Running head: PRISONERS AS A VULNERABLE POPULATION 1

Prisoners as a Vulnerable Population

Jessica Crumpler

Bon Secours Memorial College of Nursing

November 5, 2015
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Introduction

Vulnerable populations are at great risk for harm in society and are often those with the

least social capital. Risk encountered by the vulnerable are generally not voluntary or under their

control. The more risk encountered, the more vulnerable a person or population becomes

(Anderson &McFarlane, 2011). This small exert from a textbook speaks volumes to me,

especially when it comes to the topic of prisoners. Prisoners are no ones fight. There are no

Save the Prisoners campaigns. One might even ask themselves, when the last time they had a

concerned outlook on the life of a prisoner was. Many people will answer this question with a

never. Maybe thats okay, they werent any good to society anyway, right? They didnt care

about fitting into society in the first place; drugs would indicate that they didnt even care about

their own health, so we shouldnt either, right? WRONG! The life of a prisoner does matter, for

two big reasons. Some may agree with both, others only one, and thats alright as long as we

create a way to solve some of the issues that are plaguing this vulnerable population. The first

reason to care is that prisons are a petry dish for disease, mental illness, and financial instability.

The second reason is when these prisoners make parole, they will bring their belongings out into

the world with them. This includes their diseases, their mental illness, and their financial

instability. If we as the outside society helped to alleviate the issues within the prison systems,

then we would also be saving the whole of American society from those same issues and who

knows, maybe even the world. This sort of intervention could also be implemented in prison

systems all over the world. A focus on the prisoners is ultimately a focus on the health and safety

of everyone.
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Social Determinants of Health

There are many issues that arise from prisons. A few of the main, seemingly modifiable

ones are disease, mental illness, and financial instability. These factors are rampant among

prisoners; when these prisoners are released back into the community, the people closest to them

are the ones that are affected most. Communities with strong social ties to the inmates that have

been released will have increased rates of infectious diseases among family members, neighbors,

and friends (Wakefield &Uggen, 2010). Tuberculosis, HIV, and Hepatitis C are among the most

likely infectious diseases to obtain in a prison. Because many prisoners have been incarcerated

for drug related issues, the likelihood of Hepatitis, HIV, and other diseases related to intravenous

drug use coming into the justice system is highly likely. In 2010 51% of inmates were serving

time due to drug related offences (Guerino et al., 2011). Promiscuity or sexual relations within

the prison is the biggest cause for the spread of these diseases. Other reasons for the spread

would be inner prison tattooing, drug smuggling/ use, and the use of hand made weapons. Over

crowding is the reason for the spread of tuberculosis. When gathering data for 2010, 35% of the

cases of TB in the U.S., 13% and 17% of HIV/ AIDS illnesses in the U.S., and 29% of Hepatitis

C illnesses in the U.S. were all inmates having served or are serving time in the prison system

(Wakefield &Uggen, 2010). Treatment for these illnesses are expensive, but some prisons

provide them to the inmates. Upon leaving the correctional facilities however, the treatments

stop.

Due to the high rate of physical illness and just being in prison in general, many prisoners

are with dangers and risks; because of this they develop cases of PTSD and anxiety. Other
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prisoners are incarcerated due to events caused by their mental illnesses, such as schizophrenia

and psychosis. For some, mental health treatment measures are taken using therapy and

prescription medications. However, this is expensive and can lead to sharing of prescriptions and

even dependence. When the prisoners have finally served their time or are released for good

behavior, they no longer can afford to receive medical care, and their mental illness comes back

full force. Reentry into the prison system then occurs. An estimated 56% of state prisoners, 45%

of federal prisoners, and 64% of local jail inmates self-report having mental illness, yet as few as

26-39% of those documented psychiatric conditions were receiving medications at the time of

their arrest. After incarceration, only 46-69% were eventually treated. (Springer et. al., 2011).

Another reason for entry and reentry into the prison system is the lack of education. In

fact, 45.1% of male inmates between the ages of 20-40 were high school drop outs. These

prisoners did not have much of an income before arrival, and certainly do not have a significant

amount of money coming out of the prison system having only made somewhere between $0.23-

$1.15/hour on average while incarcerated. Many of the inmates accrue debt due to an order for

child support that has not been paid while incarcerated. Due to the need for money, the return to

a life of crime such as drug dealing where the income is high and untaxed, causes the former

prisoner to return to the system upon being caught (Wakefield &Uggen, 2010). According to the

World Health Organization (WHO), education, physical environment, support networks, gender,

health services, and economic status, all play a huge role in the health determinants of a person.

