Prisons aren’t exactly the shining stars of our health care universe; they are populated with people who in many cases did not have much access to care before they were booked, and who now live together in crowded, violent places where drug use and unprotected sex are often rampant. This reality is widely understood and, sadly, widely tolerated. What’s more, Contexts (Winter 2009) reports, ignoring the health and well-being of prisoners blinds us to the complexities of the “prison-health connection,” which affects inmates, their families, and the communities they return to after they are released.
“Former inmates, who already have a diminished social position because of their past, often suffer from long periods of unemployment, poverty, and marital instability—some of the best-known risk factors for poor health,” writes the highly readable sociological journal.
The stigma of incarceration, along with the various forms of “legally sanctioned” discrimination that differ from state to state, weigh heavily on an ex-prisoner’s mental state. And because a criminal record makes it nearly impossible to secure full-time employment, health insurance is significantly harder to come by, thus reducing the likelihood that former inmates (or their families) will receive necessary medical or psychiatric care. Additionally, because laws in some areas dictate where people convicted of certain crimes may or may not live, large populations of uninsured ex-inmates stress a community’s health care infrastructure, driving up expensive emergency room visits that force hospitals to raise prices and cut back in other areas of treatment.
There’s also “remarkable overlap between the psychological symptoms experienced by ex-prisoners and those experienced by their children,” according to Contexts, and “many children of inmates report symptoms of posttraumatic stress disorder, including hypervigilance, anxiety, and even flashbacks of their parents’ arrest.”
The problem with complex social issues, of course, is that they require complex solutions. Contexts suggests focusing broadly on “the transition from prison to home,” including a compelling proposal to integrate health and counseling into the country’s already “mature” parole system. “Of course,” the magazine clarifies, “improving reintegration also necessitates creating real opportunities for former inmates.”