Women in California Prisons: Healthcare and Rehabilitation

Introduction

According to the California Department of Corrections, there are approximately 160,000 individuals incarcerated in the state of California. (California Prison Growth, 2003) Census data shows that 9,797 of these individuals are women and approximately 150,000 are men. (California Prison Growth, 2003) There are several issues that make prison life in California particularly difficult for women. These issues concern vocational services, educational services, healthcare, and rehabilitation services. The purpose of this discussion is to review previous studies that have examined the disparity in the treatment of men and women in California's correctional system.

Methodology: Secondary Data Analysis

Healthcare in California's Women's Prisons

One of the most significant issues facing female inmates in California and throughout the country is healthcare access. The first study examined the challenge of providing healthcare to California's female inmate population. The report was published by the California Policy Research Center at the University of California. The author of the report did not conduct the primary study but instead synthesized existing research.

The published report is a combination of various studies on the conditions facing female inmates in California's corrections system. The research includes information gathered from filed complaints and interviews with prisoners. The study examines access to healthcare for women who are incarcerated in California state prisons through quantitative and qualitative analysis of a large database of interviews, medical records, legal documents, and judicial reports assembled in conjunction with inmate complaints over a four-year period. The report's recommendations compare the California correctional healthcare model with "best practice" models for healthcare delivery, offering an empirical foundation on which to base deliberations on correctional health options.

The study was instigated by the fact that 1,269 complaints were filed by female inmates between 1994 and 1999. These complaints came from several of the state's correctional facilities, including the California Correctional Women's Facility, California Institution for Women, Valley State Prison for Women, and the Northern California Women's Facility. The report also explains that the study "examined reports by the California Department of Health Services and the State Auditor, legal materials, and contemporary standards for medical care in prisons and jails. This research was supplemented with interviews with prisoners and healthcare specialists." (Stoller, 2000)

The complaints covered a range of topics, including insufficient access to needed medicines. This was particularly true among women with HIV/AIDS. Many inmates complained that they were not receiving appropriate amounts of anti-viral medications, which can reduce both the length and quality of life for these individuals. (Stoller, 2000) Many of the women also complained that they had been misdiagnosed, and some reported that the healthcare they received was actually detrimental to their wellbeing. (Stoller, 2000)

Rehabilitation and Social Support

The research for this section was gathered through secondary data analysis. The study used was published in the Journal of Addictions & Offender Counseling and was conducted by Catherine Lemieux. The purpose of the study was to examine differences in social support among female and male offenders in correctional facilities.

The data were retrieved through a questionnaire survey, which was administered to inmates over a three-week period. A total of 101 surveys from 131 eligible inmates were completed, resulting in an overall response rate of 76.3%. The response rates for ACCC, SAAP I, and SAAP II were 100%, 92.8%, and 67.4%, respectively. Most of the SAAP II non-participants were on work call when the survey was administered. No significant differences emerged between respondents and non-respondents when age and length of time in the program were compared. (Lemieux, 2002)

The participants included male and female offenders enrolled in the Substance Abuse Awareness Program Sheriff's Drug Farm (SAAP) and the Atlantic Correctional Community Center (ACCC). SAAP is a two-phase program: the first phase involves drug education and counseling, and the second phase is a 4–12-month therapeutic community program focused on preventing relapses. ACCC is a program designed specifically for incarcerated women struggling with drug abuse.

The questionnaire was designed to measure both independent and dependent variables while also collecting data from custodial records. The independent variable drew from existing research, while the dependent variable was derived from inmates' perceptions of available social support. Lemieux (2002) notes that custodial records were used to examine the number of visits and types of visitors inmates received.

The author explains that perception of available social support was measured with the 12-item Multidimensional Scale of Perceived Social Support (MSPSS; Zimet, Dahlem, Zimet, & Farley, 1988). Respondents rated their level of agreement with 12 statements using response options ranging from 1 (very strongly disagree) to 5 (very strongly agree). The MSPSS yields an overall score ranging from 12 to 60, with higher values indicating higher levels of perceived social support. (Lemieux, 2002)

Results and Analysis

The data used in this research were both quantitative and qualitative in nature. The purpose of the research is explanatory and descriptive. The unit of analysis consists of groups of both male and female inmates.

In the first study, research found that there was a disproportionate number of complaints filed by women about healthcare services compared to male inmates. Much of this relates to the fact that women have unique gynecological needs requiring medical attention. In addition, many of the women had problems associated with pregnancy and childbirth. The availability of medical specialists also appeared to be more prevalent for male inmates. Some of the healthcare problems in California's correctional facilities also stem from the fact that the female inmate population has grown exponentially over the past decade — growth that was not anticipated and has led to an overcrowded system. The study found that:

"Nearly 22% of the women had missed important medications at least once, while many had missed them repeatedly... 19% of the women complained of at least one problem accessing the healthcare system... Thirty-two percent of the women report gynecological and reproductive health problems. Almost 9% of the women complain about care associated with a pregnancy... For over 13% of the women, the care provided by medical staff was harmful to their health, sometimes very seriously... Almost 26% of prisoners in the sample suffered from a wide array of miscellaneous symptoms that were uncodable due to inadequate diagnostic information in their files." (Stoller, 2000)

The second study found that women had more in-person visitors in prison than men, but that men received more letters than women while incarcerated. Interestingly, more than half the women in this study (62.5%) believed they received the emotional support and help they needed from their families, compared to fewer than half (48.3%) of the women in Singer et al.'s study. Although women in this study perceived higher levels of social support than men did, MSPSS scores for men also revealed perceptions of adequate available social support, with many men perceiving moderately high levels of social support from a significant other. (Lemieux, 2002)