Correctional Facilities: Healthcare

May 5, 2017

Prepared by Valeria Leon

Introduction

Correctional facilities are an industry that is consistently growing as mayhem across the nation is
increasing. A major player in this industry is healthcare and how it is being distributed to all
inmates. This document provides a better understanding of the various aspects of health care
within correctional facilities and how it has been changing. Below you will find information on
health care rights, juvenile health risk behaviors, common diseases, and addiction treatments
within correctional facilities.

Industry Overview

The correctional facilities industry encompasses all types of prisons and juvenile detention
centers across the nation. This industry in 2016 generated 5.3 billion dollars in revenues
(OHollaren, 2016). This is an enormous amount of money that is being generated by
correctional facilities, and which we can infer means that crime rate in our nation is high.
According to OHollaren (2016), crime rate is projected to fall 0.1% and incarceration rate 0.5%,
officials hope this will mean it will reduce the overcrowding in these facilities.

The graph below shows the given percent change during the years of 2008 through 2022. As one
can see since 2008 the percent changes in the industry's revenue has had many ups and downs.
From 2014 to 2016 there was a major change in revenue decreasing from about 10% to almost
0%. According to OHollaren (2016) the projected increase in 2016 alone was 0.2% after the
Department of Justice (DOJ) announced that they were reducing their alliance with private
prison contractors. The Department of Justice deciding to not aid private prisons came after a rise
in criticism that these private corporations were violating human rights and mistreating inmates
at these facilities. This move by the DOJ to stop their alliance with private prisons will affect the
industry by having a lasting effect on its revenues and growth.
Healthcare Rights in Correctional Facilities

Healthcare in the United States is an infamous topic that is constantly being questioned. With the
United States having the highest incarceration rate in the world, its correctional facilities are not
left behind with this heated topic. Care delivered to the incarcerated disproportionately impacts
the poor, people of color, and those with behavioral health problems (Venters, 2016, p. 613).
This is one of the many reasons why people disagree with the quality of healthcare given to
inmates. Health care is a legal right for inmates to receive, meaning they cannot be denied care in
these correctional facilities. Even though this is a legal right it does not imply that it is executed
or distributed equally. Minorities at these facilities as shown by the quote above suffer from a
lower delivery rate when treating their behavioral health problems.

The large population of inmates at correctional facilities are suffering from some type of disease,
such as mental health, behavioral problems, addiction and HIV, to name a few. After examining
this demographic, it was found that non-white, low income, undereducated people were the ones
that were associated with poor health (Macmadu, 2015). This is largely due to where these
inmates are from when determining the poor health problems that they face. Having various data
on correctional facilities with inmates that suffer from these problems and them not having
enough funds result in nationwide criticism. Criticism of correctional facilities on their
inappropriate treatment of inmates suffering from these diseases is a major reason why this
industry is constantly looking for ways to improve this problem.

Most public health models while effective outside of these correctional facilities, do not always
function the same once at one of these facilities (Venters, 2016). However, according to Venters
(2016) some states have altered their Medicaid eligibility plan to include people who experience
short term incarceration. This is because usually correctional facilities treat inmates with small
problems instead of major ones due to their lack of funding. Others that suffer from greater
addictions or diseases are usually not treated correctly because correctional health care officers
do not have all the necessary resources to treat these patients.

Correctional facility administrators are the ones that have the responsibility to look for ways for
their short-term inmates Medicaid can be suspended rather than taken completely. During the
two weeks that follow release from prison, people are 13 times more likely to die than members
of the general population (Macmadu, 2015, p.65). When these peoples health care is taken
away it is difficult for them to obtain it again after release. The usual causes of recently released
inmates deaths are overdose, cardiovascular disease, homicide and suicide (Macmadu, 2015).
This is largely because before going to prison they were addicts or had behavioral problems, and
once released they went back to their old ways, since they did not receive additional addiction or
behavioral healthcare. Many believe if the proper healthcare is provided at these facilities, then
these once corrupt members of society will want to improve their lives after release.

Juvenile Health Risk Behaviors

Juvenile correction facilities are also a major part of this industry. According to Haidula (2016),
it was reported that 2,187 inmates were under 30 years and about 60% were young people. These
are shocking numbers to many and is one of the reasons that helping our youth who may have
committed a crime and helping them shape into better people through detention facilities is
something that people find important. A research study was administered by the National
Commission on Correctional Health (NCCHC) along with the Center for Disease Control (CDC)
to obtain background on juveniles in detention facilities and their health risk behavior (Morris,
1995). Through this survey, it was found that risky behavior starts around 15 years of age. With
the intent of making juveniles answer questions more comfortably, a questionnaire and
anonymity was used. Many of the juveniles at correctional facilities do not reach out for help on
their behavioral problems or health problems because many are scared to say anything. This
study showed that the large percentage of our juveniles are undereducated in the areas of how
diseases such as STDs are contracted (Morris, 1995). This is a major problem because if the
mission is to lower the percentage of youth with diseases such as this one it is important that they
are well educated.

