Strickland and Shetty (1998, pp. 25-26) posit that "measures of health status, a relatively long-term property of the individual.. .tend to show more marked social class differences." In the American context, the medical marketplace is the primary mode of health care delivery. As a consequence, Heurtin-Roberts and Reisin (1993, p. 223) point out that just as "American affluence is not equitably distributed, neither are our basic health care services."

In the American context, Appalachia is often described as enamored of "folk" remedies. Cavendar and Beck (1995, p. 140) argue that in fact, members of this community are pragmatic, and though pious, are not overly given to superstition or faith healing. "Traditional" remedies, such as turpentine or onion poultices to treat upper respiratory ailments, have slowly been replaced with commodities available in today's health market, namely pharmaceuticals and professional services. Younger generations may express disdain for the backward ways of their parents and grandparents because they have internalized the "primitive" characterization of this type of healing as it has been expressed to them by outsiders (Cavendar & Beck, 1995, p. 140). The changing health practices, namely a preference for health commodities, are reflective of the changing subsistence base of this area.

As a class structure, incarcerated criminals constitute the lowest social order in society. They are deprived of rights, privileges, and often personhood itself (Foucault, 1975). Prisons are a particularly intriguing area of study, especially from an anthropological perspective. Coupled with the legal mandate of 1976 which required prisons to provide adequate and timely medical care to inmates, correctional systems have been searching for ways to provide both safe and timely response to inmate health care. Federal prisons alone held over one million inmates, and the incarceration rate increased from 139 per 100,000 in 1980 to 373 per 100,000 in 1994, a tripling in just over a decade (Hipkins, 1997, p. 375). Disease is endemic in the prison system because prisoners have lower health indicators to begin with and are exposed to highly potent and communicable diseases such as AIDS. Endemic also are high rates of mental illness among inmates as they are shunted out of a shrinking mental health system and into the prison system (Hipkins, 1997). Given the large numbers of individuals living in prisons in the United States and around the world, a systematic analysis of the articulation of health and social control as it is expressed in the criminal justice system is long overdue.

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