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When we consider the relative cost of medical co-pays to incarcerated people who typically earn 14 to 62 cents per hour, it's clear they can be cost-prohibitive. Co-pays that take a large portion of your paycheck make seeking medical attention a costly choice.
If your doctor charged a $500 co-pay for every visit, how bad would your health have to get before you made an appointment? You would be right to think such a high cost exploitative, and your neighbors would be right to fear that it would discourage you from getting the care you need for preventable problems. That’s not just a hypothetical story; it’s the hidden reality of prison life, adjusted for the wage differential between incarcerated people and people on the outside.
In most states, people incarcerated in prisons and jails pay medical co-pays for physician visits, medications, dental treatment, and other health services. These fees are meant to partially reimburse the states and counties for the high cost of medical care for the populations they serve, which are among the most at-risk for both chronic and infectious diseases. Fees are also meant to deter people from unnecessary doctor’s visits. Unfortunately, high fees may be doing more harm than good: deterring sick people from getting the care they really do need.
A $2-5 medical co-pay in prison or jail may not seem expensive on its face. But when we consider the relative cost of these co-pays to incarcerated people who typically earn 14 to 63 cents per hour, it’s clear how they can be cost-prohibitive. To compare the cost of medical co-pays in prisons and jails to what people pay on the outside (relative to the wages available to each population), I first calculated how many hours of work it would take a low-paid incarcerated person in each state to pay for one co-pay. Then, I translated this hourly cost into the wages earned by a minimum wage, “free world” worker in the same state.
In West Virginia, a single visit to the doctor would cost almost an entire month’s pay for an incarcerated person who makes $6 per month. For someone earning the state minimum wage, an equivalent co-pay that takes the same 125 hours to earn would cost an unconscionable $1,093. In Michigan, it would take over a week to earn enough for a single $5 co-pay, making it the free world equivalent of over $300. I found that fourteen states1 charge a medical co-pay that is equivalent to charging minimum wage workers more than $200.
The excessive burden of medical fees and co-pays is most obvious in states where many or all incarcerated people are paid nothing for their work: Alabama, Arkansas, Florida, Georgia, Mississippi, South Carolina, and Texas. Texas2 is the most extreme example, with a flat $100 yearly health services fee, which some officials are actually trying to double to $200. People incarcerated in these states must rely on deposits into their personal accounts – typically from family – to pay medical fees. In most places, funds are automatically withdrawn from these accounts until the balance is paid, creating a debt that can follow them even after release.
Co-pays in the hundreds of dollars would be unthinkable for non-incarcerated minimum wage earners. So why do states think it’s acceptable to charge people making pennies per hour such a large portion of their earnings? Some might argue that incarcerated people have nothing better to spend wages on than medical care. But wages allow incarcerated people to buy things they need that the prison does not provide: toiletries, over-the-counter medicine, additional clothes and shoes, as well as phone cards, stamps, and paper to help them maintain contact with loved ones. Co-pays that take a large portion of prison wages make seeking medical attention a costly choice.
Part of the justification for charging incarcerated people medical co-pays is to force them to make difficult choices. Administrators want to deter “frivolous” medical visits. The National Commission on Correctional Health Care (NCCHC), however, argues that abuses of sick call can be managed with “a good triage system,” without imposing fees that also deter necessary medical services. And although providers must treat people regardless of their ability to pay, incarcerated people with “low health literacy” may not understand this right. The NCCHC warns that co-pays may actually jeopardize the health of incarcerated populations, staff, and the public.
Out-of-reach co-pays in prisons and jails have two unintended but inevitable consequences which make them counterproductive and even dangerous. First, when sick people avoid the doctor, disease is more likely to spread to others in the facility – and into the community, when people are released before being treated. Second, illnesses are likely to worsen as long as people avoid the doctor, which means more aggressive (and expensive) treatment when they can no longer go without it. Correctional agencies may be willing to take that risk and hope that by the time people seek care, their treatment will be someone else’s problem. But medical co-pays encourage a dangerous waiting game for incarcerated people, correctional agencies, and the public – which none of us can afford.
For details and sourcing information on co-pays (and what happens when incarcerated patients can’t afford them), see the Appendix.
March 2020 update: Please see our post about legislative changes in California, Illinois, and Texas to see what state policies have changed since we first published this briefing, and our page tracking correctional responses to the COVID-19 pandemic, which includes temporary suspensions of copays in some states.
This table includes co-pay fees for non-emergency, patient-initiated visits with medical staff. The co-pay average excludes Texas, which charges on a yearly basis rather than per-service. For details and sourcing information on co-pays, see the Appendix. For information on wages, see “How much do incarcerated people earn in each state?” State minimum wage information was obtained from the National Conference of State Legislatures. Exceptions: for states with no minimum wage law or minimum wages below the federal law, I used the federal minimum wage. For states with two tiers of minimum wages for free-world workers, I used the higher wages that apply to larger businesses (Minn., Mont., Ohio, and Okla.). For Nevada, I used the lower of the two minimum wage tiers, which applies to jobs with health benefits.
