There has been a significant change in the involvement of women with the criminal justice system over the last 20 years. This has been attributed to greater law enforcement efforts, more stringent drug sentencing laws, and post-arrest reentry barriers that only affect women. Between 1980 and 2019, the number of incarcerated women increased over 700%, from 26,378 (1980) to 222, 455 (2019), and the number of women under the supervision of the criminal justice system rose to 1.2 million. In 2020, women comprised 7% of the US prison population and 15% of the jail population. Research has shown that there are many reasons why incarcerated women have an increased need for healthcare. Thus, gender issues must be considered in correctional healthcare.

As many as 57% of incarcerated women have been physically or sexually abused at some point in their lives.  This trauma contributes to increases in depression, stress & anxiety disorders, learning problems, behavioral disorders, and substance use according to NCCHC. The trauma-informed approach recognizes trauma as a central issue in the health of the majority of incarcerated women.  Sensitivity and acknowledgment of a traumatic history can lead to interventions that promote recovery.

Trauma and abuse, added to drug and alcohol use, lead to increased mental illness. Thirty-six percent of incarcerated women are treated for some form of mental illness, compared to 24% of incarcerated men. Correctional nurses working in women’s prisons experience first-hand the increased prescription of medication, especially psychotropics, for their patients.  Incarcerated women are more willing to seek out counseling and psychiatric services, although many facilities are understaffed in these areas.

Pregnancy and Reproductive Health

Incarcerated women often have complicated and high-risk pregnancies due to their past medical histories, lack of prenatal care, and drug/alcohol use.  Reproductive health is jeopardized by increased sexually transmitted infections, pelvic inflammatory disease, and poor hygiene. Inadequate attention to female-specific screenings such as breast exams and Pap smears can lead to undetected cancers. 

Chronic Diseases

Chronic diseases uniquely affecting incarcerated women include menopause, osteoporosis and cancers like uterine, ovarian, and breast.

A study in the United Kingdom found that imprisonment was largely detrimental to women’s health for a number of reasons. The shock of imprisonment coupled with separation from family and children affected women’s health, as did poor health habits such as lack of exercise, poor dietary choices and close proximity to smokers.

What other female-specific health conditions have you seen in corrections?