Reviewed by Associate Editor Upasna Saha
Nadya Kronis’ “Prisons, HIV/AIDS, & Digital Patients: Governing the Health of Carceral Citizens Between Abandonment & Care” touches on a number of important modern political issues. By looking at primarily HIV/AIDs patients, it considers how telemedicine functions for incarcerated individuals, the impacts of mobile health, or mHealth, on non-incarcerated communities (most of whom tend to include members of marginalized groups), and the connections between these phenomena. Kronis believes that these two groups are very interrelated and much can be learned from applying to the findings of one to the other.
Kronis begins by discussing the history of medical services in the prison context, focusing on privatization, access, and quality control. She then moves to discuss how the relationship between healthcare and prison is reflective of Michel Foucault’s concept of biopower, power which is manifested through the control of a group’s health. Kronis also brings up the concept of carceral citizenship, considering the rights an inmate has, namely to healthcare, when they enter the prison system. As she continues to explain how the positives and negatives of telemedicine in the incarcerated context, she also raises questions related to the format of the technology itself, the difficulties currently and formerly incarcerated individuals face in accessing healthcare, and how the broader concepts of racism and prejudice factor into this relationship.
In the later half of the essay, Kronis looks at the use of mHealth in a non-incarcerated context, particularly in a relatively less affluent African-American community. Here, her focus becomes more centered on whether mHealth has lived up to the standards its creators and other scholars have claimed for it. Kronis finds that, while mHealth does certainly have its beneficial effects, issues of accessibility and clinical success nevertheless do still persist.
I sincerely applaud Kronis for her focus on issue of such serious relevance to today’s world; much more research should be done in this vein so that health insurance companies, policymakers, and non-profit organizations will better know how to provide more effective healthcare to both incarcerated and non-incarcerated individuals in the future. Unfortunately, I felt as though Kronis’ paper read very much like a pro-con list, in that she simply explained what worked about telemedicine and mHealth and what needed to be improved. It would have been more illuminating had she also considered the fundamental issues behind the applications of these technologies, and perhaps what could be done to better them in the future. I also felt that the theoretical lens employed with the Foucault, while certainly interesting, did not really come up much, so I would have preferred either if had been taken out or if it had factored more greatly into the subject matter. Finally, while I thought that the discussions of both communities were compelling, I wished greater connections between them – wish is what Kronis had set out to explore – were ultimately made. Still, these considerations notwithstanding, Nadya Kronis brings a well-researched, passionate voice into a field that, particularly given the political climate of today, cannot nearly be discussed enough.