Prison Health, Public Health: Obligations and Opportunities

We don't care enough about prisoners’ welfare. We should care deeply because, as two prominent commentators on the history of prisons have said, “Prisoners are ourselves writ large or small. And, as such, they should not be subjected to suffering exceeding fair expiation for the crimes for which they have been convicted.” Well over two million persons are imprisoned in America today. We imprison a higher percentage of our population than any other country. Those we imprison are disproportionately poor, of color, uneducated, and sick. They have chronic conditions, mental illnesses, sexually transmitted diseases and other infectious diseases. They usually receive inadequate health care—and sometimes shockingly poor care.6 It has always been so. Prison reformers have argued for decent prison care based on humanitarian principles since the founding of the Republic, and, notwithstanding some notable achievements, have failed to achieve decent conditions. In the last fifty years, reformers shifted to individual rights arguments based on prisoners’ constitutional rights.