Where's the Doctor in the Big House?

Due to improved medical care and lots of personal resilience, people are living much longer. We are living longer than our parents and the next generation should outlive us. There are new ways available to prevent, as well as detect, various infections, and even basic healthcare providers offer these minimal services. With summary information, individuals are equipped to ask concrete questions and make rational decisions to impact their quality of life. It may be as simple as eating fruits and vegetables, exercising on a regular basis, and having an exam every year.

Just like men and women in society, prisoners are growing older behind the towering walls of concrete and steel. But while this social phenomenon unfolds through barbed wire, the primary concern of penal authorities is the increasing cost of incarceration. The focus seems to be to reduce services, including healthcare, in order to decrease expenses. A large percentage of prisoners enter the criminal justice system under 30 years of age to serve a lengthy sentence of life or a mandatory minimum of amount of time. After several years in the prison environment, treatable ailments can instead become chronic. Even common colds can cause serious problems to those prisoners whose prior risky behavior has compromised their immune system.

Prisoners may need more medical and mental healthcare than members of the general society. Illnesses such as HIV/AIDS, diabetes, Hepatitis, TB, and sexually-transmitted diseases are prevalent throughout the prison system. Proper testing and treatment are necessary for the inflicted, while counseling and a basic education curriculum must be accessible in every institution. In addition, to guard interference and the evaporation of the doctor/patient confidentiality clause, another major obstacle is the inability of some prisoners to articulate their symptoms or to comprehend the diagnosis. There may be a language barrier, as well as a low-to-average IQ, which could prevent full appreciation of exam results.

As long as life without parole and mandatory sentence policies remain intact, the prison budget will be humongous. It costs Massachusetts over $45 thousand annually for each prisoner and approximately $60 thousand for each 50-and-over prisoner. In contrast, it only costs $6,500 to supervise human beings upon release to the community.

Research indicates that prisoners over 50 years old and who have been incarcerated for more than 25 years do not commit new crimes or violate parole regulations upon release. Several states, like Pennsylvania, have developed policies within the prison system to address the escalation of aging prisoners, and subsequent medical complications. Some facilities are being designed as "geriatric/lifer" prisons, and new criteria for parole eligibility are viewed as progressive. Adequate health care is an essential component of a successful reentry effort decreasing the rate of repeat offenders. It is important to address any significant illness during the incarceration period and prior to release from custody.

Though death is inevitable, the final moment doesn't have to be in a prison cot. With improved treatment and a change in parole eligibility, men and women can return to the community with hope for a brighter sequence of moments. But the process must begin with a caring touch during the assessment interview and with subsequent contact with the doctor/medical vendor. It's simply an act of kindness towards another human being, which may ignite a willingness to change lifestyle choices. We need to begin now in order to make a difference tomorrow.

Published on www.edgeboston.com on 10-09-05

Arnie King writes from a Massachusetts prison cell, which he has occupied for over 34 years.