Writer: Lina Raouf
Editor: Sim Khanuja
November 24, 2023
If you do not already know someone who has been or is in the criminal justice system, chances are you will at some point. With 1 out of every 20 people serving time during their lifetime, the United States has the highest incarceration rate in the world according to the U.S. Department of Justice (Alsan et al., 2023 & Bonczar et al., 1997).
The American criminal justice and healthcare system are two of the most important co-existing components in society. This being said, there have been many legitimate criticisms at the local, state, and national levels. Although their shortcomings can be discussed at length, I will focus on a more niche subject that is often overlooked: the relationship between racial and ethnic health disparities and the criminal justice system.
The constitutional right to correctional health care was a result of the 1976 Supreme Court decision in Estelle v. Gamble. The ruling stated that not providing incarcerated individuals with sufficient medical care if they have serious medical needs due to “deliberate indifference” is a violation of the Eighth Amendment’s “cruel and unusual punishments” clause. However, the conditions that are considered cases of “serious medical needs” vary. Shockingly, medical malpractice, negligent treatment, and undiagnosed conditions are not interpreted to be cases of serious need by the court, which is extremely problematic and cause for concern (Alsan et al., 2023).
Apart from the challenges related to healthcare in the incarceration system, the disproportionate likelihood of people of color being incarcerated compared to their white counterparts is also a cause for concern. According to a report from the D.C.-based research center ‘The Sentencing Project,’ Wisconsin has the highest rate of imprisonment of Black people in America (Rezal, 2021). Individuals who are incarcerated are already at risk for poor health outcomes. The reason for this is that people who are incarcerated are also disproportionately low-income, having a median annual income that is 41% less than those who are not incarcerated (Camhi et al., 2020). Lower-income individuals are more at risk for poor/adverse health outcomes as they are more likely to face challenges such as securing health insurance and affording medication, among many other difficulties (Khullar & Chokshi, 2018).
Since individuals who are incarcerated are people of color who are excessively at risk for poor health outcomes before serving time, the treatment they receive during their time in the criminal justice system is crucial. As stated above, although providing medical care to inmates is the law, health professionals who work in correctional cases are not required to treat all cases. Further, the quality of care at such facilities is low-quality, difficult to access, and expensive (Initiative).
As a result, the health of inmates, especially people of color, is likely to worsen while they are in the system. The Journal of Health and Social Behavior reports that individuals record more chronic health problems after their incarceration compared to before. The authors of this report considered already existing chronic health problems before incarceration. This enabled them to demonstrate that their health status declined directly because of their incarceration period (Schnittker & John, 2007). Additionally, incarcerated individuals excessively suffer from infection and stress-related diseases (Massoglia et al., 2011). If these facts don’t seem convincing enough, what about the fact that mass incarceration has shortened the overall U.S. life expectancy by five years (Initiative)?
There needs to be more of an effort to investigate the healthcare system within the criminal justice system, including recording the structure of, process within, and outcomes of this system (Bellass et al., 2022). The collection of more data increases the possibility of creating and implementing more effective policies to target this issue and decrease health inequities for incarcerated individuals. This issue must receive more attention from politicians, as not doing so poses the risk of disparities being further perpetuated.
The Department of Justice claims that it is guided by four core values, including “respect for the worth and dignity of each human being.” It claims that it treats those it serves with “fairness” and “dignity” and is committed to the “growth and development” of individuals. Given the evidence presented in this argument, I implore you to question whether the Department of Justice truly leads by its core values, specifically this one. Does providing subpar treatments, assuming treatment is provided at all, facilitate an environment of “growth and development?” Is it “fair” that inmates of color are disproportionately affected by such shortcomings in the criminal justice system?
References
Alsan, M., Yang, C., Jolin, J., Tu, L., & Rich, J. (2023, March 2). Health Care in U.S.
correctional facilities — a limited and threatened ... https://www.nejm.org/doi/full/10.1056/NEJMms2211252
Bellass, S., Canvin, K., McLintock, K., Wright, N., Farragher, T., Foy, R., & Sheard, L. (2022,
March 7). Quality indicators and performance measures for Prison Healthcare: A scoping review - health & justice. BioMed Central. https://healthandjusticejournal.biomedcentral.com/articles/10.1186/s40352-022-00175-9
Bonczar, T., & Beck, A. (1997, March). Lifetime likelihood of going to state or Federal Prison.
Camhi, N., Mistak, D., & Wachino, V. (2020, November). Medicaid’s evolving role in
advancing the health of people involved in ... https://www.commonwealthfund.org/sites/default/files/2020-
11/Camhi_Medicaid_role_health_justice_system_ib.pdf
Initiative, P. P. (n.d.). HELP (Health, Education, Labor, and Pensions) US END MASS
INCARCERATION. Public health | Prison Policy Initiative. https://www.prisonpolicy.org/health.html
Khullar, D., & Chokshi, D. (2018, October 4). Health, income, & poverty: Where we are &
what could help. https://www.healthaffairs.org/do/10.1377/hpb20180817.901935/
Massoglia, M., Remster, B., & King, R. (2011, September 1). Stigma or Separation?
Understanding the Incarceration-Divorce Relationship. Academic.oup.com. https://academic.oup.com/sf/article-abstract/90/1/133/2235560
Rezal, A. (2021, October 13). Report highlights ‘staggering’ racial disparities in U.S.
incarceration ... https://www.usnews.com/news/best-states/articles/2021-10-13/report- highlights-staggering-racial-disparities-in-us-incarceration-rates
Schnittker, J., & John, A. (2007, June). Enduring stigma: The long-term effects of
incarceration on health ... https://journals.sagepub.com/doi/abs/10.1177/002214650704800202
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