Running head: AT RISK POPULATION: INCARCERATED WOMEN

At Risk Population: Incarcerated Women

Courtney Wright
Ferris State University

Introduction
Thinking about at risk populations there are many groups that come to mind, such as
women, African Americans, individuals with diabetes, the elderly, children and many more.
There are often many at risk population groups that go unnoticed such as women that are
incarcerated. Sometimes this population is an afterthought, but they are a very vulnerable
population and should be properly cared for and mentored. With this population there are many
stereotypes and biases that could potentially hinder how well they are taken care of. Fortunately,
there are specific laws in place to protect incarnated women to ensure their health is considered a
priority.
Vulnerability and Biases
Incarcerated women are a vulnerable population that many people do not even think
twice about. Some factors that cause their vulnerability is the fact that prisons are a high-risk
environment and illnesses and diseases can be prevalent in this environment. One major situation

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that the prisons are vulnerable to is injection drug use (Galea & Vlaho, 2002). The rate of
injectable drug use for prisoners is 10 times higher than for non-prisoners (see Appendix A for
more information on the relation of illicit drugs to other behaviors such as incarceration). For
every year a person is in prison their likelihood of becoming an injectable drug user increases by
17 percent (Galea & Vlaho, 2002).
Along with vulnerability many stereotypes and biases are associated with incarcerated
women. Many individuals from the public were polled to determine what they knew about
individuals in prison (Roberts & Hough, 2005). The results from the people polled showed that
they thought prison is a blessing for many because they believe living there is easy and their
needs are met. They get their meals prepared for them, many get to work, their laundry is done
for them and much more. The incarcerated women are looked at as they are inferior and being in
prison is what they deserve. It is many peoples beliefs that too much money is spent on
individuals in prison and they do not deserve all of the privileged services they receive while
they are incarcerated (Roberts & Hough, 2005).
Demographics of the Population
In Michigan in 2013 there were a total of 43,759 individuals in prison (Carson, 2013).
Out of the 43,759 there were only 2,059 females in the prisons in Michigan. For every 100,000
female adults in Michigan, 41 female adults will end up in prison. In Michigan in 2013 there
were 5 females in prison that were non-citizens. In the same year there was only 1 inmate under
the age of 17 years old (Carson, 2013). At the local level the demographics for women in prison
were not made readily available.
On the national level in 2013 there was a total of 104,134 women in prison (Carson,
2013). With men and women combined it brought it to a total of 1,574,741 individuals in prison
in the United States. This number adds up to equal for every 100,000 adult women in the United
States, 83 will end up in prison. Next the 104,134 women that are in prison will be broken down

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into age by total percentage. From ages 18-19 equal 0.6%, 20-24 equals 10.2%, 25-29 equals
17.3%, 30-34 equals 18.3%, 35-39 equals 14.4%, 40-44 equals 13.2%, 45-49 equals 11.3%, 5054 equals 7.7%, 55-59 equals 3.8%, 60-64 equals 1.7% and 65 and older equals 1.2%. Breaking
down the 104,134 female women in prison by race 51,500 are white, 23,100 are black, 17,600
are Hispanic and 11,900 are of other race. When looking at the offenses categorized, under
violent encompasses murder, manslaughter, rape, robbery and aggravated or simple assault.
Under Property it encompasses burglary, larceny-theft, motor vehicle theft and fraud. Under drug
it encompasses drug possession and other drugs. The two other categories are public-order and
other. For females in the United States the crimes committed are 37.1% violent, 28.2% property,
24.6% drug, 8.9% public order and 1.2% other (Carson, 2013).
Health Concerns
Incarcerated women have a high prevalence of many different diseases and illnesses.
Over the past five years a study was conducted to determine different health concerns of
incarcerated women that were mothers (Turney & Wilderman, 2015). During this study over
4,000 individuals were researched and their self reported health problems were documented.
Some of the self reported health concerns were depression, illicit drug use, heavy drinking and
overall poor health. Women who have been to prison at some point in their lives have a greater
chance of obtaining the human immunodeficiency virus then women who have not been in
prison before (Farel et al., 2013). These are just a few of the health concerns related to
incarcerated women, but as you can image there are many more.
Based on the stereotype that women who are incarcerated are inferior, it is thought that
they would be treated differently when it comes to their health care. Though this does still occur
in prisons, it was much more likely to occur before the 1970s (Kinsella, 2004). Around this time
individuals who were incarcerated were thought to be slaves of the government. Their health care
was not a priority and not many people gave it a second thought to treat their illnesses. As time

