Clifford Farrar, 51, was a prisoner at Stafford Detention Center in Washington state. He also had type 1 diabetes and had been insulin dependent since age 15. His condition was known to the prison, yet in December 2021, he died after pleading for insulin that would have saved his life, his family said.

Farrar died in prison after requesting insulin supplies and informing prison officials, “I don’t have the funds.” His story recently came to light in the media in November 2022, and his death, many prisoner advocates, say, highlights the racial healthcare gap in the country’s prisons.

On that fateful day in December 2021, Farrar collapsed in a common area. His medical records show his blood sugar was dangerously low, and when the staff gave him glucagon to raise his levels, his blood sugar shot up. This shock to his system caused him to have a seizure and a fatal heart attack, according to his medical records. The official coroner’s report said Farrar’s cause of death was “natural”, due to heart disease and diabetes. This has been disputed by his family, who claimed the inmate begged for better access to insulin, something vital to diabetics, for weeks before his death.

“They let him die. They killed my brother,” said Mary Farrar-McQueen, Clifford Farrar’s sister, in a Guardian interview in November 2022. “My brother was not ‘sick’. He was only a diabetic like millions. He had a long life ahead of him. He died a senseless death, a preventable death.”

Farrar had a wife and nine children. He was imprisoned at Stafford in the summer of 2021 after a short period in county jail to serve roughly two years for a felony. He required four insulin shots a day, and was initially given access to needles, test strips and a glucometer that measures blood sugar levels, The Guardian reported. On Aug. 27, 2021, he wrote to prison doctors requesting a pump or access to one he’d used at home for years. The pump delivers continuous doses of insulin through a catheter. He also asked for glucose tablets in case of emergencies. His requests were not fulfilled. On Sept. 13, Farrar suffered a seizure from low blood sugar and again asked for, but did not receive, a pump. He informed the prison he didn’t have funds to pay for the equipment.

Most prisons charge incarcerated people a copayment for doctor visits, according to the organization Prison Policy.

Inmates nationwide are subject to poor healthcare, advocates say. In the U.S., where 2 million people are imprisoned, thousands die while locked up each year and incarceration has been shown to significantly reduce life expectancy.

People in prisons and jails are disproportionately likely to have chronic health problems, including diabetes, high blood pressure, and HIV, as well as substance use and mental health problems. Nevertheless, correctional healthcare is low-quality and difficult to access. Mass incarceration has shortened the overall U.S. life expectancy by five years.

Health disparities between Black and white female prisoners are similar to disparities in the general population, a 2017 study found on racial disparities in health conditions among prisoners compared with the general population. The lack of sufficient healthcare results in more Black men’s deaths in prison than white. Various studies have found that the mortality rate for Black male prisoners age 15 to 64 is 19 percent lower than for Black men in the noninstitutionalized population.

Clifford Farrar with his daughter Oshia. Photograph: Courtesy of Farrar’s sister, Mary Farrar-McQueen.