Structuring and re-creating inequality: Health testing policies, race, and the criminal justice system

Research shows that prison inmates have a higher risk of contracting HIV than the general population, which prompts measures aimed at diagnosis, quarantine, and treatment. Research has also linked released inmates to an increase in the HIV incidence rate of communities. The authors explore the disjuncture between institutional policies and potential community outcomes by evaluating health assessments of inmates before and during prison admission. The authors argue that the penal institution is an active agent in structuring and re-creating health inequalities within prisons, thereby exacerbating existing community health inequities when inmates are released. Using data from the 2002 Survey of Inmates in Local Jails and the 2004 Survey of Inmates in State and Federal Prisons, the authors find significant racial, educational, and marital inequalities in health testing and test results. These inequalities vary across types of institutional testing policies and inmate cohorts, with later admission cohorts being less likely to receive HIV tests and future release cohorts having a higher likelihood of being HIV-positive.