by Grayson Shaw (PO ’25)
“One of the main reasons I filed the lawsuit was to try to save my life… It was really horrible being sick, and the only access to water I had was poison”
This testimony from Lamar Singleton, along with 18 independent lawsuits from former inmates, illustrates the reality of the Kern Valley State Prison in Delano, California. Prisoners were reportedly forced to drink from a water supply with high concentrations of arsenic which resulted in skin damage, circulatory system problems, and significantly higher risks of developing cancer. These lawsuits argued that the repeated consumption of the prison water with no alternative led to a drastic decrease in quality of health, and often led to serious hospitalization that had to be carried out at a different jail because Kern Valley State Prison did not have the adequate health facilities to treat its inmates.
Unfortunately, this is far from the first time that the prison healthcare system has failed Californian inmates. To make matters worse, COVID-19 has forced the state of California to rethink an already strained system, and questions for the future remain unanswered. The California prison healthcare system cannot afford to repeat the mistakes of its past. Averting another humanitarian crisis is done through an analysis of its past, an understanding of its present, and advocacy for its future.
Prison healthcare pre-COVID
The prominent Supreme Court case first established the rights of prisoners to healthcare in the 1976 case Estelle v. Gamble. Despite siding against the petitioner, the Supreme Court did establish, “the government’s obligation to provide medical care for those whom it is punishing… indifference to serious medical needs of prisoners constitutes the ‘unnecessary and wanton infliction of pain’… proscribed by the Eighth Amendment.” The state of California has seriously neglected their constitutional duties, and prison healthcare has gone notoriously unattended, ultimately disregarding the state’s constitutional duties.
A statewide report from the Office of the Inspector General in 2017 rated 11/13 state prisons inadequate on applicable standards. In other words, the report found that prisoners had inadequate access to care, preventative services, diagnostic services, and quality of providers. Insufficient resources were the largest contributor to the lack of healthcare access for the ever-increasing prison population. At one point, California operated at over 200% capacity for its jails, and this overflow resulted in the 2011 Brown v. Plata Supreme Court case confirming that the overcrowded prisons violated the 8th Amendment: prisons experienced “backlogs of up to 700 prisoners waiting to see a doctor for physical care,” and vacancies in over half of their psychiatrist positions.
Unfortunately, little has changed since Brown v. Plata. A report from the California state auditor in early 2020 deemed the California Department of Corrections and Rehabilitation (CDCR) a “high-risk” organization due to its inadequate healthcare systems. Additionally, that same report indicated that the problem is getting worse as “quality of care has declined in six institutions since its 2017 evaluation”. The problems of overcrowding, lack of resources, and high vacancy rates all continue to plague the prison system, and the COVID-19 pandemic exacerbated these difficulties to an unprecedented level.
Prison healthcare in a COVID world
Unsurprisingly, the global pandemic that hit vulnerable populations the hardest did not spare the vulnerable population that is California’s prisoners. In an attempt to prevent uncontrolled infection, the California Department of Corrections and Rehabilitation issued emergency measures to release 3,500 inmates. This policy did little to stem the tide of COVID-19 on an already overworked healthcare system. The emergency measure still had the state operating at 107% prisoner capacity in its jails, and by 2021, over half of California inmates have tested positive for COVID. To make matters worse, the 107% capacity is actually higher than it was at the beginning of 2021, rising 4% in 6 months.
California managed to avoid some of the worst impacts of COVID, largely through widespread vaccination and eliminating copayments for healthcare before the pandemic started. Despite this, the Prison Policy Initiative, a non-profit criminal justice think tank, still only gave California a “C-” grade for its mitigation efforts (no state received higher than a “C”). Certainly, COVID could have been much worse in California prisons, but it also could have been handled significantly better. Stanford researcher Elizabeth T. Chin outlined in her recent study that COVID-19 rates in prisons represent “substantially higher” rates of infection and mortality than the state’s general population. Chin’s research also found that prison officials created no mitigating efforts in the living dormitories for those most vulnerable to the disease. Paired with continued labor that involved constant interaction with other prisoners, the carceral nature of the California prison system handcuffed the COVID response before the pandemic ever started.
Prison healthcare post-COVID
Even before the ongoing COVID-19 pandemic, California prisons consistently mistreated inmates with under-resourced healthcare facilities; a maltreatment tantamount to human rights and Constitutional violations. Looking forward, the same methods of the past will likely result in the same mistakes. Whether the answer is a radical realignment of the framework of prisons themself or tangible changes right now, relying on the existing literature of prison scholars can illuminate possible solutions to these pressing issues.
California is currently enacting certain legislation that is a step in the right direction for alleviating the burdens on prison healthcare systems. In 2021, Governor Gavin Newsom signed budget legislation that will close two prisons in California, with three more on the table for closure by 2025. Gov. Newsom’s reasoning was that the prison population has declined since the “tough on crime” policies of the 80’s and 90’s, so older prisons that require serious renovation are better closed for the economic burden these facilities bear. This, along with other measures to reduce the state’s incarcerated population such as the closing of four juvenile prisons with a focus on “minimally restrictive centers”, is a positive step towards better allocating resources for prison healthcare.
These reforms signed into law by Gov. Newsom are good for improving the conditions of prisoners right now, but to many, they fail to address the bigger picture. Despite this positive news, activists still fear the role prisons play in contemporary society. Activists against mass incarceration such as Woods Ervin warn that reforming the existing prison system only makes it stronger by recognizing it as a legitimate response to crime in the United States, saying that prisons actively “feed off of reform”. Abolitionist Ruth Wilson Gilmore discusses in her book Golden Gulag that prisons facilitate the process of dehumanization because they require that society justify millions of people living “in a cage” their entire life. Activists and abolitionists alike advocate for a broader understanding of prisons themself as violating human rights, as opposed to individual bad cases. In other words, they believe the social understanding of prisons needs to change before institutional practices can.
Ultimately, there are prospects for positive reform in California. Whether these reforms will entrench a broken system or lead to widespread change is yet to be seen.