Prisoners are at the low end of this spectrum in all ways, which has inevitably led to their life

styles and incarcerations.

These prisoners need a to be provided a way to decrease their likelihood of contracting

disease, help with their mental illness, and some form of financial relief.
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Evidence-Based Interventions Addressing Health needs

There is a tremendous amount of funding that goes into prison systems, it is evident that

the programs that help the prisoners with their health disparities work as long as they are being

implemented. It is also evident that these programs need some adjustments. For instance,

educational programs for prisoners while serving their time, requiring them to get a GED and

even teaching how to manage and accrue money, would likely give the prisoners a new sense of

belonging to society; as well as the ability to get a job once out of the system. Since most

employers want at least a high school diploma, education would help bring up the ability to not

only get a job but potentially stay out of trouble. If an ex con has a job, then he may not need to

be on the street selling drugs. This will decrease the number of infected needles on the streets,

thus leading to less infection in the community. The job will also give the former prisoner a new

sense of self worth and they will be able to begin paying off their debts. Given the history of

reentry into the prison system, it would also be a good idea to have strict check in appointments

and drug testing. There should be a program that helps these people find jobs, and any other

services they may need, like prevention programs.

The Millennium Development Goals (MDG) that correlate to this particular vulnerable

population are: Goal 1. Eradicate Extreme Poverty and Hunger, Goal 2. Achieve Universal

Primary Education, and Goal 6. Combat HIV/AIDS, Malaria, and Other Diseases (Anderson

&McFarlane, 2011). If Goal 1 was met then the need for money for material things and food

would decline, and more people would have at least the basics. If Goal 2 was achieved then the

increase in education level would enable more people to get jobs, thus helping with Goal 1s

achievement. Meeting the requirements to reach Goal 6 would mean less of a prevalence of
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these diseases, and healthier people not only in prison, but in communities all over the United

States.

Global Approach in Addressing Health for All

Reaching MDGs in America is probably easier than meeting them in other countries

such as Russia, Africa, or China. It is important however to try to globalize the solutions to

prisoner health and well being as a vulnerable population. If prison systems globally were

provided the explanation of how helping the prisoner is ultimately helping the rest of society,

then more doors may open to reaching our MDGs. The teaching for education in the prison

systems would be significant in every way. The enforcement of check-ins and preventative

programs would also be a significant factor in reaching the goals. The continuous monitoring

and treatment of mental health and other illnesses is vital in protecting the outside population,

even if it came down to separating the prisoners by illness to help with eradicating the spread of

disease. If these methods were instituted and practiced, there is no telling how many people

would be saved, protected, and even cured from issues dealing with education, poverty, disease,

drugs, etc. among the prison systems and ultimately the entirety of the global population.

Conclusion

In conclusion prisoners should be everybodys fight, and a Save the Prisoners

movement should be established. Because ultimately it is a Save Humanity movement. The

eradication of disease, mental illness, and financial instability among the prison population, will

trickle down into the education and drug use factors of prison life too. Eventually maybe all

prison issues can either become less significant or completely disappear. Either way, society will

reap the benefits. Less prisoners and more education will mean less disease, less poverty, less
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drugs, and less crime. Better treatment for disease and mental health will also put a tremendous

dent in the issues plaguing prisoners and society. If these ideas are honed and implemented

globally, then they would make a significant impact on the world.

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References

Anderson, E.T., McFarlane, J. (2011). Community as a partner: theory and practice in nursing

(6th ed.). Philadelphia, PA: Lippincott Williams and Wilkins. pg 7-9 & 94.

Springer, S. A., Spaulding, A.C., Meyer, J.P., Altice, F.L. (2011). Public health implications for

adequate transitional care for HIV-infected prisoners: Five essential components.

Invented Article HIV/AIDS, 53, 469-476. DOI: 10 1093/cid/cir446

Wakefield, S. and Uggen, C. (2010). Incarceration and stratification. Annual Review of

Sociology., 36, 387-406. DOI:10.1146/annurev.soc.012809.102551

Guerino, P., Harrison, P.M., and Sabol, W.J. (December, 2011). Prisoners in 2010. Retrieved

November 3, 2015. http://www.bjs.gov/index.cfm?ty=pbse&sid-32

Health impact assessment (HIA): The determinants of health. (2015). World Health

Organization. http://www.who.int/hia/evidence/doh/en/