Running head: THE EFFECTS OF PRISON ON HEALTH 1

The Effects of Prison on Health

Megan Pollock

Professor Kathy S. Faw RN, MSN

Bon Secours Memorial College of Nursing

NUR 3113

April 2, 2017

Honor Code “I pledge..”

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The Effects of Prison on Health

Our textbook quotes the definition of a vulnerable population as “social groups who

experience limited resources and consequent high relative risk for morbidity and premature

mortality (Anderson, 2015).” To me a major vulnerable population is prisoners in the United

States and in other countries. A lot of prisoners are lacking primary education and come from

poverty to begin with. Some of them have mental illnesses that are not being properly controlled

in the prison environment. Some are just being effected within the system by contracting

diseases and becoming malnourished.

Social Determinants of Health

Social determinants are factors within an environment that either increase or decrease the

health of individuals and communities. Before I stated why prisoners are seen as a vulnerable

population. One primary factor that has been shown to increase likelihood of imprisonment is

lack of education. Out of 4,544 prisoners, only 351 attended some college, 1,869 graduated high-

school, and 1,667 didn’t even finish high school (Gates, 2015). Once in prison the health of a

person can just decline. People are exposed to different diseases, a major one being HIV.

Different studies done around the world show that the risk of contracting HIV increases when a

person is incarcerated, drug use being the main culprit. A study done in different European

countries reported that up to fifty-six percent of inmates will use drugs during their sentenced

time. In Greece alone, up twenty-four percent of prisoners injected drugs, up to ninety-two

percent of them shared their syringes (Dolan, 2015). To me, the craziest part of this study

reported that in the United Kingdom, forty-six percent of the inmates that injected drugs were

HIV positive and were more likely to share their syringes (Dolan,2015). Even with these

numbers that are provided, it is still hard to really know the prevalence of HIV within or
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contracted in prisons because of lack of testing and unwillingness for prisoners to actually admit

that they are HIV positive. Another detrimental effect that prisons can have on inmates and their

health is weight gain leading to obesity. Over a seven-year study, it was found that inmates were

gaining weight and increasing their body mass index (BMI) during their time spent in prison.

During just a two-week time period, it was discovered that seventy-one percent of the prisoners

had gained weight of one pound (Gates, 2015). This may not seem like much but if you think

about the bigger picture, or bigger sentence, the inmate is serving, these pounds begin to add up.

The study showed that women were more likely to gain weight in the prison environment

suggesting that there aren’t enough programs promoting physical and mental health (Gates,

2015). Lastly, another disparity would the way patients with mental health are treated in prison.

A study done in 2012 estimated that there were about 356,268 inmates with severe mental

illnesses in prison. This number is roughly ten times greater than the number of severely mental

ill patients in state hospitals (Torrey, 2014). Treatment for mentally ill inmates is not always

provided. This can be accredited to many reasons such as unclear or difficult procedures to carry

out in a prison setting, lack of room in nearby psychiatric hospitals for treatment, or lack of

equipment and training (Torrey, 2014). All of these issues have been shown to lead to the

decrease in health of the incarcerated.

Evidence-based Interventions Addressing Health Needs

Two Millennium Development Goals that could decrease the probability of future

imprisonment would be to eradicate extreme poverty and hunger, and also achieve universal

primary education. Many prisoners come into jail in poor health due to poverty and lack of

proper health care. Poverty can then lead to lack of education. If someone has to drop out of

school in order to help provide for their family, they could resort to illegal actions and increase
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their chances of becoming incarcerated. When it comes to interventions to reduce the factors that

lead to prisoner’s health downfall, it is important to take steps within the prisons and judicial

system. In regards to contracting diseases, the most important thing that you can do is provide

education. More than likely, people with drug addictions are going to do drugs whatever the risk

may be, but offering more education will provide them with the high-risks that come along with

it. While there are other interventions such as methadone maintenance treatment, providing

condoms, and needle and syringe programs have been proven to help in prisons, they have not

been implemented in a way that significantly decreases the spread of HIV (Dolan, 2015). If

prisons and jails provided more programs that increased physical and mental exercises, this could

reduce weight gain. If a women’s emotional status declines, it could lead to depression, with

promotes a more sedentary lifestyle. Increasing the amount of physical activity could get her

mind off certain thoughts. Providing counseling to inmates can also improve mental and

emotional health. Different diversion programs have been implemented in the judicial system to

recognize mental illness before people are actually sentenced to prison. These programs include

trained mental health professionals and also police officers that can recognize mental illnesses

(Hiday, 2014). A big intervention that could improve the treatment of prisoners with mental

health is taking the time to create a screening technique that includes identifying the need for

different medications, patients at risk for suicide and other risks associated with mental illness

(Torrey, 2014). Once you have assessed these, it is important to provide adequate treatment for

inmates with severe mental illnesses (Torrey, 2014).

Global Approach in Addressing “Health for All”

One important role as a nurse to promote global health is by “contributing to the equity

that involves developing a global perspective and awareness of important global health issues,
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and then finding ways to make a personal contribution to address these issues (Anderson, 2015).”

This is essential because nurses should want to make a difference and provide care for those that

are in need of good health care. Most people can not afford adequate health care or just may not

have access to it. If we recognize different vulnerable populations, figure out their needs, and act

on them, we can improve the health of many different individuals. I think this is very prominent

to the idea of mental illness in prisons. I believe that mental illnesses can often go unrecognized

in these environments because of our preconceived stereotypes of people incarcerated. Another

global approach important to improving health care is to participate in international exchanges

and collaborations. Everyone has a lot to learn from each other and this is not just limited to

individuals. We can learn from and teach a lot to other countries. A lot of my statistics when it

came to the spread of HIV in jails came from studies done in European countries. Maybe, our

statistics of the prevalence and spreading of HIV from inmate to inmate is lower. If this was the

care or not the case, its important to come together and create interventions that could help

people around the world as a whole. It does not good to improve the health of the United States if

other countries are still going through epidemics of different diseases being spread. As shown

through many examples in the past, it doesn’t take much from one illness to spread overseas.

Conclusion

In conclusion, there are many factors that lead to the decrease of health in prisoners

globally. Only a few mentioned is the education and poverty leading to incarceration, the spread

of diseases within prisons, the risk of obesity due to lack of proper programs, and the inadequate

treatment of inmates with mental illnesses. However, if we were to come together to think of

different interventions that could be implemented around the world, we could increase awareness

and improve the health of this vulnerable population.

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References

Anderson, E. T., & McFarlane, J. M. (2015). Community as Partner: Theory and Practice

in Nursing (Seventh ed.). Philadelphia: Wolters Kluwer Health.

Dolan, K., Moazen, B., Noori, A., Rahimzadeh, S., Farzadfar, F., & Hariga, F. (2015).

People who inject drugs in prison: HIV prevalence, transmission and prevention. International

Journal of Drug Policy, 26, S12-S15.

Gates, M. L., & Bradford, R. K. (2015). The impact of incarceration on obesity: are

prisoners with chronic diseases becoming overweight and obese during their confinement?.

Journal of obesity, 2015.

Hiday, V. A., & Moloney, M. E. (2014). Mental Illness and the Criminal Justice System.

The Wiley Blackwell Encyclopedia of Health, Illness, Behavior, and Society, 1-5.

doi:10.1002/9781118410868.wbehibs513

Torrey, E. F., Zdanowicz, M. T., Kennard, A. D., Lamb, H. R., Eslinger, D. F., Biasotti,

M. C., & Fuller, D. A. (2014). The treatment of persons with mental illness in prisons and jails:

A state survey. Treatment Advocacy Center.