Limiting women prisoners' healthcare access: Implications for the management of communicable disease and healthcare justice

Background: One in 100 individuals in the US is in jail or prison, and women represent the fastest growing segment of this population. Women prisoners are at higher risk than men for a number of serious health problems including HIV, other bloodborne diseases, and STIs. This paper presents the findings from a study of healthcare access among formerly incarcerated women and analyzes how barriers to healthcare impact prevention and treatment of communicable disease. Method: This community-based participatory research project included 31 formerly incarcerated women. Focus group data were transcribed verbatim and analyzed using grounded theory. Participants' mean age was 38 years. Fourteen were White, 8 Hispanic, 6 African American, and 3 other. Their mean level of education was 12 years. They reported an average of 6 incarcerations in jail and 1 in prison. Results: Participants in this study described circumstances that hindered their healthcare access while in jail and prison. Specifically, they reported how co-payments, fees paid by prisoners for healthcare, presented barriers. Their accounts illustrate how communicable disease often went untreated, and how they found limited access to care on community reentry. Conclusions: Restricted healthcare access and untreated communicable disease violate prisoners' human rights and compromise safety for other prisoners, staff, and the larger community. These findings have implications for public health nursing practice in the community settings to which over 600,000 prisoners return each year, and raise questions of health justice for public health nurses working with this vulnerable population.