Co-pay or fee
Prison job minimum wage
Hours of work required to afford one co-pay
State minimum wage
Equivalent co-pay at minimum wage (hours x minimum wage)
This was updated April 28, 2017 with information from a new source on wages for Oklahoma’s regular prison jobs (non-industry). The source used when this was first posted did not state a minimum prison wage, only a maximum. According to DOC policy, however, the minimum wage for regular jobs is $7.23 per month, or about 5 cents per hour. A $4 co-pay for someone earning that much is the equivalent of a $580 co-pay charged to a non-incarcerated minimum wage earner in Oklahoma. The table, text, and graphs in this post have been updated to reflect Oklahoma’s updated information. ↩
As of 2019, the Texas legislature had made progress by replacing the notorious $100 fee Texas had charged incarcerated people with a $13.55 per-visit fee. While this change marks a substantial improvement, incarcerated people in Texas – who earn nothing for their labor – continue to be charged the highest medical co-pay in state prisons nationwide. ↩
In 2019, California passed legislation ending medical co-pays in prisons and jails. ↩
In 2019, Illinois passed legislation ending medical co-pays in state prisons and juvenile residential placement facilities. ↩
As of 2019, the Texas legislature had made progress by replacing the notorious $100 fee Texas had charged incarcerated people with a $13.55 per-visit fee. While this change marks a substantial improvement, incarcerated people in Texas – who earn nothing for their labor – continue to be charged the highest medical co-pay in state prisons nationwide. ↩
Referencing the collateral damage caused by weapons of mass destruction, O’Neil coined the term “weapons of math destruction” (WMDs). She defines WMDs as opaque mathematical models that embed human prejudice, misunderstanding, and bias into the software systems that automate numerous aspects of our lives. Her book covers several types of these models and the frustrating injustices they can perpetrate. In addition to case studies about credit scoring, online advertising, employment, and insurance, O’Neil discusses the use of WMDs in the criminal justice system. In particular, the book considers models used to deploy police, predict a defendant’s chances of recidivism, and calculate prison sentences.
Weapons of Math Destruction covers a lot of ground, but four distinct themes emerge in connection with the criminal justice system’s use of WMDs.
1) Fairness
The book repeatedly points to the unfairness that results from WMDs. O’Neil gives examples of algorithms that map crime so that police can predict crime hotspots, as well as models that take demographic information about a criminal defendant and calculate a “risk score” purporting to predict the likelihood that the defendant will recidivate. Although the creators of such WMDs usually claim not to consider race as a factor, facially neutral data like neighborhood can act as a highly accurate proxy for race. As a result, mathematical models, which are marketed as supposedly removing human bias from the system, often perpetuateracialdiscrimination.
WMDs also work to the disadvantage of low-income people. Crime-mapping programs direct police to focus on poor neighborhoods with high crime rates, leading to increased arrests in those areas (usually for “quality of life” non-violent offenses), thus reinforcing the initial data that led to heavier policing of poor neighborhoods. Residents from these localities who are convicted of crimes are—because their friends and neighbors are more likely to have criminal records—more likely to be flagged by risk-scoring models as high recidivism risks and receive longer sentences. As other researchers have noted, this faulty logic shifts responsibility for community-wide problems to individuals who have no control over neighborhood conditions like racial profiling, inadequate job opportunities, limited educational opportunities, and lack of access to mental health care. In O’Neil’s words, because WMDs have no way of considering fairness, “the result is massive, industrial production of unfairness. If you think of a WMD as a factory, unfairness is the black stuff belching out of the smoke stacks. It’s an emission, a toxic one.”
In addition to the broader issues of fairness, O’Neil points to narrower questions of legality. Even though recidivism risk scores are problematic from the outset (as discussed above), they could arguably be useful as one of several factors in making certain decisions (for example, identifying people who could benefit from intensive education or therapy programs). But grave legal issues are implicated when these models are used in determining a criminal sentence (a practice that is currently used in nine states, according to a 2016 ProPublica report, and which seems to be gaining in popularity). The U.S. Constitution guarantees that a criminal defendant can confront witnesses and challenge the evidence presented against him or her. But O’Neil explains that recidivism risk scores, unlike witness testimony, cannot be recorded and challenged in court, but instead “are tucked away in algorithms, intelligible only to a tiny elite.” Moreover, risk scores can be based on information that would not be admissible in a court proceeding, such as the criminal background of a defendant’s friends and family members, or the crime rate in his or her neighborhood.
3) Garbage in, garbage out
Ever since the early days of computer programming, programmers have acknowledged that inaccurate input data will produce inaccurate results. In the criminal justice context, this arises when deciding what type of crime statistics to feed into a WMD. When discussing crime-mapping, O’Neil posits that if a model is built on data about burglary, car theft, and violent crime, then perhaps the results could be useful in deploying limited police resources (although, even then, she acknowledges that crime reports and arrest records aren’t particularly reliable proxies for the true amount and nature of criminal activity). The big problem comes when nuisance offenses like vagrancy, panhandling, and simple drug possession are fed into models. These data distort crime calculations, fueling the proliferation of “broken windows policing” and ever-growing numbers of arrests.
On the flip side of the coin, plenty of harmful crime is not incorporated into WMDs. Financial firms defraud customers (sometimes nearly bringing the global economy to a halt) and industries violate environmental laws—but these harmful activities are not included in crime-prediction models, and the algorithms do not dispatch battalions of police to look for violations in wealthy suburbs and gated communities. As O’Neil writes, “[t]he result is that we criminalize poverty, believing all the while that our tools are not only scientific but fair.”
4) Using data for good
Finally, O’Neil expresses her frustration with the fact that sophisticated mathematical models can be used to improve society, but such deployment is not common because it would threaten entrenched powers. For example, she notes that prisons collect massive amounts of data on incarcerated persons, yet this information is not used to tackle questions like: what are the impacts of solitary confinement, what are effective tools for combatting sexual assault in prison, and what types of prison experiences (big or small) effectively reduce recidivism. Data that could be used to address issues like these are either not held in a usable format, or are purposely withheld from researchers. According to O’Neil, prison administrators “use data to justify the workings of the system but not to question or improve the system.”
Food for thought
I found Weapons of Math Destruction to be a good read because it provides an expert’s insight into how WMDs impact all of us. But this is a huge topic, and at roughly 200 pages, O’Neil’s book can’t cover all the ground, particularly in regards to criminal justice. There are many topics that remain lurking in the background, including three that come immediately to my mind.
