AT ANY ONE TIME, OVER 400,000 PRISONERS ARE INCARCERATED IN STATE AND FEDERAL PRISONS, LOCAL JAILS, AND JUVENILE DETENTION FACILITIES. DISADVANTAGED SOCIOECONOMIC CLASSES ARE DISPROPORTIONATELY REPRESENTED IN THE POPULATIONS OF CORRECTIONAL FACILITIES; OVER 40 PERCENT OF ALL JAIL INMATES ARE BLACK AND OVER 50 PERCENT HAD PREARREST INCOMES OF LESS THAN $3,000. REFLECTIVE OF THEIR DISADVANTAGED BACKGROUNDS, PRISONERS ARE MORE LIKELY THAN THE GENERAL POPULATION TO HARBOR UNDETECTED HEALTH PROBLEMS OF A SERIOUS NATURE. ALCOHOLICS, WHO SHOULD BE GIVEN MEDICAL TREATMENT RATHER THAN INCARCERATED, MAKE UP ONE-THIRD OF ALL ARRESTS. DESPITE THESE CIRCUMSTANCES, JAIL INMATES RARELY RECEIVE MEDICAL EXAMINATIONS OF ANY SORT, AND STATE PRISONERS MAY BE HELD FOR YEARS WITHOUT MEDICAL CARE. WHILE ENTRY TO CARE IS THROUGH SICK CALL, ACCESS TO SICK CALL IS OFTEN BARRED BY UNTRAINED GUARDS. A COMMON THEME RUNNING THROUGH STANDARDS FOR PRISON HEALTH CARE SERVICES DEVELOPED BY VARIOUS ORGANIZATIONS, INCLUDING THE UNITED NATIONS AND THE AMERICAN CORRECTIONAL ASSOCIATION, IS THAT MEDICAL CARE PROVIDED FOR PRISONERS SHOULD BE EQUIVALENT TO 'MAINSTREAM' CARE IN BOTH QUALITY AND ACCESSIBILITY. IN CONTRAST TO THESE STANDARDS, HOWEVER, RECENT SURVEYS CONDUCTED BY THE DEPARTMENT OF JUSTICE AND THE AMERICAN MEDICAL ASSOCIATION INDICATE THAT 49 PERCENT OF ALL LOCAL JAILS LACK EVEN BASIC PROVISIONS FOR FIRST AID, AND OVER THREE-FOURTHS OF ALL JAILS HAVE NO ARRANGEMENTS FOR REGULAR MEDICAL COVERAGE. A 1972 RULING DECLARED THAT FAILURE TO PROVIDE ADEQUATE MEDICAL CARE IS A VIOLATION OF PRISONERS' CONSTITUTIONAL RIGHTS; THE FEDERAL PRISONERS HEALTH CARE PROGRAM WITH AN ANNUAL BUDGET OF $500 PER INMATE INDICATES THAT ADEQUATE PRISON HEALTH SERVICES CAN BE PROVIDED. IN SHORT, THE ABYSMAL STATE OF HEALTH SERVICES IN STATE PRISONS AND LOCAL JAILS REFLECTS LACK OF BOTH MOTIVATION AND RESOURCES. (AUTHOR ABSTRACT MODIFIED)