As California prisons let in visitors and other "non-essentials," a time to reflect on disease and prisons
The closing of California prisons for the past two weeks to visitors and non-essential personnel based on one possible case of N1H1 virus in a Southern California highlights the link between infectious disease and incarceration and is yet another negative implication of California’s over-reliance on incarceration to address crime. In this case the conditions and numbers of people incarcerated may threaten the public health of California as an efficient system to transmit H1N1.California incarcerates over 170,000 people. Our prisons are filled to twice their capacity and because little forethought is given to the implications of “tough on crime” sentencing laws including mandatory minimums and three strikes. Despite the dire fiscal situation in the state, we continue to send more people to prison and for longer periods of time at exorbitant cost to California’s taxpayers.
While H1N1 is a concern in the community, in California’s overcrowded prisons where basic hygiene and medical care are difficult to maintain, H1N1 and other infectious diseases are an even greater problem because of the increased likelihood that they will spread, and without proper medical response. We know that H1N1 is highly treatable, but in a prison setting concerns that early symptoms may go without attention are real.
Prisons concentrate people who are more likely to have serious health issues: the rate of HIV, Hepatitis C and MRSA to name a few is much higher among prisoners than in the community. In prison, people at high risk for disease are placed in environments where disease is likely to spread. Outbreaks of Norovirus, tuberculosis and MRSA have all occurred in correctional facilities in California in recent years. It’s therefore unsurprising that an early case of H1N1 has occurred there, too.
Because prisoners are frequently transferred throughout the system and more than 95% of prisoners return to our community after an average sentence of two years, we should be concerned, too. It’s not unreasonable that a prisoner outside of San Diego might have just come through San Quentin’s reception center, or had contact with someone sent to Vacaville or Sacramento or any one of the 33 prisons in the state. Any of these prisoners could have come in contact with hundreds of correctional service staff and others who work in prisons daily. And, given the period before symptoms present, it’s not unreasonable to conclude that H1N1 might have been spread to others throughout the state’s prison system. The same is true of any infectious disease in this environment.
This situation highlights yet another deleterious effect of incarcerating hundreds of thousands of Californians each year in a system that can neither prevent nor treat disease at the basic level required by our federal constitution. When you think about H1N1, consider the effect California’s criminal justice laws have on the health of the broader community. It’s time for a change.
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