Whitehead: Corrections, 3rd Edition

1. Explain the issues/concerns when dealing with aging prisoners.
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   The National Commission of Correctional Health Care defines elderly inmates as those who are 55 or older. Prisoners are considered elderly at a younger chronological age because of several factors. For instance, inmates may have inadequate access to health care, including preventive medicine (early detection of diseases). Unlike many people, those who are incarcerated may be unemployed or underemployed when they are on the streets. As a result, they do not have access to medical care because they are unable to acquire health insurance. Additionally, inmates often engage in risky lifestyles. For example, they are more likely to be IV drug users, which exposes them to the risk of developing HIV/AIDS or other infectious diseases like hepatitis C. Alcohol and other drug use not only leads to an increased risk of infectious diseases and other health-related problems, but can lead to lowered inhibitions, which, in turn, leads to an increased the chances of engaging in risky sexual behavior (e.g., unprotected and casual sex and sex with multiple partners).
   

2. Explain the issues/concerns dealing with chronically ill offenders.
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   In correctional settings, there is a higher rate of such illnesses as HIV/AIDS, sexually transmitted infections, and tuberculosis (TB) than found in the general population. In addition, given the at-risk behavior of those found in prisons, these diseases are more prevalent among the prison population. Once released from confinement, many inmates return to their pre-incarceration lifestyle, thereby increasing the risk of transmitting these diseases to others.

   Because of the close relation of HIV and TB and the closed confinements of correctional settings, TB is one major health concern. Tuberculosis is a disease that attacks the lungs and symptoms include persistent coughing, coughing up blood, chest pains, fever, fatigue, and weight loss.

   Correctional facilities—jails and prisons—are settings that are conducive to the spread of this communicable disease. Smith (1994) suggests that the constant movement of inmates from jails to prisons, coupled with the overcrowding and poor ventilation found in jails and prisons enhances the spread of TB. Although the spread of TB in jails can be addressed by placing infected inmates in units with rooms with negative air pressure, a recent study in Indiana by Kane and Dotson found that only one jail among 24 utilized negative air pressure.

   With inmate populations three times more likely to have TB than the general public, the potential for the spread of the disease among inmates is frightening. The American Red Cross recently voiced concerns about the spread of dangerous drug-resistant strains of TB. They estimate that as many as two billion people worldwide carry the microbes that cause TB and about 200 million become sick with disease in their lifetime (Hooper, 2010). The American Red Cross also stated that efforts to control TB will fail unless countries do more to address the deadly disease in prisons.
   

3. Explain the issues/concerns dealing terminally ill inmates.

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   In recent years, reports indicate that an increasing number of prisoners are in the advanced stages of incurable diseases such as cancer and AIDS.

   Reports also indicate that many correctional facilities are ill-equipped to deal with these inmates. In 2009, a total of 4,356 inmates died in state prisons and jails.

   As a result of the rising number of terminally ill inmates and increasing medical costs, many states have enacted medical-parole laws, also known as “compassionate release,” which allow for the early release of terminally ill offenders. All states have a variety of methods for early release that include the reduction of the inmate’s sentence by a judge or parole or clemency hearing, administrative release, or even commutation of sentence.

   One solution for the treatment of terminally ill prisoners is the use of separate facilities designed specifically to address their needs. Tennessee, for example, houses its chronically and terminally ill inmates at the Lois Deberry Special Needs Facility in Nashville. In addition, any inmate within the Tennessee Department of Corrections (TDOC) who needs special medical services such as surgery will be temporarily housed at this facility until their treatment is completed.

   Other states have also opened medical prisons to house chronically and terminally ill offenders including California, Florida, Iowa, and Pennsylvania. Housing special-needs inmates in one central location often improves the quality of care these inmates receive and lowers medical costs.

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