First is the proliferation of data sources that can potentially feed WMDs. When discussing criminal-justice WMDs, O’Neil frequently mentions data comprised of arrest records, court records, and other public documents, but doesn’t explore the growth of “alternative” datasets that could be sucked up into risk-scoring algorithms. There is cause to worry on this front. In a report that I wrote for the Prison Policy Initiative last year, I noted that some prisons are embracing electronic messaging as an alternative to mailed correspondence to and from incarcerated persons. These services are typically operated by private contractors that provide users with little or no privacy protections. This raises the all-to-real possibility that years’ worth of correspondence between an incarcerated person and their family could be used as data in a risk-scoring WMD. As another example, the federal Bureau of Prisons is trying to weaken financial privacy protections so that it can collect banking information on people who send money to people in prison (the Prison Policy Initiative and other groups have formally opposed this move, and BOP has not yet finalized the draft rule).
Second, the ease with which data travels can mean that it’s harder for formerly-incarcerated people to escape the stigma attached to a criminal record. As more businesses and government agencies rely on WMDs to automate decision-making, criminal records will inevitably flow through more databases, thus ensuring an ever widening net that prevents formerly incarcerated people from meaningfully participating in economic, civic, and social life. Communities must start discussing fair ways to honor public access to information without condemning formerly incarcerated people to a permanent diminished tier of citizenship.
Finally, there is the fact that opaque and unfair WMDs developed in the criminal justice system today are likely to be applied to society-at-large tomorrow. News reports recently indicated that about half of the adult population of the U.S. is unwittingly contained in an FBI facial-recognition database that has a reported 15% inaccuracy rate (and is far more likely to misidentify Black people). While we can expect to see more expansion of such systems, the real question is where this leads: will experiments such as the FBI’s catalyze a thoughtful discussion of privacy, fairness, and expectations about risk; or, will they hasten a Minority Report-style society where people are punished because they might commit a crime in the future?
Some legislators are beginning to take notice of the abusive video visitation industry. Policymakers across the country should consider adopting legislation so that incarcerated people and their families are not prevented from face-to-face contact during difficult times.
As our research has shown, local jails are increasingly replacing in-person visits with expensive and poorly implemented video visitation systems.
Fortunately, some policymakers are taking notice. Illinois State Rep. Carol Ammons introduced a bill earlier this year that would protect in-person visitation from being eliminated in Illinois correctional facilities and limit the cost of video visits. There is also active legislation in New Jersey that would guarantee face-to-face family visits for incarcerated individuals, cap video costs at 11 cents a minute, and ban fees on professional video visits from lawyers and clergy.
Policymakers across the country should consider adopting similar legislation so that incarcerated people and their families are not prevented from in-person contact during difficult times. Preserving face-to-face visitation is not just humane, it’s good policy because contact between incarcerated people and their loved ones is proven to reduce the likelihood that an individual will re-offend after release.
How much do incarcerated people earn? For this update, we combed through the policies of state correctional agencies and any other available sources, and found information for every state. Despite the inaccessibility of data for some state prison jobs, this is the most comprehensive list of wages paid to incarcerated people available today:
Wages are per hour. Some states publish wage policies differently. For states that calculate wages on daily, weekly, monthly, and annual bases, I calculated the hourly rates based on work hours per day and work days per month, according to the written policies or what was reported in the 2001 Corrections Yearbook survey. For states where I could find no information on work hours, I assumed 22 work days per month and an average workday of 6.35 hours (for regular jobs) or 6.79 hours (for industry jobs) per day. I included all non-industry jobs paid by correctional agencies as “regular prison jobs” for the table, including rare and off-site jobs that pay more. In many states, most regular prison jobs pay well below the highest rates stated here. See the Appendix for policy details.
Regular jobs (non-industry)
Jobs in state-owned businesses (“Correctional Industries”)
Low
High
Low
High
Alabama
0.00
0.00
0.25
0.75
Alaska
0.30
1.25
0.65
4.90
Arizona
0.15
0.50
0.20
0.80
Arkansas
0.00
0.00
0.00
0.00
California
0.08
0.37
0.30
0.95
Colorado
0.13
0.38
n/a
n/a
Connecticut
0.13
1.00
0.30
1.50
Delaware
n/a
n/a
0.25
2.00
Florida
0.00
0.32
0.20
0.55
Georgia
0.00
0.00
0.00
0.00
Hawaii
0.25
0.25
0.50
2.50
Idaho
0.10
0.90
n/a
n/a
Illinois
0.09
0.89
0.30
2.25
Indiana
0.12
0.25
n/a
n/a
Iowa
0.27
0.68
0.58
0.87
Kansas
0.09
0.16
0.25
3.00
Kentucky
0.13
0.33
n/a
n/a
Louisiana
0.04
1.00
n/a
0.40
Maine
n/a
n/a
0.58
3.50
Maryland
0.15
0.46
0.20
0.82
Massachusetts
0.14
1.00
n/a
n/a
Michigan
0.14
0.56
n/a
n/a
Minnesota
0.25
2.00
0.50
2.00
Mississippi
0.00
n/a
0.20
1.30
Missouri
0.05
n/a
0.30
1.25
Montana
0.16
1.25
n/a
n/a
Nebraska
0.16
1.08
0.38
1.08
Nevada
n/a
n/a
0.25
5.15
New Hampshire
0.25
1.50
0.50
1.50
New Jersey
0.26
2.00
0.38
2.00
New Mexico
0.10
1.00
0.30
1.10
New York
0.10
0.33
Average 0.62
North Carolina
0.05
0.38
0.05
0.38
North Dakota
0.19
0.88
0.45
1.69
Ohio
0.10
0.17
0.21
1.23
Oklahoma
0.05
0.54
0.00
0.43
Oregon
0.05
0.47
0.05
0.47
Pennsylvania
0.19
1.00
0.19
0.42
Rhode Island
0.29
0.86
n/a
n/a
South Carolina
0.00
0.00
0.35
1.80
South Dakota
0.25
0.38
0.25
0.25
Tennessee
0.17
0.75
n/a
n/a
Texas
0.00
0.00
0.00
0.00
Utah
0.40
n/a
0.60
1.75
Vermont
0.25
0.40
0.25
1.25
Virginia
0.27
0.45
0.55
0.80
Washington
n/a
0.36
0.70
2.70
West Virginia
0.04
0.58
n/a
n/a
Wisconsin
0.09
0.42
0.79
1.41
Wyoming
0.35
1.00
0.50
1.20
Federal Prisons
0.12
0.40
0.23
1.15
Average
0.14
0.63
0.33
1.41
What kinds of work do incarcerated people do?
