Because of intravenous drug use, unprotected sex and tattooing with unsterile needles, rates of H.I.V. infection are nine times higher in prison populations than in the public, according to a 2009 report from the RAND Corporation. The rates of hepatitis C were found to be at least 10 times higher, and probably much more.
Additionally, with the prison population aging, and a large segment lacking consistent care for most of their lives, advanced diabetes, hypertension, asthma and cancer are common.
Current public health care systems are not designed to accommodate the varied logistical and cultural needs of men and women who have been incarcerated. As a result, many former inmates simply do not seek care at all, said several doctors who work with former prisoners.
“Incarceration strips you of responsibility for yourself,” said Clifton Martin, who spent 20 years in and out of prison on drug and theft convictions and now works at a drug counseling center. “You get three meals a day. Your laundry is done for you. Even your medication is brought to you.”
The failure of former inmates to connect with medical services also has consequences for public health. Untreated infectious diseases like hepatitis C, latent tuberculosis and H.I.V. infection can be spread to family members or the public. Missing even a few days of H.I.V. medication can lead to drug resistance and increased viral loads, making the virus easier to transmit.
By locking more people up for longer periods of time, we are creating a permanent underclass. Our society continues to fail to provide pathways for large numbers of offenders to re-enter legitimate society. Instead, convicted felons face a myriad of obstacles to success.
Add medical problems to recidivism, unemployment, underemployment, increased welfare costs, etc. States like Idaho continue to incarcerate but with no real plan for offender re-entry. With 2.3 million people in prison (and counting), the permanent underclass is already having a detrimental impact on costs and the quality of life for everyone in one way or another.