While most Americans never see or become ensnared in the nation’s vast correctional system, there are unprecedented costs—economic, social, and ethical—that are being paid, one way or another, by everyone in this country. It is no secret that prison inmates face health threats behind bars that equal anything they face in the streets. Violent assault, rape, or the outbreak of highly infectious diseases are much more common in correctional facilities than in the general population. Prison conditions can easily fan the spread of disease through overcrowding, poor ventilation, and late or inadequate medical care. Effectively protected from public scrutiny, the prison health care system has almost zero accountability, thus escaping outside attention to serious failures of care. If you want to know about the practice of health care in prison settings, ask someone who has been “in” the system. Prisoners have a story to tell and this article gives voice to the experiences of those who have been directly impacted by the provision of health care in the prison system.
Contribution to public health from prison health care, Spanish experience on prison harm reduction programs (1998-2017)