The United States has experienced an explosion in the number of people in prison, an explosion that cannot be attributed to changes in the crime rate, but rather reflects changes in public policy, particularly sentencing policy regarding drug crimes. These changes have had a devastating impact on African-American communities. The changes have also adversely affected the social, economic, and political culture of the nation as a whole. The rate of increase in incarceration for women prisoners has been disproportionately high, although women are generally imprisoned for non-violent crimes and have lower recidivism rates than men. Once in prison, women are particularly at risk of harm from failure to treat their medical problems. The author cites many examples from her experience litigating medical care issues for women prisoners of harm caused by the lack of necessary medical care.