“It’s Their House”: The Effects of Health Care Privatization in Prisons and Jails

• In Event: Correctional Health Care in Crisis

Abstract

This study involved 47 interviews with privatized (n = 18) and non-privatized (n= 29) health care providers (HCP’s) who worked in jails, prisons, and juvenile detention facilities across the U.S. in the summer of 2022. While quantitative research consistently demonstrates worse health outcomes in privatized correctional settings (Bedard & Frech 2009; Smith & Gliddens 2022), this study sought to identify mechanisms that produce such outcomes beyond simplistic “bottom line” arguments common in prison privatization research. The present study found that HCPs in prison and jails with privatized care were less likely to assert autonomy and authority when negotiating with custody staff and were more likely to acquiesce to appeals of “safety and security.” They also lamented the turnover cycle of privatized health care companies, which resulted in health care administrative staff turnover and policy turnover. Respondents reported that this led to compromised ethical guidelines and unclear procedures.

Author

• Allison Gorga, Webster University