Once at the correctional facilities if these juveniles are not provided with the necessary treatment
or education then they will not be able to improve themselves. This study as well detailed that
most of the juveniles at these facilities were suffering from substance abuse, gang involvement
and interpersonal violence was frequent (Morris, 1995). In conclusion juveniles of both sexes at
a correctional facility in all areas have high rates of risky behavior making them more exposed
and vulnerable to disease and injury. It is possible that this rate can be lowered if correctional
facilities make healthcare easier to obtain, and as well have the necessary funds to treat all
inmates.

Overview of Healthcare

As mentioned healthcare given in correctional facilities is not the same as the healthcare other
citizens receive. In the past many people did not view inmates as part of society which is why
they did not pay attention the type of healthcare they were receiving. Healthcare providers at
correctional facilities often involved untrained nurses and unlicensed former military corpsmen.
With the Supreme Court case of Estelle v. Gamble, it determined that inmates had the legal right
to receive healthcare and not be unfairly treated (Anno, 2004). With the passing of this case it
forced correctional facilities to improve their health care services and began to treat inmates that
had serious medical needs that often-included psychiatric needs. These facilities were forced to
make a change to avoid serious backlash from the nation.

Today this system has for the majority stayed the same, but it resembles the standard health
system in place. The major difference is that today all inmates are checked by licensed healthcare
providers and physicians (Morris, 1995). Correctional facilities are more precautious when it
comes to infection control, even if they lack the sufficient equipment (Bick, 2007). The majority
of these facilities are mentioned above do not have enough funding to effectively treat all
inmates. Also, the quality of care is always difficult to determine because it changes through
each facility. However, it is widely known that it is certainly not up to par with community
health care quality. Also, the inmates that are often overlooked or not treated are those who
suffer from mental health issues.

In specific states correctional facilities are audited, for example in Nebraska their medical care is
audited every three years. The American Correctional Association (ACA) leads these audits by
sending teams for three days to a facility (Mabin, 2000). By spending three days their teams can
assess the facilities healthcare capability by examining hundreds of different standards. To
improve a facility's healthcare, the ACA is now requiring a healthcare professional to be part of
the audit team (Mabin, 2000). By including a medical professional, the ACA can assure that the
correctional facilities are in fact following all regulations.

Some ways that the quality of care can be improved would be by hiring healthcare staff that are
well educated on how to treat inmates with these diseases (Venters, 2016). The staff needs to be
able to sustain difficult patients and must be driven to provide good care to inmates. This
attention to detail would help reduce the amount of disease found in inmates and largely improve
quality of care. Another form would be for correctional facilities to find ways to obtain more
funding so they can adequately provide healthcare to more inmates and treat them properly.

Summary

The correctional facilities industry is a huge industry that is growing everyday as crime rates
increase. They are often overlooked because they house criminals and other offenders, but the
quality of healthcare these people receive is nonetheless a concern for policy makers. As shown
above the quality of healthcare given compared to the amount needed is vastly different. Inmates
are suffering from all types of healthcare problems and diseases, most of which are not being
treated, especially minorities of low income. Overall, the industry is changing every day and
healthcare policies will continue to change with the industry.
 References

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Bick, J. (2007). Infection Control in Jails and Prisons. Clinical Infectious Diseases, 45(8), 1047-
1055. Retrieved from JSTOR database.

Haidula, T. (2016). Majority of Prisoners are Youths. The Namibian (Windhoek). Retrieved
from LexisNexis Academic database.

Mabin, B. (2000). Prison medical care audited every 3 years. Lincoln Journal Star. Retrieved
from LexisNexis Academic database.

Macmadu, A., & RICH, J. (2015). Correctional Health Is Community Health. Issues in Science
and Technology, 32(1), 64-70. Retrieved from JSTOR database.

Morris, R. Harrison, E. Knox, G. Tromanhauser, E. Marquis, D. Watts, L. Health risk behavioral

survey from 39 juvenile correctional facilities in the United States. Journal of Adolescent Health.
December 1995. Elsevier. Retrieved from Google Scholar database.

OHollaren, K. (2016, November). IBISWorld Industry Report 56121. Correctional Facilities in

the US. Locked up: Public outcry has forced some facilities to close, damaging revenue.
Retrieved from IBISWorld database.

Venters, H. (2016). A Three-Dimensional Action Plan to Raise the Quality of Care of US

Correctional Health and Promote Alternatives to Incarceration. American Journal of Public
Health, 106(4), 613-614. Retrieved from EBSCOhost database.