For women, incarceration comes with an additional, silent punishment: abandonment. Once in prison, many women are forgotten by their families and friends, never receiving any visits. “They face a double punishment—first by society for their crimes, and then by their families for failing as mothers and providers,” says Ligia Kerr, an epidemiologist and public health physician at the Federal University of Ceará (UFC). “This isolation takes a profound emotional toll on them, leading to very high rates of anxiety and depression.”
Kerr knows the situation well. She led a study that identified the main health issues and conditions faced by Brazilian female inmates, who make up 5% of the prison population. From January 2014 to December 2015, she and a team of health professionals visited 15 correctional facilities across eight states and the Federal District. In total, they examined and interviewed 1,327 women. The results of this study — the most comprehensive nationwide study on Brazilian female prisoners — has led to a series of articles published over recent years.
“It was through the research led by Ligia Kerr’s group that we began to focus on the needs of female inmates,” says Cíntia Rangel Assumpção, general coordinator of civics and penal alternatives at the National Office for Penal Policy (SENAPPEN), an agency under the Ministry of Justice and Public Security. “Governments need to collaborate more with academia to address these issues.”
– Brazilian prisons increase risk of illness and violent death
– Elderly population in Brazilian prisons has increased more than ninefold in 18 years
– Most crimes committed by men over 60 involve sexual assault
One of the study’s most striking findings is that these women, though mostly young, already have serious health issues that typically only appear later in the general population. Of the 1,327 inmates evaluated, 44% were under 30 years old and 48% were between 31 and 50. However, the prevalence of hypertension, cancer, and other cardiovascular problems was two to four times higher than in women of the same age group who had never been incarcerated.
The prevalence of health problems among the youngest inmates surprised the researchers: 13% of female inmates under 30 were hypertensive; 5.1% had other cardiovascular issues; 18.7% suffered from asthma; 1.3% had some form of cancer; and 0.4% had already suffered a stroke, reported Kerr and her collaborators in a 2023 article in Scientific Reports. In contrast, the prevalence of these conditions in the general Brazilian population of the same age is significantly lower: 2.9% have hypertension; 1.1% have other cardiovascular conditions; 6.7% have asthma; 0.7% have cancer; and 0.2% have had a stroke.
Prison conditions contribute to worsening these women’s health. According to a 2022 article in Ciência e Saúde Coletiva, 92% of inmates were sedentary in prison, and the same proportion reported poor diets. The study also found that, in addition to chronic diseases, certain infectious diseases are more prevalent among female inmates than in the general population: 51% of inmates had symptoms of sexually transmitted diseases; 7.4% had leprosy (a rate 100 times higher than in the general population); 11.7% had syphilis; and 2.3% were HIV-positive. The prevalence of syphilis was lower than what Julio Croda’s group found in prisons of Mato Grosso do Sul, but the prevalence of HIV was higher.
“For many female inmates, incarceration represents their first opportunity to access the healthcare system. Brazil is missing an opportunity by not identifying and treating these problems,” says Kerr.
The period of incarceration also disrupts families and makes these women feel abandoned. Before their conviction, 36.5% of female inmates were the primary breadwinners for their households. Eight out of 10 were mothers—most (81.2%) had their first child during adolescence. The most common reason for their conviction was drug trafficking (65.5%), followed by theft or robbery (17.5%).
“Many women are in prison because of Brazil’s highly punitive national drug policy,” explains psychologist Sara Reis, health coordinator at the Office for Penal Policy at SENAPPEN.
Once behind bars, many family and friendship ties dissolve. One in three inmates never receives a visit. A similar proportion is visited only by their mother, and 23% by siblings or children, as reported by nursing professor Patrícia França de Araújo in a 2020 article in BMC International Health and Human Rights.
“The breakdown of family ties leaves these women hopeless,” says Zeyne Scherer, a nursing professor at the Ribeirão Preto School of Nursing (EERP), University of São Paulo (USP). Scherer led qualitative studies in São Paulo with female inmates and former inmates, finding that, for them, family was seen as a key factor in reintegrating into society.
The story above was published with the title “Double punishment” in issue 342 of august/2024.
Project
Study of the violence to which incarcerated women are exposed in their lives (nº 07/07052-5); Grant Mechanism Regular Research Grant; Principal Investigator Zeyne Alves Pires Scherer (USP-RP); Investment R$21,296.52.
Scientific articles
LEAL, M. et al. Differences in non‐communicable diseases between women in prison and the general population in Brazil. Scientific Reports. oct. 31, 2023.
LEAL, M. et al. Health of female prisoners in Brazil. Ciência e Saúde Coletiva. June 30, 2022.
ARAÚJO, P. F. et al. Behind bars: The burden of being a woman in Brazilian prisons. BMC International Health and Human Rights. oct. 29, 2020.
