For many years, mass incarceration has been a significant problem in the United States. As such, this has increased the public attention to the issue of imprisonment with a keen emphasis on the experience of women. According to a statistics compiled by the University of Chicago School of Social Administration magazine, the number of incarcerated women in the federal prisons has increased by approximately 908% between 1977 and 2014 (Fedock, 2018). Today, more than 1.2 women are imprisoned, making about 19% of the adult population under the criminal justice system. The non-violent offenses make up the most significant portion of the reason behind their incarceration, accounting for approximately 60% (Fedock, 2018). Scholars have attempted to explain the reason behind the ever increasing population of women behind bars. Some have attributed it to the increased over-policing in the racial minority areas while others have accused the changing dynamics in the arrest and sentencing practices. Some studies have however pointed a finger towards the expansion of prisons especially for-profit reasons. The increased number of non-convicted women in the jails has also raised critical questions on the role of the criminal justice in fostering justice. With trends showing increasing incarceration of women and the subsequent marginalization, concerns have been raised regarding their welfare on matters such as human rights, ethics, gender sensitivity, and public health concerns.
Background
Statistics have shown that about 1.2 million women in the US are incarcerated, making up to 19% of the adult population in prison (Kajstura, 2018). Since the 1970s, their population has increased nine-fold, hence leading to increased attention to the trend. The growth of the female population in the prison has also been higher compared to that of women. From 2000 to 2010, the number of men in the prison rose by approximately 1.4% per year while that of the women grew by about 1.9% yearly (Fedock, 2018). It, therefore, signals an alarming trend in the criminal justice department. Statistics have also shown that women are disproportionally kept in the prisons. According to the University of Chicago School of Social Administration magazine, “A staggering number of women who are incarcerated are not even convicted: more than a quarter of women who are behind bars have not yet had a trial” (Fedock, 2018). Also, the magazines reports that about 60% the jailed women are awaiting trial. Statistics have shown that the highest number of the incarcerated women belong to the African American racial group. Their number is four times as much as that of the white women. The rate of incarceration for the Hispanic women is almost twice that of their white counterparts. Overall, the incarceration rate of women is the highest in the whole world. Although the rates have been increasing, the number of incarcerated women remains at an all-time high.
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According to the Prison Policy Initiative, “Only 4% of the world’s female population lives in the U.S., but the U.S. accounts for over 30% of the world’s incarcerated women” (Kajstura, 2018). The state with the highest number of incarcerated people in the US is Oklahoma. The state has had a long history of over-incarcerating women especially the ones accused of alcohol and drug addiction. Currently, Oklahoma has an incarceration rate of approximately 281 women in 100,000 people. It is followed by Wyoming, Kentucky, and South Dakota at 250, 241, and 232 women in 100,000 people (Kajstura, 2018). Some of the states with the lowest number of incarcerated women include Connecticut and Minnesota.
Economic Aspects of the Group
According to the Center for American Progress, “Half of all women in prison are incarcerated more than 100 miles from their families” (James, 2017). Statistics has further shown that children belonging to the incarcerated mothers are more likely to end in foster care compared to the imprisoned fathers. The disparity emanates from the fact that a whopping 59% of the imprisoned women have children below the age of 18 years (James, 2017). Prior to the incarceration, 77% of these women served as the primary caretakers. Research has shown that women of color are more likely to be the primary caregivers to their children compared to their white counterparts. Another primary social concern for these women is the fact that they have a potential of losing their children even if the mothers demonstrate the ability of offering care upon release. As per the Adoption and Safe Families Act of 1997, incarcerated mothers can permanently lose the rights to their children after 15 months (James, 2017). Another harsh reality with regards to the social welfare of women includes the unique hardships of faced by the pregnant women. Statistics show that about 3% of women are pregnant at the time of their incarceration. Other problems that these women encounter include inadequate medical care, poor nutrition, and placement in the solitary confinements which not only endangers them together with their fetuses but also violates their rights (James, 2017).
