Originally published in Synapse on March 15, 2007.
The healthcare facility in the San Francisco County jail looks like most clinics. It has exam rooms, a pharmacy, an X-ray facility, a dental clinic, a nursing station and a waiting room area. The only difference is that deputies sit at the nursing station, and the waiting room and pharmacy are impossible to escape due to their heavy security.
In fact, in order to open any one of these doors, staff rings a bell to call the attention of the facility watch guards who can see and hear everything that goes on throughout the jail through video cameras and speakers.
These people, in some unknown place, unlock doors much like you or I would buzz someone into our apartment. Two of my classmates and I, all pharmacy students, had the opportunity to visit San Bruno County jail as part of the course requirement of a Prison Health Elective we took through the School of Medicine.
The three of us were thrilled to be able to see the jail, especially after a quarter-long series of lectures during which we had heard about the corrections healthcare system.
As Diana, one of my classmates put it, “We must be the happiest people in here.”
The federal and state prisons and county jails offer universal healthcare to all inmates. Given the economic status of many of those who end up incarcerated, jail represents one of the only times that they will receive comprehensive healthcare.
In order to see a physician, nurse practitioner, clinical pharmacist, or dentist, inmates fill out request forms that document their condition and/or symptoms and submit the forms to a nurse. Nurses then triage patients to determine who will visit with each healthcare practitioner.
Generally, inmates are escorted to the clinics and wait their turn to be seen in the heavily secured waiting rooms. However, there are also healthcare consulting rooms in each pod. A pod represents the unit of prison “housing” in which inmates are grouped oftentimes according to gang affiliation.
About 60-80 people live in these pods and share I upcoming events & more at UCSF common lounging, “showering and eating space during the times they are allowed out of their cells.
Nurses frequently hold consultations in the pod, however maintaining privacy is an issue as all doors are transparent and other inmates may interrupt patient consultations. The United States incarcerates the largest proportion of its citizens compared to all other nations in the world.
Russia used to hold this record until a tuberculosis epidemic in their facilities forced them to let people out of the system. Implementation of harsher drug penalties federally and the three strikes law in California has led to a population explosion within the prisons and jails.
In California, it costs over $23,000 to imprison one person per year. This is more than the University of California’s 2006-07 estimate for total annual cost of undergraduate education per person per year, including tuition, room and board, books, health insurance, personal costs and transportation.