Not everyone works in prison. Facilities face budget limitations and sometimes there is just not enough work to go around. But generally, correctional facilities assign incarcerated people to work as close to a regular day as possible. These work assignments fall into four broad categories, the first of which is by far the most common:
Not everyone works in prison. Facilities face budget limitations and sometimes there is just not enough work to go around. But generally, correctional facilities assign incarcerated people to work as close to a regular day as possible. These work assignments fall into four broad categories, the first of which is by far the most common:
Regular prison jobs. These are directed by the Department of Corrections and support the prison facility. This category includes custodial, maintenance, laundry, grounds keeping, food service, and many other types of work. Sometimes called “facility,” “prison,” or “institutional support” jobs, these are the most common prison jobs.
Jobs in state-owned businesses. Often called “Correctional Industries,” these businesses produce goods and provide services that are sold to government agencies. Correctional agencies and the businesses coordinate to operate these “shops,” and the revenues they generate help fund these positions. Agency-operated industries employ about 6% of people incarcerated in prisons.
Jobs outside the facility. Work release programs, work camps, and community work centers provide services for public or nonprofit agencies. These programs are directed by the Department of Corrections, but sometimes community employers pay incarcerated workers’ wages. These jobs are typically reserved for people considered lower security risks, and/or those preparing to be released.
Jobs in private businesses. A small number of incarcerated people work for businesses that contract with correctional agencies through the PIE program. This program allows private companies to operate within correctional facilities and provide job training and supervision. Companies must pay local “prevailing wages” for these jobs, but workers may only end up with a small portion of these wages; up to 80% of these earnings can be deducted for various fees.
One major surprise: prisons appear to be paying incarcerated people less today than they were in 2001. The average of the minimum daily wages paid to incarcerated workers for non-industry prison jobs is now 86 cents, down from 93 cents reported in 2001. The average maximum daily wage for the same prison jobs has declined more significantly, from $4.73 in 2001 to $3.45 today. What changed? At least seven states appear to have lowered their maximum wages, and South Carolina no longer pays wages for most regular prison jobs – assignments that paid up to $4.80 per day in 2001. With a few rare exceptions, regular prison jobs are still unpaid in Alabama, Arkansas, Florida, Georgia, and Texas.
Incarcerated people assigned to work for state-owned businesses earn between 33 cents and $1.41 per hour on average – roughly twice as much as people assigned to regular prison jobs. Only about 6 percent of people incarcerated in state prisons earn these “higher” wages, however. An even tinier portion of incarcerated workers are eligible for “prevailing local wages” working for private businesses that contract with states through the PIE program. The vast majority spend their days working in custodial, maintenance, grounds keeping, or food service jobs for the institutions that confine them.
The wages listed above do not include any deductions, which in reality often leave incarcerated workers with less than half of their gross pay. In Massachusetts, for example, at least half of each paycheck goes into a savings account to pay for expenses after release. “Any and all funds” can be used to pay court-assessed fines, court costs, victim witness assessments, etc. New Mexico deducts 15-50% of each paycheck for a Crime Victims Reparations Fund, discharge money, and family support. These policies arguably serve legitimate purposes, but such deductions also mean that $1 per day earned to make day-to-day life behind bars more bearable is really 50 cents (or even less).
The question of wages paid for prison labor is an important one, especially when we consider the relative costs of fees charged and things sold to incarcerated people. The value of a dollar is different when you earn pennies per hour. (And in six states, the wage is almost always zero pennies per hour.) In Colorado, for example, it costs an incarcerated woman two weeks’ wages to buy a box of tampons; maybe more if there’s a shortage. Saving up for a $10 phone card would take almost two weeks for an incarcerated person working in a Pennsylvania prison.
Making it hard for incarcerated people to earn real money hurts their chances of success when they are released, too. With little to no savings, how can they possibly afford the immediate costs of food, housing, healthcare, transportation, child support, and supervison fees? People with felony convictions are often ineligible for government benefit programs like welfare and food stamps, and face barriers to finding stable housing and employment. And they may leave prison with just a bus ticket and $50 of “gate money,” if they have no other savings. So the meager earnings from prison work assignments can be essential to a person’s success – and even survival – when they return to their community.
Most prison jobs teach incarcerated people very few skills relevant to the labor market they will rejoin upon release, so the wages they earn may be the only payoff they see. These perpetually low wages are especially frustrating when we consider the increasing expenses incarcerated people face, both inside and after release. Of course, raising wages is a tough sell politically, but policymakers and the public must acknowledge that almost everyone in prison will eventually be released. Their success and independence depends largely on financial stability, which is undermined by low wages, nickel-and-diming through “user fees,” mandatory deductions, and work that does little to prepare them for work outside of prisons. Forward-thinking policymakers must consider the importance of earnings and relevant job training for people they hope will be independent one day.
