National Statistics on Diabetes
The national statistics on diabetes are shocking: According to the National Center for Health Statistics, among adults 20 years and over the percent with diabetes (physician-diagnosed or undiagnosed) stood at 12.6% (2011-2014) of the population. This breaks down to 9.6% with physician-diagnosed diabetes and 3% undiagnosed.
Diabetes is currently the number 7 cause of death in the United States, resulting in over 80.000 deaths each year. The Center for Population Health Management released its projections on the prevalence of diabetes in the US population in 2017 in a report entitled, Diabetes 2030: Insights from Yesterday, Today, and Future Trends. According to the report, “The prevalence of diabetes (type 2 diabetes and type 1 diabetes) will increase by 54% to more than 54.9 million Americans between 2015 and 2030; annual deaths attributed to diabetes will climb by 38% to 385,800; and total annual medical and societal costs related to diabetes will increase 53% to more than $622 billion by 2030.”
The Center for Disease Control (CDC) also released its statistical report in 2017 noting that over 100 million Americans either have diabetes or prediabetes. For those who have prediabetes or Type I diabetes, early treatment or intervention is critical. If the problem is not addressed properly, the end result is Type II diabetes. Type II diabetes is a far more serious condition and also far more expensive to manage.
Diabetes in Correctional Settings: Prisons and Jails
While the statistics on diabetes are alarming, they are considerably worse in our prisons and jails. According to the Department of Justice, Bureau of Justice Statistics (DOJ-BJS) in 2011–12, an estimated 40% of state and federal prisoners and jail inmates reported having a chronic health condition. Prisoners were about 1.5 times more likely than members of general population to have high blood pressure, diabetes or asthma. While the increases in the prevalence of prediabetes and Type I and Type II diabetes among the US population are bad, the increases among inmates in prisons and jails are surely worse. The total number of those suffering from diabetes, according to the DOJ-BJS stood at 9.0% and the numbers, as among the general population, are rising.
Indicators that are predictive of diabetes among prison and jail inmates are definitely indicated. The same report noted that a majority of prisoners (74%) and jail inmates (62%) were overweight, obese, or morbidly obese. Dietary regimes and options, the lack of proper care and lack of exercise due to the restrictions imposed upon inmates exacerbate prediabetes. Furthermore, the lack of appropriate medical care also serves to increase the likelihood that those with prediabetes or Type I diabetes will, over time develop Type II diabetes. Again, in the absence of appropriate medical care, intervention and treatment, the development of Type II diabetes will yield very costly consequences, not only in economic but in human terms. The economic impacts will be imposed upon taxpayers and should yield common sense measures which, if for no other reason, will result in lower public cost overlays over time.
The American Diabetes Association (ADA) provides a listing of the impacts of untreated diabetes, among them; foot complications such as neuropathy, Ketoacidosis, kidney problems including kidney disease, high blood pressure, stroke, HHNS and Gastroparesis. These are serious health problems which, if they are allowed to develop and then go untreated, may result in catastrophic and costly medical conditions.
More on Diabetes and Resultant Problems and Conditions in Prisons and Jails
In 2012, the Bureau of Prisons released its clinical guidelines on the management of diabetes. The guidelines include basic diagnostic tests for determining whether or not someone has diabetes and, on determination, provides measures that can be undertaken to prevent the onset of Type II diabetes, noting,
“Many studies have demonstrated that diabetes can be delayed, and sometimes prevented, in individuals at high risk for developing diabetes (those with IFG, IGT, or both).”
On determination that inmates are at high risk for developing Type II diabetes, aforementioned preventative measures may include; maintenance of a health diet, the benefits of exercise, engaging in a plan toward weight reduction and encourage to engage in physical exercise.
Perhaps needless to say, there are considerable barriers to undertaking such measures in a correctional setting: In facilities where private healthcare contractors are entrusted with medical service provision, low cost outlays rule the roost—inexpensive, in the short term, is the best when your primary driver is the maximizing of profits. This short-sightedness yields big gains for the private health care contractor, but those short-term games are picked up on the back-end by taxpayers.
Some Local Notes and Observations in New Mexico
A more recent data-set on inmates in New Mexico has been provided by the CDC in the form of a Diabetes Atlasof diagnosed cases as a percentage among prison inmates in the state. The percentage in New Mexico stands at 10.4%, placing our State among the top 10 worst in the country.
In 2018, the New Mexico Department of Health issued its State of Health report, and for at least the fifth year in a row, noted that diabetes was one of the number one public health concerns in the state. Diabetes is listed as being in the top five causes of death among state residents. The report raises public alarms around the need to address this burgeoning public health concern and goes on to note that among specific communities the prevalence of the disease is far greater: Among Native Americans and Hispanics, in particular, rates are higher. This should provide cause for targeted measures, particularly in correctional settings given overall disparities in our justice systems.
Sadly, as mentioned above, efforts will be meager in our state prisons in this arena. Again, when you let a private health care contractor run the show the emphasis falls not upon long-term economic impacts or human costs, it falls upon turning a profit.
Can Anything Be Done?
In the realm of policy, the short answer is “yes”. Yes, something can be done. We can do what most States have done: we can turn control of health care provision back over to those in the public sector and remove the profit motive from the equation. There’s ample evidence in the form of scads of research and statistics, from all sectors, that supports reeling back privatization of services in prisons and jails.
On a personal or individual level, deliberate indifference and negligence and medical malpractice that results in serious physical injury or death, something can be done. Medical malpractice and/or civil rights lawsuits may be filed. And they should be. Money is the only language that private corrections contractors know. Paying settlements or judgments is the only way to get their attention and to change their practices. The same is unfortunately true for the New Mexico Corrections Department which for its part is seriously breaching its fiduciary duty to New Mexico taxpayers by allowing these practices to persist.
If you or a loved one, while incarcerated in a correctional facility in New Mexico, were not offered appropriate medical care for a diabetic condition and that resulted in one of the impacts mentioned above; amputation, stroke or even death, contacting an practiced attorney with experience in dealing with prisons and jails in our state is an advisable course of action.