nicolas 2001 Jails & Prisons and the Health of Urban Populations), especially among individuals who have experienced multiple injuries or traumatic events early in life. The risk of developing PTSD is even higher if these injuries occur over an extended period or are repeated. It's important to note that inner-city youths and recently immigrated individuals from troubled countries have a higher incidence of this disorder. A study titled "An Examination of Antecedent Traumas and Psychiatric Comorbidity Among Male Inmates

with PTSD" conducted by Gibson et al. (1999) reveals a significant prevalence of PTSD in prisons. The authors argue that addressing this issue requires new solutions, policies, and approaches. Additionally, women tend to experience PTSD more frequently than men. Considering all these health concerns, as well as the understanding that the increase in prison population is driven by social control and economics, it is essential to question who benefits financially from incarceration. It is as simple as examining how companies profit from prisoners.All of these companies share a commonality - they are major corporations that profit from prisons through contracts for inmate labor. This results in a captive workforce (Dyer, p.19, 2000) and requires prisons to maintain high occupancy rates to maximize profits. This also perpetuates a new form of oppression targeting minority groups. The text suggests that the most exploited group for financial gain represents a modern form of bondage. Dyer argues that this practice has become widespread (Dyer, p.9, 2000). The majority of America's prison population originates from impoverished urban areas primarily comprising minority citizens; thus, the prison population mirrors this inequality. According to Dyer (2000), by 1992, one out of every three young black men between ages 20 and 29 in the United States were under supervision within the criminal justice system. There is now growing recognition that prisoners have human rights which must be respected within prisons. Acknowledging health as an essential aspect of human rights inside correctional facilities is crucial. Enhancing prison conditions and fostering a positive environment can greatly impact the effectiveness of health interventions on society at large. It is imperative to find solutions addressing these health and

human rights concerns.
The health of prisoners is crucial for public health, making it necessary to improve their well-being to have effective public health policies. (Source: http://www.usdoj.gov/content/glance/tablebjs.ojps/cpracepttab.cfm). In conclusion, I believe that mass incarceration is both unjust and inhumane. Those who are imprisoned are not only strangers but also our own family members, friends, and neighbors. I suggest that the increasing imprisonment rate is unnecessary. The healthcare provided to prisoners impacts their families and communities; therefore, it should concern everyone. Additionally, tuberculosis (TB), besides being a serious threat on its own, can also spread within prisons due to existing diseases in such facilities. This leads to a higher number of individuals infected with TB and contributes to escalating epidemics. Furthermore, inmates face risks related to other contagious diseases as well as challenges to their mental health and overall well-being due to confinement. Many inmates experience mental illnesses like depression and PTSD upon release. It is vital to implement preventive measures, improve conditions in correctional facilities, and find real solutions for addressing these issues. The importance of American involvement is significant, requiring us to seek genuine solutions rather than constructing more prisons that exacerbate the problem.There are effective techniques and innovative strategies available for addressing the challenges within our Criminal Justice System.One example of successfully promoting community strength and engagement without relying on prison expansion is Project Safe vicinity (Klofas, Hippie & McGarrell, 2010, p.103).