For details about each state’s wage policies, see the Appendix.
Updated April 28, 2017 with information from a new source on Oklahoma’s regular prison jobs (non-industry). Originally, I included information based on a DOC website statement that these jobs pay up to $20 per month. According to DOC policy, however, most pay between $7.23 and $14.45 per month, and the highest possible wage for “special project pay” is 54 cents per hour. The averages have been updated to reflect these changes as well.
When we consider the relative cost of medical co-pays to incarcerated people who typically earn 14 to 62 cents per hour, it’s clear they can be cost-prohibitive. Co-pays that take a large portion of your paycheck make seeking medical attention a costly choice.
A misguided relic from the War on Drugs suspends the driver’s licenses of 190,000 people every year for drug offenses that do not involve driving. This law makes it hard for people with drug convictions to get back on their feet. After helping Massachusetts end this practice in 2016, we released a report urging the remaining 12 states and the District of Columbia to follow suit.
This week, bi-partisan legislation was introduced that would repeal the problem’s origin: a federal incentive that encouraged states to pass this regressive legislation in the first place.
Yesterday, the Drug Policy Alliance sent a letter to Congress from more than 30 criminal justice reform, addiction recovery, faith, and civil rights organizations supporting the full repeal of the underlying federal law. The Prison Policy Initiative joined the letter and reprints the press release here:
U.S. Representative Beto O’Rourke Leads Bipartisan Bill that Repeals Federal Transportation Law Requiring States to Suspend Driver’s Licenses for Drug Offenses
Nearly 200,000 Driver’s Licenses Are Suspended Annually for Drug Offenses Unrelated to Driving Because of Federal Mandate
More than 30 Addiction Recovery, Criminal Justice, Civil Rights and Faith Organizations Send Letter to Congress Urging Repeal of Federal Suspension Law
Washington, D.C. – U.S. Representative Beto O’Rourke (D-TX-16) has introduced bipartisan legislation with Representatives Justin Amash (R-MI-3), Hakeem Jeffries (D-NY-8), Jim Sensenbrenner (R-WI-5), Jerrold Nadler (D-NY-10), and Mia Love (R-UT-4) that would repeal a 26-year-old federal law that mandates states to automatically suspend driver’s licenses for anyone convicted of a drug offense or risk losing federal highway aid money.
Since this mandate was adopted in 1991, 38 states have opted-out demonstrating that the policy is counterproductive. The remaining twelve states – including Texas, New York, Michigan and Florida – still comply with the federal mandate. A recent report by the Prison Policy Initiative found that nearly 200,000 driver’s licenses are still suspended in these states each year for drug offenses unrelated to driving. The American Association of Motor Vehicle Administrators has also pointed out that roads are more dangerous when law enforcement time and resources are wasted enforcing license suspensions unrelated to dangerous driving. More than 30 criminal justice reform, addiction recovery, faith and civil rights organizations have signed a letter to Congress supporting full repeal of this federal mandate.
“Limiting an individual’s ability to get around because of a drug law violation is excessively punitive and stifles efforts to find employment, take care of family responsibilities, and access health care and support networks,” said Queen Adesuyi, policy associate of national affairs with the Drug Policy Alliance. “It was 1991 when Congress passed a law requiring states to automatically suspend driver’s licenses for a drug offense, and the catch phrase then was ‘smoke a joint, lose your license.’ In the years since, the harsh impact on people trying to get back on their feet is shining a light on just how counterproductive the war on drugs has been and continues to be.”
Advocates point out that the ability to legally drive is essential to maintaining employment, housing and sobriety, which are also often conditions placed upon individuals as a condition of court-ordered supervision post-conviction and release. The U.S. Census Bureau found that 86% of people surveyed use a vehicle to get to work and employers often require proof of a valid driver’s license to even be considered for certain jobs. Many communities and most rural areas do not have access to public transportation, including many of the states that still follow the federal mandate. In fact, almost half of the 25 least accessible metropolitan areas are within the 12 states that are still automatically suspending licenses for drug convictions. This makes the ability to legally drive essential to maintaining employment and meeting responsibilities.
Low-income communities and communities of color are disproportionately hurt by this antiquated federal mandate. All of the states that suspend driver’s licenses after a drug conviction have reinstatement fees, as high as $275, on top of court fines and fees. Moreover, 44% of the United States’ Black population lives in one of the 12 remaining jurisdictions that suspends driver’s licenses.
“Despite using drugs at similar rates to whites, Blacks and Latinos are disproportionately arrested and convicted for drug offenses, which makes them more likely to be impacted by driver suspension laws,” said Adesuyi. “Driver license suspension laws hit the most marginalized people the hardest without any actual benefit to public safety. A drug conviction should not bar you from being able to pick up your kids from school or go to work. Repeal is long overdue.”
Contact:
Tommy McDonald 510-338-8827
Queen Adesuyi 202-810-1481
You can also see Representative Beto O’Rourke explain his proposed legislation in this video:
With this year’s updated edition of Mass Incarceration: The Whole Pie, we once again answer the essential questions of how many people are locked up, where, and why.
March 14, 2017
Are there 1.3 million people behind bars in the U.S., or is it actually closer to 2.3 million? How important are probation and parole when we think about the scope of the criminal justice system? In 2014, the Prison Policy Initiative first aggregated data on the country’s fragmented systems of confinement. With this year’s updated edition of Mass Incarceration: The Whole Pie, we once again answer the essential questions of how many people are locked up, where, and why.