Economically, most of the incarcerated women’s path to crime is primarily characterized by poverty. Research has shown that approximately 70% of the imprisoned women had a previous income of less than $22,500 a year (James, 2017). The jobs in the prison facilities are not only scarce but also pay meager wages of about one dollar a day. For the women who secure jobs in the prison department, some of the expenses outweigh their earnings. For instance, the cost of the menstrual products can take almost half of their weekly earnings. Other than the cost of the menstrual products, rationing and product shortages are particularly burdensome for the incarcerated women. Poverty is also a major issue for women who have just left prison. Since they are unable to fend for their needs and that of their children, they are more likely to engage in crime leading to recidivism. The overall impact is an ever-unending cycle of incarceration targeting the women as the victims. The issue of gender inequality has also contributed to the suffering of the incarcerated women. The hegemonic tendencies in the prison have increased the likelihood of women to suffer in the prison areas. They are prone to sexual and physical abuse which significantly implicates their ability to engage in breadwinning activities.
Social Justice and Its Relationship to Health Disparities and Healthcare
Social justice primarily refers to the equitable distribution of opportunities, wealth, and privileges within the society. Social justice has a strong relationship with the criminal justice system. Social justice continues to be one of the disregarded issues when it comes to dealing with the welfare of the incarcerated women. The needs of the detained women have not been neglected by the prison authorities alone but also the health systems. It is now clearer more than ever before that women prisoners are a minority in the US. Most of the incarcerated women in the US justice system are arrested due to non-violent, drug-related, and property offenses (Smith & Braithwaite, 2016). Also, a large proportion of the women emanate from deprived backgrounds and further experience a wide array of problems including drug dependency, poverty, infectious disease, and history of domestic violence among others. Research has noted that many incarcerated women face health-related issues such as depression, post-traumatic stress disorder, anxiety, and suicidal ideation. Social justice can also be looked through the lenses of the impact of incarceration to the society. As previously opined, women in many societies are the primary caregivers (Smith & Braithwaite, 2016). Their imprisonment, therefore, means that children either suffer or undergo an institutionalization.
The healthcare in the US prisons and jails is inadequate to address the medical and psychological needs of the incarcerated women. The health services provided are of low quality especially in the area of reproductive health. Many women face problems adjusting to the correctional environment. As such, this predisposes the inmates to substance abuse, mental issues, trauma, and sexual victimization. All of which have a critical role in determining their health needs. Women imprisoned in the local, state, and federal prisons experience many health challenges. In a study documented in an article, "Health Issues of Incarcerated Women in the United States,” a sample of 156 inmates was used to assess the health conditions of this group of people. The research found out that 95% of the women reported at least one physical condition (Mignon, 2016). The health disparity is partly due to the lack of healthcare services before and after incarceration. According to the article by Mignon (2016), “this can be attributed to their low socioeconomic status and problems such as substance abuse, lack of good nutrition, and lack of preventive health care.” Their increased risk of sexual violence has meant that they are exposed to many sexually transmitted infections such as HIV/AIDS, syphilis, and Hepatitis C among others.
Ethical Issues
A critical moral issue that affects the incarcerated women revolves around the prospects of losing the rights to mother their children. It remains vital to note that the average sentencing of a woman is about 18 months. By the time of their releasing, chances are high that they would have already lost ownership of their child. It, therefore, means that a sentencing of up to 15 months can cause a woman to lose the rights of owning their child (Coughlin, Lewis, & Smith, 2016). Therefore, parenthood is an inherent right that should not be thrown away due to incarceration. Secondly, the use of imprisoned women in research such as those involving knowledge regarding diseases such as HIV/AIDS and syphilis remains one of the most critical ethical issues that should be assessed (Coughlin et al., 2016). Also, the right of privacy is another ethical factor that has frequently missed within the American prisons. For women, the demand for privacy is vital especially in fostering their reproductive life and most importantly, safety.
Plan of Action
Although the US has the highest incarceration rates globally, it has lacked in providing the inmates especially women with an enabling environment that would bolster their welfare and health conditions. It is in this regard that I will create a three-step evidence-based model that will improve the situation of the incarcerated women in the country. The first step would be to create a funding model for the healthcare system within the prison to cater for the healthcare and reproductive needs of the females. It is important to note that healthcare is a legal right for the inmates especially after the Supreme Court ruling in the Estelle v, Gamble ruling of 1972 (Venters, 2016). The inmate women will be covered by the Affordable Care Act (ACA) in ensuring that they can money does not become a healthcare barrier. The second strategy will involve increasing the scope of services provided in the jail. According to research by Venters, (2016), “Most correctional health systems focus their work on brief intake screenings and responding to acute complaints.” Increasing the in-jail services will include the incorporation of medical, public health, educational, and reproductive health services under one roof.
