The prison industry has become a growth industry. There has been an explosive increase in the inmate population, along with a corresponding increase in facilities. In terms of public health, this means that there are more individuals with major medical problems in confined spaces, and that there are serious prevention and treatment needs. The intention is to look at the situation in the Milwaukee County House of Corrections located in Franklin, Wisconsin in order to discover some of the problems there, and then devise a plan for an intervention from a public health perspective.
As Dubik-Unruh (1999) noted, despite the fact that there is an increase of HIV and other infectious diseases in prisons, and that the population is a mix of infected and high-risk individuals in crowded living conditions, nationally funding for prevention and education programs has actually been reduced or eliminated.
For Dubik-Unruh (1999), one answer is to use nurses' knowledge and access to the prison population to influence prison policy toward the development and implementation of more educational and prevention programs for both prisoners and staff. She noted that nurses can serve as advocates for prisoners, since they are more likely to gain the trust of the prisoners than corrections staff and also likely to retain the trust of prison officials, because of their education and status.
Her recommendation was the development of inmate peer education and prevention programs, with nurses serving as the initiators of programs and educators of inmate educators.
One of the main problems in the criminal justice system today is the rapid and continuing expansion of the population behind bars. This is as true of the state of Wisconsin as it is of states more associated with burgeoning crime, like New York. For example, the Milwaukee County House of Corrections had a head count in the fall of 1998 of 1,400, greatly exceeding its listed cap...