Carceral Health Care
Abstract
This Review Article delves into the complex medical, behavioral, and structural health challenges faced by incarcerated individuals in the United States. With more than 1.2 million people in prisons and 11 million cycling through jails annually, the U.S. system of mass incarceration exacerbates health inequities rooted in structural racism and inadequate community health services. Key issues include solitary confinement, environmental exposures (e.g. heat, crowding), poor chronic disease management, inadequate behavioral health services, and rising opioid overdoses particularly after release. The article emphasizes the constitutional right to health care for incarcerated persons, yet highlights widespread neglect, dual loyalty conflicts among providers, and logistical and ethical complexities in delivering care. It also focuses on vulnerable subgroups, such as older adults, women, and transgender individuals, and calls for reforms including Medicaid expansion during incarceration, stronger care transitions post-release, and independent oversight of correctional health systems. The authors champion “abolition medicine,” a movement advocating for decarceration and reinvestment in community-based care, to address the broader public health harms of mass incarceration.
Keywords:
carceral health
mass incarceration
dual loyalty
solitary confinement
health disparities
COVID-19
opioid use disorder
structural racism
oversight
aging incarcerated population
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