What questions do Texas inmates ask about their health?
The United States incarcerates more people per capita than any other nation. Many of these inmates manage chronic health problems and mental health conditions during their incarceration. Although efforts to provide inmates with access to legal information is well documented, data about access to health information is harder to find. For inmates in Texas, a mail-in health reference service provides one channel for consumer health information. A colleague and I answered inmate questions for several years as part of our responsibilities at the Texas Medical Center Library. We performed a content analysis on a sample of 212 letters received to better understand the most urgent health information needs of Texas inmates.
We had no administrative contacts within the correctional facilities, so I am not sure which directories were pointing inmates to our service. Some of their letters suggest word of mouth recommendations help to advertise the service. You can explore which units sent the most questions below.
Our analysis matched recent surveys of inmate health issues. Most requests were for information about mental health and chronic health conditions. Perhaps more interesting was what the questions revealed about inmate distrust of information provided by the prisons. Many expressed belief that their health conditions were being ignored, as well as beliefs that environmental factors such as food and prison sanitation were endangering their health. Many also sought legal assistance, highlighting the need for our service to establish a stronger legal information referral network. Our 2016 Medical Library Association annual conference poster presents our findings, and the full article is available through Taylor & Francis:
Couvillon, E., & Justice, A. (2016). Letters from the big house: Providing consumer health reference for Texas prisons. Journal of Hospital Librarianship, 16(4), 281-286. doi:10.1080/15323269.2016.1221272
The most important tool for providing this service was “MedlinePlus. Produced by the National Library of Medicine, the site provides reliable health information at an accessible reading level. Solitary Watch was also helpful for frequently asked questions about the mental health toll solitary confinement takes.
As medical librarians, it easy to take having access to current health information for granted. Most of us cannot imagine having to wait for the U.S. Mail to learn about our health. Providing people with access to health information is our mission, and we can offer a lot of value to this population with a fairly low time commitment. I hope to see other health libraries expanding inmate health reference services in the future.
- Wilper, A. P., Woolhandler, S., Boyd, J. W., Lasser, K. E., McCormick, D., Bor, D. H., & Himmelstein, D. U. (2009). The Health and Health Care of US Prisoners: Results of a Nationwide Survey. American Journal of Public Health, 99(4), 666–672. http://doi.org/10.2105/AJPH.2008.144279
- CDC statistics on correctional health
- Inmate mental health statistics
- Al-Rousan, T., Rubenstein, L., Sieleni, B., Deol, H., & Wallace, R. B. (2017). Inside the nation’s largest mental health institution: a prevalence study in a state prison system. BMC Public Health, 17, 342. http://doi.org/10.1186/s12889-017-4257-0