The publication of the new report, with 15 new data visuals, comes at a critical moment. The new administration has taken aim at the past decade’s advances toward criminal justice reform, and has a troubling reliance on “alternative facts” to support its agenda. The Whole Pie 2017 brings together the most current government data available to provide policymakers and the public a clear and accurate big picture view of punishment in the U.S.
The 2017 report shows that mass incarceration is not a single monolithic system. Instead, we have a federal system, 50 state systems, and thousands of local government systems. The byzantine structure of justice systems means the policymaking is equally complex and changes must be made at each level. While the White House is moving away from criminal justice reform, The Whole Pie offers the reassuring reminder that the bulk of incarceration flows directly from the policy choices made by state and local — not federal — governments.
Other surprising findings include:
99% of jail growth over the past 15 years was in the detention of people who are presumed innocent.
While law enforcement continues to arrest more than 1 million people each year for drug possession, the numbers in The Whole Pie show that ending mass incarceration will require rethinking not just the war on drugs, but also our society’s response to violent crimes.
The juvenile justice system locks up 7,200 youth whose “most serious offense” is not even a crime. 6,600 children are locked up for “technical violations” of their probation, and 600 for “status” offenses which are “behaviors that are not law violations for adults, such as running away, truancy, and incorrigibility.”
57,000 people are locked up for criminal or civil immigration offenses, and ICE detention numbers are growing.
The United States locks up more people than any other country, at a rate more than five times higher than most other nations. One impediment to reform is the lack of available data to guide that conversation. In The Whole Pie, the Prison Policy Initiative provides the comprehensive view of mass incarceration that society needs in order to plot a path forward.
The non-profit non-partisan Prison Policy Initiative was founded in 2001 to expose the broader harm of mass criminalization and spark advocacy campaigns to create a more just society. The organization leads the nation’s fight to keep the prison system from exerting undue influence on the political process (a.k.a. prison gerrymandering) and plays a leading role in protecting the families of incarcerated people from the predatory prison and jail telephone industry and the video visitation industry.
Contact with the criminal justice system impacts not only individual experiences of political participation, but also community-wide political engagement.
New research confirms what we already know happens to people when they are locked up. Their physical isolation leads to experiences of social isolation and their very real political disenfranchisement leads to a feeling of alienation from government. These psychological effects stay with people long after the physical and legal restrictions of their prison sentences end, affecting individuals, families and communities for years after release.
Some new data shines a light on these long-term psychological effects of incarceration. A new survey about literacy behind bars also included some important questions about individual experiences of social and political isolation. The literacy findings have few surprises; like earlier studies indicate, incarcerated people score lower on various measures of literacy. (The new U.S. Program for the International Assessment of Adult Competencies does add some new dimensions to our understanding of literacy in prisons, providing data on prison employment and educational programming.)
In the U.S. Program for the International Assessment of Adult Competencies, participants were asked to respond on a five-point scale from “strongly agree” to “strongly disagree” with the following three statements:
People like me don’t have any say about what the government does.
There are only a few people you can trust completely.
If you are not careful, other people will take advantage of you.
The findings of these three questions about social and political isolation reinforce the conclusions of prior research, suggesting that criminal justice involvement at any level impacts political engagement and trust. Compared to the data collected from U.S. households, the survey of U.S. prisons indicates higher levels of mistrust, political disenfranchisement, and political alienation among incarcerated adults.
The fact that incarcerated people feel more socially and politically isolated fits with previous research on how incarceration impacts the relationship people have with their government, beyond explicit political disenfranchisement. For example, a 2010 study found that people with justice system involvement “withdraw from political life,” evidenced by decreased participation in civic groups, decreased expression of political voice in elections, and diminished trust in government.
This issue has the capacity to affect entire communities. Research by Dr. Traci R. Burch finds that the criminal justice system shapes community political participation. She studied the ways in which political disenfranchisement restricting one individual impacts the political involvement of neighbors living around him or her in North Carolina. Dr. Burch found that people living in neighborhoods with more criminal justice-involved individuals (previously incarcerated and/or under community supervision) are less likely to vote, even if they are not disenfranchised themselves. Not only are they less likely to vote, but they are also less likely to engage in multiple forms of political participation, to be registered voters, and to participate in broader civic engagement. This means that contact with with the criminal justice system impacts not only individual experiences of political participation, but also community-wide political engagement.
With this study, we are reminded again that the harms of incarceration ripple outward from individuals throughout communities. Incarceration has a deadening effect on the political engagement of incarcerated people, and also on their families, friends, and neighbors. At this critical time, when political participation is at fever pitch, it’s important to recognize that mass incarceration undermines the political participation of entire communities.
During Black History Month, the twitter user @AltBJS presented 28 under-discussed facts about racial disparities in the justice system. I collected the sources.
Last month, in honor of Black History Month, the twitter user known as @AltBJS highlighted a different fact each day about racial disparities in the criminal justice system:
Here's to celebrating Black History Month with a fact a day about the Criminal Justice system & Black Americans #BlackHistoryMonth
Some of these facts were well-known, but many were not. Some were published in obscure corners of Bureau of Justice Statistics publications and some were published in academia or by other analysts. The tweets highlighted important research, but old tweets are hard to find and the @AltBJS’s academic citation style made it a little hard for us to follow.
So, to the best of my ability and for the preservation of these important facts, I’ve put together links to the underlying sources here:
February 1st:
Here's to celebrating Black History Month with a fact a day about the Criminal Justice system & Black Americans #BlackHistoryMonth
Fact 1: Impact? Over 3/4 million Black kids directly effected by US prison policies (Glaze & Maruschak, 2008). Indirect effects unaccounted https://t.co/XaWm14bzzD
Research confirms that prison food is not just gross; it is often nutritionally inadequate. A recent report from Washington provides new evidence and our policy analyst examines the public health costs.
