Utilizing community-based participatory research methods to document women's health issues in prison

Background: Currently in California, 177,100 individuals are incarcerated in correctional facilities. Over 66.1% are African Americans or Latinos. San Bernardino County, California ranks third for the largest inmate population in the State numbering 22,000, of which 25% are women. In 2006, reports indicated that one inmate death occurred a week due to medical neglect.

Objectives: This paper will discuss the methodology of documenting issues, barriers, and access to health and healthcare of women in prison by: (1) identifying health needs of women in prison; (2) understanding from the perspective of women inmates' problems accessing health, healthcare services, and health resources; and (3) identifying needs for the prevention of recidivism.

Methods: Focus group interviews included 61 inmates in a California Institution for Women (CIW) facility, stratified by three categories of inmates: “lifers,” “long-termers” and “short-termers.” Participant responses were recorded by three trained statisticians. Statisticians utilized Grounded Theory approaches to independently document emergent themes and to develop a coding scheme to quantify themes. Upon completion of coding, descriptive statistics were performed for more in-depth analyses and to better contextual findings for appropriate interpretation.

Results: Eighteen emergent themes were identified: education, eligibility, employment, discrimination, living environment, finances, dental health, general health, medical health, mental health, vision care, housing, child protective services/foster care system, parole, prison environment, red-tape, supportive services, and self-hindering behaviors.

Discussion: This study provides a “real” time needs assessment that can be used to direct resources and service delivery to underserved African American and Latina women in prison.