Running head: VULNERABLE POPULATIONS

Vulnerable Populations: Inmates

Aaron Phillips
Ferris State University

VULNERABLE POPULATIONS

Vulnerable Populations: Inmates

It is not difficult to see that we live in a society that is full of injustices. There are the
privileged and there are those who do without. Even though we live in the United States, where
we say we fight for things called Civil Rights and Equality, our communities are full of
disparities. One disparity that we cannot overlook is health disparities. We do not just see these
disparities in our local communities; we see them across the world. Todays technology grants
us instant access to these health disparities. In this paper I will discuss health disparities among
inmates in the correctional setting in the United States. I will discuss what makes this population
vulnerable and personal biases that may contribute toward these disparities.
Disparities
In my daily practice I see many health disparities among the clientele that I serve.
Healthy People 2020 (2014) define health disparity as, a particular type of health difference that
is closely linked with social, economic, and/or environmental disadvantage. I work for the
Michigan Department of Corrections. The majority of the inmates in the department of
corrections come from low-resource urban communities, with high unemployment rates, and
lacks health insurance (Dumont, Gjelsvik, Redmond, & Rich, 2013). Social disparities among
inmates prior to incarceration often include a life of poverty, violent or abusive home
environments, lack of educational opportunities, mental health issues, and lack of community
programs (Harkness & DeMarco, 2012).
According to Dumont et al. (2013), the United States incarcerates a higher percentage of
its population than any other country. The U.S. Department of Justice (2012) states, 6,937,600
offenders were under the supervision of adult correctional systems at yearend 2012. Of the
people incarcerated in the US, two third is African American and Hispanic males (West, Sabol,

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& Greenman, 2010). African Americans citizens are 13 times more likely to be convicted of
drug charges compared to white citizen (Dumont et al., 2013). A major contributing factor to
this trend is the US policies on drugs and the get tough on crime initiative starting back in the
1980s. According to Harkness and DeMarco (2012), 75% of all prisoners are incarcerated for
non-violent crimes such as drug charges, bribery, or extortion.
Determinants
There are many factors that contribute to the health of inmates coming into the prison
system. These factors include lack of access to health services, fear or mistrust of the health
care system, and lack of education. Many of the prisoners I see have undiagnosed medical and
mental health needs that have never been addressed. People that come to prison often have
complex chronic health conditions, mental health needs, drug addictions, and a high prevalence
of infectious disease conditions related to risky behaviors (Harkness & DeMarco, 2012). Jail or
prison can be the first time that many offenders ever receive preventive health care services. This
provides health care professionals the unique opportunity to make dramatic impacts on the wellbeing of inmates while incarcerated and when discharged or paroled back to their communities.
Reflection
It is not always easy caring for prisoners. The Supreme Court ruled in 1976, Failure to
provide adequate health care to individuals conned in correctional institutions violated
prisoners constitutional rights (Weiskopf, 2005). Even though the care of inmates can be
difficult, nurses in the correctional setting must find a way to deliver quality care while
maintaining the strict regulations required by correctional institutions. I have been asked many
times, how I can deliver care to an individual that has been convicted of murder, rape, or child
abuse? My answer has always been, I try to treat them as I would my brother, regardless their

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offence. The only difference is you have to separate your emotions from the care you deliver.
This can be a very difficult task for some people and is something that we as nurses are not
trained to accomplish. Weiskopfs (2005) study found:
Custody boundaries in prison settings restricted nurses free expression of caring. This
led them to feel frustrated and angry as they tried to create a caring and healing
environment, and connect with their inmate patients within the boundaries of custody. No
other health care setting imposes such a devastating impact on nursepatient
relationships. (p.341)
I learned early in my correctional career that it is best not to learn what the individual was
convicted of. Knowing the crime an inmate committed can indirectly influence the care you
deliver. It can also impact your attitude of how you treat and stereotype all inmates. According
to Weiskopf (2005) a major influence in the environment in the correctional setting was the noncaring attitude among nursing staff. In Weiskopfs study many nurses expressed that they did
not care for the clientele they cared for (2012). I have seen this first hand and can admit that
some days caring for inmates can be both difficult and stressful. I look at the individual and see
a person in need of care. I assess their need and develop the best plan of care that is available.
Conclusion
There is overwhelming amounts of information that show the health disparities in the
correctional systems within the United States. These disparities directly affect the poor and
underserved African American and Hispanic males in urban communities. Many factors affect
the determinant(s) including culture and public policy. Lack of health insurance, health access,
education, and environment factors affect health statistics of offenders entering to the
correctional setting. When caring for inmates personal safety must come first. Even though you

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are confined by custody regulations you have to deliver quality care while developing safeguards
that protect you and youre staff from the possible threats that are involved with delivering care
to inmates. My final reflection on the health disparities of correctional inmates have made me
better understand of how big of an impact I can actually have on the offenders I care for. My
care does not just affect my patients while incarcerated. It hopefully assists them with becoming
healthy productive members of society.

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6
References

Dumont, D. M., Gjelsvik, A., Redmond, N., & Rich, J. D. (2013). Jails as public health partners:
incarceration and disparities among medically underserved men. International Journal Of
Men's Health, 12(3), 213-227. doi:10.3149/jmh.1203.213
Harkness, G. A., & DeMarco, R. (2012). Community and public health nursing: Evidence for
practice. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Healthy People 2020 (2014). Disparities. Retrieved July 16, 2014 from
http://www.healthypeople.gov/2020/about/disparitiesAbout.aspx
U.S. Department of Justice (2012) Correctional populations in the United States, 2012.
Retrieved from http://www.bjs.gov/content/pub/pdf/cpus12.pdf
Weiskopf, C. (2005). Nurses' experience of caring for inmate patients. Journal Of Advanced
Nursing, 49(4), 336-343. doi:10.1111/j.1365-2648.2004.03297.x
West, H., Sabol, W., & Greenman, S. (2010). Prisoners in 2009. Washington, DC: U.S. Department of Justice Bureau of Justice Statistics.