On National Rural Health Day, I find myself thinking about an invisible diaspora – the diaspora of people from cities to prisons in rural America.

People who live in rural communities wind up in rural jails when they get arrested. But thousands upon thousands of people are also sent to serve their time far from home in state and federal prisons that dot the rural landscape.

Since 1980, the majority of new prisons have been built in rural areas, and the majority of people in prison are now confined in rural prisons.

Many factors account for this trend – from “not in my backyard” politics in urban centers to the active pursuit of new prisons by rural legislators as an economic development strategy.

For 17 years, the two largest women’s prisons in the world operated across the road from each other in the town of Chowchilla, California.

According to the 2010 Census, Chowchilla’s population of 18,720 included no less than 7,353 women in prison, or almost 40% of the town’s total population.

Surrounded by fields, the prisons are about 150 miles from the San Francisco-Oakland Bay Area and 240 miles from Los Angeles, where many of the women come from.

Impact on Women & their Families

What are the challenges of providing health care to women in rural prisons? Just as rural areas face a shortage of medical providers, so too do prisons have trouble attracting and retaining top medical talent.

Combine these two problems and you can see the implications for access to women’s health care, whether abortion care, high-risk pregnancy care, drug treatment, or therapy for trauma and abuse.

Imprisonment inevitably disrupts family relationships. But the practice of siting prisons far from cities needlessly magnifies the disruption.

Most people in prison are poor. When prisons are built in remote locations without public transportation or even a stop on the Greyhound bus route, how can low-income families who don’t own a car manage to visit?

More than half the women in state prison never have a visit with their kids, and almost half the women in federal prison never see their kids.

Policymakers have pursued this course despite what seems to be universal agreement that people who maintain relationships with their family during incarceration are less likely to go back to prison again after finishing their sentence.

Because women tend to be the primary caregivers for their children prior to arrest and because they need to demonstrate an ongoing relationship if their children are in foster care, being displaced to a rural area is especially problematic. Only a handful of states have laws that recognize the special circumstances of children who are in foster care because of a parent’s imprisonment.

In most of the country, courts will terminate parental rights after a child spends 15 months in foster care. The prospect of losing a child, let alone the reality of losing a child, takes a heavy toll on women’s emotional well-being, an important component of health.

National Rural Health Day is an opportunity to raise awareness of the often-overlooked needs of people in rural communities, including women in rural prisons.

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Learn more about the consequences of building prisons in rural areas:

Visit the Prison Policy Initiative’s project on prison gerrymandering, which looks at the way that importing people to prison unfairly boosts the political power of rural districts.

Visit the Real Cost of Prisons Project and search for the word “rural” to find evaluations of prisons as an economic development strategy.

Check out the aerial view of the two prisons in Chowchilla, CA using Google Maps. (The state recently converted one of the two into a men’s prison.)