Public Health and Prisons: Priorities in the Age of Mass Incarceration

Abstract

Mass incarceration is a sociostructural driver of profound health inequalities in the United States. The political and economic forces underpinning mass incarceration are deeply rooted in centuries of the enslavement of people of African descent and the genocide and displacement of Indigenous people and is inextricably connected to labor exploitation, racial discrimination, the criminalization of immigration, and behavioral health problems such as mental illness and substance use disorders. This article focuses on major public health crises and advances in state and federal prisons and discusses a range of practical strategies for health scholars, practitioners, and activists to promote the health and dignity of incarcerated people. It begins by summarizing the historical and sociostructural factors that have led to mass incarceration in the United States. It then describes the ways in which prison conditions create or worsen chronic, communicable, and behavioral health conditions, while highlighting priority areas for public health research and intervention to improve the health of incarcerated people, including decarceral solutions that can profoundly minimize—and perhaps one day help abolish—the use of prisons. Expected final online publication date for the Annual Review of Public Health, Volume 44 is April 2023. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

“Invisible Deaths”: A Critical Analysis of the Study of Prison Homicide

“…Mass incarceration has been a strategic mechanism of stratification, segregation, and inequality, disproportionately impacting certain groups across race, ethnicity, and class (Massoglia & Pridemore, 2015). Some of public health issues in prisons include serious mental illnesses, suicides, substance abuse and overdose, diseases, aging, serious illnesses, and the effects of solitary confinement (Cloud et al, 2023).…”

Health of Convicted Persons in the Third Generation of the Longitudinal Cambridge Study in Delinquent Development

“…Current literature indicates that risks of physical health problems are significantly higher among individuals with convictions compared to those with no convictions ( Binswanger et al, 2009 ; Cloud, 2014 ; National Commission on Correctional Health Care, 2002 ; Skinner et al, 2020 ). Outside of incarcerated populations, there is evidence that juvenile and adult individuals with criminal justice involvement are at increased risk of injury in general ( Lewis & Shanok, 1977 ).…”

“…Researchers have also argued that the negative effects of imprisonment on health can occur in a variety of ways ( Braverman & Murray, 2011 ; Pajer et al, 2007 ). These include that being in prison risks exposure to infection and disease ( Cloud, 2014 ; Johnson & Raphael, 2009 ; Massoglia, 2008a , 2008b ; National Commission on Correctional Health Care, 2002 ; Thomas & Torrone, 2008 ). Studies show that stress factors, created by imprisonment, can exacerbate pre-existing health concerns ( Desai et al., 2006 ; Holman & Ziedenberg, 2006 ; Wasserman & McReynolds, 2011 ).…”

Criminal Justice Reform Is Health Care Reform

“…Mass incarceration has roots in slavery and subsequent laws following the Civil War designed to enforce racial segregation, with modern efforts to police and control excluded populations accelerating dramatically and intentionally in the late 1970s with the War on Drugs. Since then, a decades-long removal of community social infrastructures (eg, mental health care, substance use treatment, affordable housing), overpolicing in communities of racial and ethnic minority groups, and structural racism in sentencing has fueled mass incarceration . The resulting incarcerated population is disproportionately composed of Black and Latino men and other racial and ethnic minority groups who experience a higher burden of chronic medical conditions and shorter life expectancy relative to the nonincarcerated population …”

“…Since then, a decades-long removal of community social infrastructures (eg, mental health care, substance use treatment, affordable housing), overpolicing in communities of racial and ethnic minority groups, and structural racism in sentencing has fueled mass incarceration. 1 The resulting incarcerated population is disproportionately composed of Black and Latino men and other racial and ethnic minority groups who experience a higher burden of chronic medical conditions and shorter life expectancy relative to the nonincarcerated population. 2 In a country with such high rates of imprisonment, all of us are closely connected to mass incarceration.…”