Background
According to The World Health Organization (WHO), women prisoners usually account for 2-9% of the prison population in any country and this percentage is increasing every year (van den Bergh 2016: 1). The majority of the crimes for which women are imprisoned are usually non- violent and property or drug-related. Also, many women in prisons are mothers and usually the primary or sole caregivers of their children (van den Bergh 2016: 1). A huge issue about females in prison is that women in prison have mental health issues to a higher degree than the general population and males in prisons. Women are also more likely to have more physical health needs and to experience post- traumatic stress. Women are at a greater risk than men of entering prison with HIV, hepatitis C, reproductive health needs and STIs (van den Bergh 2016: 1). Menstruation is also a problem in prisons because most of them do not come with necessities such as sanitary towels or adequate bathing and washing facilities ((van den Bergh 2016: 3).
Women in prison often come from impoverished and abused backgrounds and many have already experienced inadequate healthcare before coming to prison (van den Bergh 2016: 1). Many of these women’s first access to healthcare is when they enter the prison. For many, this is the first time they have also had access to social support and counseling (van den Bergh 2016: 1).
Women in prison who are pregnant pose a higher risk to themselves and their fetus than a woman not in prison (van den Bergh 2016: 4). They are more likely to have problems during pregnancy, and as a result, to have poorer outcomes. Part of this is due to the fact that imprisoned women are more likely to be addicted to drugs and alcohol and to smoking. Additionally, they are more likely to have a medical problem, which could affect the pregnancy outcome and are less likely to receive proper prenatal care in prison (van den Bergh 2016: 4).
Perspectives
A study done by Doctor Shirley Dinkel examines the health education that incarcerated women need. It was a naturalistic qualitative study involving 2 focus groups of adult incarcerated women in Indianapolis (Dinkel 2014: 229). One group was housed in maximum security and one was housed in medium security. Three guiding questions were asked to these women: “What are the top ten health education needs of inmates in this facility? “What is the best method for educating inmates on these topics?” and “What would a health fair look like for you?” (Dinkel 2014: 331). These questions caused a lot of stimulating discussion among the inmates. For health topics important to the incarcerated women, inmates identified six themes: the important of nutrition and exercise to prevent and treat obesity, women’s health concerns, communicable disease transmission and prevention, dental hygiene, pathophysiology and complications of chronic disease, and mental health conditions (Dinkel 2014: 331). Several women expressed concern about the different nutritional needs of women compared to men and how this is not respected in prisons because meals are the same for men and women. Also, women discussed how lack of proper shoes impedes their ability to properly exercise. Women also wanted to know what they could expect as they age in terms of health (Dinkel 2014: 333). Younger women wanted health educators to teach the prison staff and other inmates about menstrual health. Lastly, while these women received mental health services, some expressed interest in wanting to know how to be proactive with their mental health. Many of these women also wanted to know about nonpharmaceutical stress management and coping (Dinkel 2014: 334).
For the best methods for educating inmates, the focus groups said respect for the adult learners and hands on teaching is key. Many women stated things along the lines of “Don’t talk to me like I’m two. We are not stupid” (Dinkel 2014: 334). Also, pamphlets tend to go in the trash and dull information is not effective. They stated that pictures help with learning and multiple presenters tend to stimulate their interest more (Dinkel 2014: 334).
Lastly, the focus groups said that their visions of a health fair involved women being able to walk around and visit educational booths that used color, words, images, and hands-on activities to make information more appealing (Dinkel 2014: 334). They all said that the topics must be significant to the incarcerated women in order for positive learning.
Topical Context
An article in the International Journal of Prisoner Health discusses women in Italy and their experiences with healthcare. In Italy, women make up about 5% of the total prisoner population (Donatella 2005: 117). Similarly to the U.S., research in Europe shows that prison regimes are designed for men, and, therefore, do an inadequate job of accommodating female prisoners (Donatella 2005: 118). These institutions do not have the proper access to healthcare for long-term health needs. Another similarity to the U.S. and the rest of the globe is that the number of imprisoned women is increasing every year (Donatella 2005: 118). This shows the necessity for prisons to have access to specific forms of healthcare. In Italy, a prisoner has to ask to see a doctor or to have access to any other health-related service. Consequently, there are limited opportunities to get preventative healthcare information in prisons (Donatella 2005: 120). Nobody in these prisons has the responsibility to respond to, or implement these services. Also, prison healthcare staff in Italy is not required specific training or specific knowledge about providing healthcare in the prison environment and most of them only work at the prisons part time (Donatella 2005: 120). Doctors and nurses mainly address emergency cases because they do not have the time or resources beyond that.
Women are the most deeply affected by this. Their unmet healthcare problems include maternity care, pregnancy, contraception, gynecological diseases and their preventions, sexually transmitted diseases, problematic drug and alcohol use and addiction problems during pregnancy (Donatella 2005: 121). Because women are the minority part of the population of prisons, they usually have to wait longer to see a doctor or to have medical screening tests than men do (Donatella 2005: 122). This is an issue because women are more likely than men to be at risk for infectious diseases and other medical problems including HIV and STDs. Additionally, many of these women are caregivers to children and elderly relatives. Sexual assault is another issue that is not being addressed in Italian prisons due to a lack of services. Also, “feelings of shame, isolation helplessness and loss of autonomy, which are particularly experienced by victims of violence, are triggered by common prison procedures such as body or cell searches” (Donatella 2005: 121). The system of prisons only enforces these feelings of shame that abused imprisoned women already feel. This can lead to mental health issues such as depression, anxiety and post-traumatic stress.
How this Relates to Politics of Health
This relates to politics of health because it discusses another institution that is not meeting the specific needs of a particular population. This relates to the way that undocumented workers do not receive proper healthcare due to the stigma towards them. Similarly, Native Americans are more likely to abuse illegal substances, just like these imprisoned women, and are also more likely to not receive proper healthcare. There is a direct correlation between minority groups and lack of access to proper healthcare and this includes women in prison. These institutions were designed by and for men, and therefore, do not have the proper healthcare necessities that women need, particularly when it comes to menstruation and reproductive health such as diseases and prenatal/antenatal care.
References
Dinkel, Shirley. “Health Education Needs of Incarcerated Women.” Journal of Nursing Scholarship 46.4 (2014): 229-234 accessed April 13, 2017. https://search- proquestcom.proxy.library.vanderbilt.edu/docview/1554348278/61AFA14 318C43CFPQ/7?accountid=14816.
Donatella, Zoia. “Women and Healthcare in Prison: An Overview of the Experiences
Imprisoned Women in Italy.” International Journal of Prisoner Health 1.2 (2005): 117-122 accessed April 13, 2017. https://search-proquest- com.proxy.library.vanderbilt.edu/docview/1272120698/550A1A83F7AA48 3EPQ/1?accountid=14816.
Van den Bergh, Brenda. “Women’s Health and the Prison Setting.” World Health Organization (2016): 1-4 accessed April 13, 2017. http://www.euro.who.int/__data/assets/pdf_file/0006/249207/Prisons- and-Health,-18-Womens-health-and-the-prison-setting.pdf?ua=1.
« Back to Glossary Index