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has gone on prisoners are now looked at as people and their care is more important. Some health
care providers have individual beliefs that are not consistent with providing excellent health care.
One reason for this is they do not believe they deserve the same level of care as the people who
are not in prison. They find it to hard to take care of these individuals and in the long run they
end up finding a different career path (Kinsella, 2004).
Prevalent Disease Process
There has been a substantial amount of research done on prevalent disease processes for
incarcerated women. One of the major health issues that is seen in many women who are
incarcerated is human immunodeficiency virus (HIV). In North Carolina there was a study done
on African-American women who were in prison to try and determine the rate of HIV and
leading causes of HIV for this population (Farel et al., 2013). In this study multiple doctors
conducted interviews that were digitally recorded for 29 women that have been in prison for 3
months or longer. Based on the interview process results, there were many recurring health
practices that could have been the potential cause for the women contracting HIV. A few of these
practices are minimal use of condoms, having men and women as sexual partners and having
complex sexual relations within months before going to prison. There is a correlation between
these risky health practices and substance use among the HIV positive women. It was also
discovered that if you have ever been in prison, you have a more likely chance of contracting
HIV then if you have never been in prison before (Farel et al., 2013).
Nurses can play a key role in this vulnerable population by using their role as an
educator. Many of the incarcerated women are uneducated and do not fully comprehend the
behaviors that lead to contracting HIV. In the study that was conducted some suggestions they
had for reducing HIV in prison are condom use, education on same sex partners and prevention
of further transmission of the disease (Farel et al., 2013). With all of these suggestions presented,

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nurses can play a vital role in implementing them. Nurses in the prison could conduct weekly to
monthly seminars to educate the women on the seriousness of HIV and how it can impact a life
forever. Since it is unlikely that the women would voluntarily attend these seminars, an incentive
program could be offered to ensue greater attendance. The health care delivery system can be
improved by adding more nurses to each prison to make it possible for nurses to tackle not only
HIV, but also other disease processes that are present in incarcerated women.
Health Care Policy
The health care policy to provide medically necessary treatment in a timely manner in
prisons should have a positive impact on incarcerated women. This health care policy was
created in response to many preventive illnesses and deaths within prisons (Kinsella, 2004).
Before the 1970s there were no laws or rules for health care within a prison. The inmates were
considered slaves of the state and their care was not of high importance to anyone. By the
1970s interest dramatically increased into whether inmates should be allowed adequate health
care. One of the major reasons that led to inmates receiving a high quality of health care is that
some of theses prisoners are released into the community. If the inmates contract a disease that
can potentially be transferred to another person and are released into the community without
being treated, innocent bystanders of the community can be infected as well. In 1972 there was
a court case about health care in prisons, which resulted in the knowledge that the correctional
system was violating the Eight and Fourteenth Amendment (Kinsella, 2004). This situation was a
true landmark and turning point for incarcerated individuals to start receiving adequate health
care.
On average the state pays $7.15 for health care per person per day for those incarcerated
(Kinsella, 2004). For this reason alone many health care providers do not want to provide
adequate care for incarcerated women. The health care policy to provide medically necessary
treatment in a timely manner impacts the care of incarcerated women in a positive way. Because

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of this policy many doctors and other health care providers strive to take care of all health
concerns of the inmates, not just medically necessary treatments. The reason behind this is
because in the past there have been many lawsuits against the health care providers, resulting in
the inmates winning large monetary awards. The health care providers do not want to bring on
any more lawsuits, so they treat all health care conditions in an appropriate and timely manner
(Kinsella, 2004).
Conclusion
Incarcerated women encompass a vulnerable population that face many biases and
stereotypes. They are looked at as inferior and the public does not want to spend any extra
money to take care of them. They make up a large group of individuals, 2,059 in Michigan and
104,134 in the United States. Since they are a vulnerable population they face many health
concerns such as HIV, depression, illicit drug use and heavy drinking. Before the 1970s
individuals in prison were thought to be "slaves" and did not receive adequate health care. Since
then many policies have been implemented to try and make it so the women in prison receive
health care in a timely manner. As nurses it does not matter what type of at risk population we
are caring for, because in the end they are all our patients and need to be treated equally.

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References
Carson, A. (2014). Prisoners in 2013. Retrieved from
http://www.bjs.gov/content/pub/pdf/p13.pdf
Farel, C. E., Parker, S. D., Muessig, K. E., Grodensky, C. A., Jones, C., Golin, C. E., & ... Wohl,
D. A. (2013). Sexuality, sexual practices, and HIV risk among incarcerated AfricanAmerican women in North Carolina. Women's Health Issues, 23(6), e357-64.
doi:10.1016/j.whi.2013.08.006
Galea, S., & Vlahov, D. (2002). Social determinants and the health of drug users: socioeconomic
status, homelessness, and incarceration. Public Health Reports, 117(3), S135-45.
Kinsella, C. (2004). Corrections health care costs. Retrieved from
http://www.prisonpolicy.org/scans/csg/Corrections+Health+Care+Costs+1-21-04.pdf
Roberts, J. V., & Hough, M. (2005). The state of the prisons: Exploring public knowledge and
opinion. The Howard Journal of Criminal Justice, 44(3), 286-306. Retrieved from
http://0-search.proquest.com.libcat.ferris.edu/docview/224823136?accountid=10825
Turney, K., & Wildeman, C. (2015). Self-reported health among recently incarcerated mothers.
American Journal of Public Health, 105(10), 2014-2020. Retrieved from http://0search.proquest.com.libcat.ferris.edu/docview/1713658210?accountid=10825

Appendix A
Conceptualmodeloftherelationshipsbetweensocioeconomicstatus,homelessness,and
incarcerationandthehealthofillicitdrugusers

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