The third strategy would encompass the recruitment of appropriate staff with the correct know-how of dealing with the health of incarcerated women. Over the recent years, many qualified health professionals have shown reluctance to work with the inmates due to the lack of incentives. Therefore, in collaborating with the local and state government, better terms of conditions will be created in a bid to attract professionals such as gynecologists, mental health specialists, and nurses with proper knowledge on women’s health. Particularly, nurses have an essential role in this endeavor. Nurse practitioners have an important role as far as helping the women in correctional services is concerned. Although nurses have been traditionally associated with clinics and hospitals, much of their work is today based in the communities and facilities such as the prisons. The family nurse practitioners, for instance, have a critical role to play in the correctional departments. The plan, therefore, will see these professionals work with correctional officers to assist in emergency circumstances.
The nurses will from time to time monitor inmates that require medical attention. With the limited resources being one of the primary challenges in the care facilities, it remains incumbent upon the nurse practitioners to enhance creativity. This plan will also remain cognizant to the fact that a prison is a closed community and as such, the women are at an increased risk of acquiring infectious diseases. Therefore, community outreach would be a viable means to educate the women inmates on several strategies they could use to prevent the spread of diseases. Public health remains one of the most vital aspects that nurses must leverage (Dhaliwal & Hirst, 2016). The family nurse practitioner will also be required to identify the children of the women inmates and provide them with the right psychotherapy to ensure that they grow up responsible individuals. Lastly, outcomes will be measured based on the health outcomes of the incarcerated women and information collection tools such as surveys and questionnaires which will report on how well the inmates experience their health life. Health indicators such as morbidity and mortality will also help in gauging outcome. For the nurses working in these facilities, a performance appraisal could be essential as a tool for measuring outcome.
Conclusion
With trends showing an increasing incarceration of women and the subsequent marginalization, concerns have been raised regarding their welfare on matters such as human rights, ethics, gender sensitivity, and public health concerns. The number of incarcerated women in the US remains at an all-time high. With the welfare of these women primarily ignored, they have experienced a plethora of problems ranging from their health to their overall well-being. It, therefore, calls on all level of governments to create policies and laws that will guarantee the observation of human rights, ethics, primary, and public health of the incarcerated women. Increasing funding, scope of services and specialists to work with the women will be a significant step in solving their problems.
References
Coughlin, S. S., Lewis, S. R., & Smith, S. A. (2016). Ethical and social issues in health research involving incarcerated people. Journal of health care for the poor and underserved, 27(2A), 18.
Dhaliwal, K., & Hirst, S. (2016). Caring in correctional nursing: A systematic search and narrative synthesis. Journal of forensic nursing, 12(1), 5-12.
Fedock, G. (2018). Number of Women in Jails and Prisons Soars . The University of Chicago School of Social Service Administration Magazine https://www.ssa.uchicago.edu/ssa_magazine/number-women-jails-and-prisons-soars
James, K. (2017). Upholding the Dignity of Incarcerated Women. Center for American Progress https://www.americanprogress.org/issues/women/news/2017/12/22/444468/upholding-dignity-incarcerated-women/
Kajstura, A. (2018). States of Women’s Incarceration: The Global Context 2018 . Prison Policy Initiative https://www.prisonpolicy.org/global/women/2018.html
Kajstura, A. (2018). Women's Mass Incarceration: The Whole Pie 2017 Prison Policy Initiative https://www.prisonpolicy.org/reports/pie2017women.html
Mignon, S. (2016). Health issues of incarcerated women in the United States. Ciencia & Saude collective, 21, 2051-2060.
Smith, S. A., & Braithwaite, R. L. (2016). Introduction to Public Health and Incarceration: Social Justice Matters. Journal of health care for the poor and underserved, 27(2A), 1.
Venters, H. (2016). A three-dimensional action plan to raise the quality of care of US correctional health and promote alternatives to incarceration.
