Health, Access to Care, and Financial Barriers to Care Among People Incarcerated in US Prisons

Prison residents often come from communities with high poverty and poor health. More than 60 percent of prison residents in the United States have a chronic physical condition and more than 40 percent have mental health conditions. This report draws on the 2004 and 2016 Survey of Prison Inmates conducted by the Bureau of Justice Statistics (BJS) to assess the health conditions and access to care for incarcerated adults in state and federal prisons. The data shows there has been an uptick in mental health conditions and chronic illness in the prison population. Researchers examined the impact of medical co-payments on access to care for prison residents facing chronic diseases, mental health conditions, or experiencing pregnancy. They found medical copays in prisons are associated with worse access to healthcare and that prison residents were significantly less likely to access necessary health services in prisons with medical co-pays greater than one week’s wage. The report also makes recommendations to make improvements to prison healthcare.

You can read the full text here and a summary by the Prison Policy Initiative here. 

Key Findings:

• 34.7 percent of residents who were receiving pharmacotherapy for a mental health condition at the time of their offense had not received mental health prescriptions in prison.
• A total of 13.8 percent of all respondents with 1 or more chronic physical conditions had not seen a healthcare clinician during their incarceration. 
• 53.8 percent of pregnant people in prisons with co-pays had a co-payment greater than 1 week’s prison wages. 
• 50.6 percent of incarcerated pregnant individuals received no pregnancy education, and 9.1 percent had no obstetrical examination before delivery.

Recommendations:

• Outlaw medical co-payments for all people incarcerated in the United States.
• Establish a regulatory body to oversee prison health services and hold governments accountable.