February 12th, 2013  Since I moved to California last year,
California’s Prison Realignment policy has been getting deserved
attention. It’s no secret that prisons are the site of an acute
concentration of medical and social service problems. But where
did that concentration come from?  In my first post I thought
I’d take a moment to enumerate some of the features of prisons
and of prisoner populations that make that concentration so
intractable, especially here in California:    1. Prisons are
rural and isolated, and this impedes the swift delivery of
medical services.   2. Prisoners are frequently transferred from
other prisons, which complicates record-keeping – an essential
feature of medical care.   3. The architectural features of
prisons themselves often either exacerbate or precipitate
medical problems.   4. Prisoners are drawn from groups where
problems typically concentrate before they arrive in prison.
5. Some prisoners refuse urgent medical care.   6. Medical
personnel don’t make much money. One