This past fall, a new report from Prison Voice Washington detailed the decline in food quality served in the state’s correctional facilities. While incarcerated people often voice complaints about (very real) quality-of-life issues related to food service, there is a broader public health concern here: the long-term health consequences of forcing incarcerated people to consume unhealthy food.
The Prison Voice Washington report
The report from Prison Voice Washington reveals how changes in food service at the Washington Department of Corrections violate the state’s own Healthy Nutrition Guidelines. Since turning over food service to the Department’s business arm, Correctional Industries, the quality of food has deteriorated and culinary job opportunities that require actual cooking skills have dried up. People incarcerated in Washington are now being forced to eat unhealthy, processed food from its central food factory.
The downturn in prison food quality can be blamed on larger trends toward industrialization and privatization. Industrialization, as exemplified by Washington state prisons, replaces cooking from scratch with processed foods that may only require reheating before serving. “When the Department of Corrections turned over responsibility for food services to Correctional Industries…, it substituted 95% industrialized, plastic-wrapped, sugar-filled ‘food products’ for locally prepared healthy food.”
Highly processed and hastily prepared food is typical of privatized food service as well. Nationally, much of prison food is outsourced to two large private corporations, Aramark Correctional Services and Trinity Services Group, the targets of increasing numbers of inmate grievances and embarrassing lawsuits. While under contract with Aramark, for example, kitchens in Michigan and Ohio prisons reportedly “served food tainted by maggots… rotten meat… food pulled from the garbage…[and] food on which rats nibbled.”
What’s especially disheartening about the state of food in Washington’s prisons is that not long ago, incarcerated people in each facility were preparing food fresh from scratch, using ingredients grown at the prisons or bought from local farmers. According to Prison Voice Washington, “Prisons grew their own food, maintained dairies and bakeries, and the food… was cooked locally.” Today, there is just one massive farm, which Correctional Industries touts as part of its “closed-loop grain-to-baker-to-prison food chain.” The most recent harvest it reports online is 200 acres’ worth of dry peas. There are still gardening programs at some facilities, but according to Prison Voice Washington, “a few small gardens… [present] a rosy veneer of sustainability and fresh produce to circumvent any real scrutiny of the bleak food reality.”
Their point? The Department is capable of doing a better job, and had done so as recently as 2009. Short-sighted administrators looking to save a few cents per meal have made a bad deal with Correctional Industries, trading a fresh, healthy food service program for highly processed foods that make incarcerated people sick.
To make their case, the authors of the Prison Voice Washington report include an incredible amount of evidence including invoices, nutrition labels, and four appendices of order forms and menus. They show that:
Incarcerated people in Washington do not receive minimum requirements for fruits, vegetables, whole grains, lean protein, or milk.
Incarcerated people are fed more than the recommended amounts of refined starches, added sugars and sodium.
The DOC is fully aware of the nutritional shortcomings of its menu, so it supplements meals with fortified drink powders. These are often left untouched, so even those supplements do little to make up for the lack of nutrients in the actual food served.
Besides the prison menu, the only other choices incarcerated people have are the products available through the commissary, where more than 90% of available products “are very unhealthy, and are categorized as ‘Avoid’ in the [State’s] Healthy Nutrition Guidelines for Vending Machines.” Even the instant oatmeal is the highly sweetened, low fiber variety on the “not recommended” list.
Again, this is all at odds with Washington’s ostensible commitment to improving nutrition. In most states, correctional agencies follow federal guidelines (or attempt to), without so much as lip-service to providing anything above a minimum standard. Washington, however, has the most comprehensive food standards of any state, although many other cities and states have adopted their own standards for food served or sold at other public agencies. The only other state with nutritional standards that apply to correctional facilities is Massachusetts; New York City and Philadelphia have sweeping city-wide nutritional standards that apply to correctional facilities as well. The Prison Voice Washington report should serve as a model to hold other agencies accountable and ensure healthy foods are available to people in correctional facilities.
Other studies of prison food show that Washington’s failings are not unique
Washington’s DOC is certainly not unique; prisons and jails are notorious for serving terrible food. Prison meals are a favorite subject for colorful photo projects and personal experiments — even Buzzfeed has made one of their trademark videos about it. And research confirms that prison food is not just gross; it is often nutritionally inadequate:
A menu analysis from a large county jail in Georgia found incarcerated people there were served a diet too high in cholesterol, saturated fat, and sodium, and too low in fiber and several micronutrients — all factors linked to an increased risk of heart disease.
An analysis in South Carolina found similar deficiencies, and like the Washington study, found the menu too stingy in fruits, vegetables, and milk, and too reliant on starches.
In a Michigan report, correctional officers reported frequent deviations from the menu, especially watering down recipes and serving small portions, making it impossible for people to get the nutrients agreed upon by contract.
The Centers for Disease Control and Prevention reports that sodium is off the charts in U.S. prisons: in 1989 (the most recent year of available data) federal prisons were serving a diet with 10,000 mg of sodium per day; by 1995, their goal was to reduce it to 6,520 mg per day — still almost three times the recommended upper limit.
So yes, prison food tastes bad. But more importantly, it’s really bad for you.
The links between chronic disease and nutrition mean that prison nutrition matters
Incarcerated people are at increased risk of chronic diseases, but rather than using Food Services to help control both health problems and the costs of medical treatment, prisons exacerbate illnesses by serving and selling unhealthy foods. Half of all incarcerated people in state and federal prisons report having had a chronic illness and are “potentially at risk for future medical problems.” Nearly as many — 40% — report a current chronic condition. Considering 1) the prevalence of chronic illness in prisons, 2) the documented impact of diet on these diseases, and 3) the much lower cost of food compared to medical treatment, it is irresponsible and shortsighted of correctional agencies to prioritize cost-cutting over nutrition.
The most problematic correlations between prison food and health include:
Weight: The most obvious link between food services and health is weight. The Bureau of Justice Statistics reports that three quarters of people incarcerated in state and federal prisons are overweight or obese. Other researchers have found that each period of incarceration increases an individual’s Body Mass Index, which is a measure of overweight and obesity. Prison food is part of the reason why: as we’ve seen, menu analyses have found that prisons and jails serve highly processed, unwholesome food, and offer primarily high-fat and sugary options for purchase. Even when the menu fits nutritional guidelines on paper, it is often prepared in ways that make it less healthy: Prison Voice Washington reports that food service workers “attempt to fry” ingredients, so entrees like meatloaf end up “literally soaked in oil and margarine.”
Chronic diseases: In addition to excess weight, incarcerated people suffer disproportionately from chronic health conditions. 30% of incarcerated people have hypertension, 10% heart problems, and 9% diabetes — all higher rates than the general population. As the American Heart Association’s diets for heart disease and hypertension make clear, conditions like these can be prevented or even reversed to some extent by a nutritious diet. Instead, they are made worse by menus with too much sodium and fat and not enough fiber and essential nutrients from fresh fruits, vegetables, and whole grains.
Racial health disparities: African Americans are more likely to suffer from hypertension and diabetes, and research points to disproportionate incarceration of African American men as a cause of these health disparities. “Incarceration may help structure obesity disparities,” according to one study, and “part of the reason African American men suffer worse health is that they spend more time on average in prison, a place that undermines health,” concludes another. By ignoring the negative effects of the unhealthy prison diet on this vulnerable population, states are willingly putting them at greater risk for premature death. Each year of incarceration reduces life expectancy by two years, and this is especially true for black men.
To be sure, prisons do provide “therapeutic” or “medical” diets, prescribed by health services staff. Unfortunately, the Washington study reveals that even the “lighter fare” diet would do little to help someone with a chronic illness; it includes an extra serving of vegetables, but even less protein. In any case, when half of the incarcerated population has a chronic illness, it would make sense for a nutritious, health-services-approved diet to be the norm, not the exception. (Thankfully, some agencies have figured this out for themselves: Pennsylvania uses the Academy of Nutrition and Dietetics’ diabetic diet for its regular menu standards, and Massachusetts has created a healthier menu to minimize the number of special dietary menus needed.)
The budget is no excuse
The fact is, serving decent food is cheaper than serving unhealthy and unappetizing food in the long run. Considering the additional costs associated with poor food quality, the cost-cutting measures correctional agencies have taken around food services are fiscally short-sighted. For one thing, deteriorating food quality causes frequent security problems: when incarcerated people see that they are getting worse — or less — food than before, they protest in various ways — from dumping bad potatoes on the floor to strikes. Additional guards may be required to manage food service, not to mention the risks associated with large-scale protests like the coordinated prison strikes in the fall of 2016.
Food costs are also dwarfed by healthcare costs in prisons, so improving the nutritional quality of prison food would be a cost-effective way to improve inmate health. In our recent analysis of criminal justice costs, we found that correctional agencies spend almost six times more on health care than on food. Prison Voice Washington found that food costs make up less than 4% of the daily cost of incarcerating a prisoner — compared with healthcare, which accounts for 19% of the cost.
As the Washington authors note, even doubling the state food budget wouldn’t cost very much for the total budget and would be well worth it considering the additional healthcare costs related to chronic illness. The American Diabetes Association, for example, estimates that healthcare costs are 2.3 times higher for incarcerated people with diabetes. And overall, 86% of healthcare spending is for people with at least one chronic condition. As Prison Voice Washington concludes, “In the short run, healthy food does cost a little more — but unhealthy people cost a great deal more.”
Moreover, some states have begun to recognize that even “cost saving” moves toward industrialization and privatization aren’t worth the problems with food quality, security, and long-term health consequences. An audit of Florida’s Aramark contract found that its food costs were lower, quality was better, and more inmates actually ate the food when the Department operated its own food services program. And after struggling with a private contractor, Minnesota decided to return food services to in-house control in 2015, “providing real food for inmates even if it costs more money.”
Before long, incarcerated people’s health problems become community health problems
People who believe prison should be as punishing as possible may see little reason for facilities to serve much more than bread and water. But there is a practical reason to care about the food served in prisons: people incarcerated in state prison return to our communities sooner than you might think. As we found in an analysis last year, the median time served in state prison is 16 months and the average is 29 months. That’s more than enough time for a poor diet to cause long-term health effects. Research shows just four weeks of eating an unhealthy, high-calorie diet can lead to long-term increases in cholesterol and body fat.
When people are released from prison, their health problems become community health problems — and a financial burden on the local public health system. Preventing and helping treat chronic illnesses by serving nutritious food is cheaper than medical treatment, both during incarceration and after release.
As the Washington report demonstrates, prison food has managed to get even worse over time — and more and more people have been forced to subsist on it as the prison populations have exploded. And now, states and communities must face the long-term health consequences — and resulting healthcare costs — of feeding large numbers of incarcerated people unhealthy food. Far from a frivolous complaint, unhealthy prison food is actually a public health concern likely costing states and taxpayers far more than it saves.
See the table below for co-pay fees and minimum wages in each state. Policy details and sourcing information can be found in the Appendix. For another perspective, I also graphed what percent of the lowest-paid incarcerated person’s monthly earnings is taken by a single co-pay in each state. 
