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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. It’s also expensive: Astonishingly, most prisons charge incarcerated people a copay for doctor visits.

The downstream effects — for both incarcerated people and the general public — have been disastrous: Mass incarceration has shortened the overall U.S. life expectancy by 5 years.

Below is our key research into the public health effects of incarceration:

Reports and campaigns

Chronic Punishment: The unmet health needs of people in state prisons

We break down the most recent national data on incarcerated people’s health, showing how prisons are neglecting the health problems of many in their care.

Our COVID-19 resources

Find our three major reports on COVID-19 in prisons and jails, as well as a list of policy recommendations, an explainer on social distancing behind bars, a powerful fact sheet, and much more. We also tracked where pandemic-related policy changes took place.

Arrest, Release, Repeat: How police and jails are misused to respond to social problems

At least 4.9 million people go to county and city jails each year, our national analysis shows. We find that people who go to jail - particularly those who go more than once a year - are more likely to have preexisting health problems.

Briefings

• New research links medical copays to reduced healthcare access in prisons, by Emily Widra, August 29, 2024
  Using our prior research on prison wages and medical copays, researchers found that higher copays obstruct access to necessary healthcare behind bars, even as prison populations face increasing rates of physical and mental health conditions.
• Research roundup: Evidence that a single day in jail causes immediate and long-lasting harms, August 6, 2024
  Recent research suggests the onset of pretrial detention’s criminal legal system, social, and economic harms is earlier than previously thought.
• What can journalists do when prisons and jails cite HIPAA to withhold information about deaths in custody?, by Wanda Bertram, June 11, 2024
  If you’re a journalist who’s been stonewalled while seeking public records about deaths in custody, you are not alone. We offer tips for requesting sensitive medical information and strengthening your story against HIPAA-related denials.
• Addicted to punishment: Jails and prisons punish drug use far more than they treat it, by Emily Widra, January 30, 2024
  Despite the common refrain that jails and prisons are "de facto treatment facilities," most prioritize punitive mail scanning policies and strict visitation rules that fail to prevent drugs from entering facilities while providing little to no access to treatment and healthcare.
• The aging prison population: Causes, costs, and consequences by Emily Widra, August 2, 2023
  New Census Bureau data show the U.S. population is getting older — and at the same time, our prison populations are aging even faster. In this briefing, we examine the inhumane, costly, and counterproductive practice of locking up older adults.
• Heat, floods, pests, disease, and death: What climate change means for people in prison, by Leah Wang, July 19, 2023
  Without consistent access to relief or safer environments, incarcerated people are punished with deadly heat, increased biological threats, and flimsy emergency protocols. We explain new epidemiological evidence confirming that heat and death are linked in prisons nationwide, and explain why the climate-change-induced plight of people in prisons deserves swift action.
• New data on HIV in prisons during the COVID-19 pandemic underscore links between HIV and incarceration, by Emily Widra, June 1, 2023
  The percent of people in prison with HIV barely budged despite the heightened risks of COVID-19 to immunocompromised individuals. We review the evidence connecting the parallel epidemics of HIV and incarceration, which disproportionately impact Black men in the South.
• Mortality, health, an poverty: the unmet needs of people on probation and parole, by Emily Widra and Alexi Jones, April 3, 2023
  Unique survey data reveal that people under community supervision have high rates of substance use and mental health disorders and extremely limited access to healthcare, likely contributing to the high rates of mortality.
• How a Medicare rule that ends financial burdens for the incarcerated leaves some behind, by Emily Widra, January 3, 2023
  Medicare expands enrollment periods for people released from prison after January 1, 2023, but offers no relief for people who have been paying premiums for zero Medicare benefits while incarcerated, nor for those released before 2023 who signed up late and are stuck paying jacked-up premiums for the rest of their life.
• What the end of Roe v. Wade will mean for people on probation and parole, by Wendy Sawyer and Wanda Bertram, June 30, 2022
  For many of the 666,413 women on probation and parole, traveling out of state for abortion care is already next to impossible.
• “Working in “a meat grinder” — A research roundup showing prison and jail jobs aren’t all that states promise they will be.
• Prisons are a daily environmental injustice — by Leah Wang, April 20, 2022
  This country’s toxic combination of environmental destruction and mass incarceration is forcing hundreds of thousands of people to live near Superfund sites and other wastelands, with deadly health effects.
• COVID looks like it may stay. That means prison medical copays must go. — by Tiana Herring, February 1, 2022
  Forty states and the federal prison system continue to charge incarcerated people unaffordable copays for medical care.
• Recent studies shed light on what reproductive “choice” looks like in prisons and jails, by Katie Rose Quandt and Leah Wang, December 8, 2021
  States that are otherwise hostile to abortion rights are especially likely to make it difficult for incarcerated people.
• Unsupportive environments and limited policies: Pregnancy, postpartum, and birth during incarceration, by Leah Wang, August 19, 2021
  Recent data offers an unprecedented, detailed look at pregnancy and postpartum experiences in prison. Findings indicate that jails, prisons, and youth facilities have yet to adequately recognize pregnancy and postpartum needs either in policy or in practice.
• New data: People with incarcerated loved ones have shorter life expectancies and poorer health, by Emily Widra, July 12, 2021
  A new study shows how strongly incarceration is associated with family member health and well-being.
• Rise in jail deaths is especially troubling as jail populations become more rural and more female, by Leah Wang, June 23, 2021
  New data show record high deaths of people locked up in jail, as jail populations have shifted toward smaller, rural jails and growing numbers of women.
• New data: State prisons are increasingly deadly places, by Leah Wang and Wendy Sawyer, June 8, 2021
  New data from the Bureau of Justice Statistics shows that state prisons are seeing alarming rises in suicide, homicide, and drug and alcohol-related deaths.
• Research Roundup: Incarceration can cause lasting damage to mental health, by Katie Rose Quandt and Alexi Jones, May 13, 2021
  Incarceration can trigger and worsen symptoms of mental illness — and those effects can last long after someone leaves the prison gates.
• The research is clear: Solitary confinement causes long-lasting harm, by Tiana Herring, December 8, 2020
  At the International Symposium on Solitary Confinement, researchers and formerly incarcerated people made it clear that isolation causes severe and permanent damage.
• New data: Solitary confinement increases risk of premature death after release, by Andrea Fenster, October 13, 2020
  Any amount of time spent in solitary confinement increases the risk of death after release from prison, including deaths by suicide, homicide, and opioid overdose.
• Compassionate release was never designed to release large numbers of people, by Emily Widra and Wanda Bertram, May 29, 2020
  With help from artist Kevin Pyle, we explain why very few people who apply for compassionate release are approved — even during a pandemic.
• Deaths in state prisons are on the rise, new data shows. What can be done?, by Emily Widra, February 13, 2020
  Prison systems have shown they are unprepared and unwilling to care for an aging prison population - whether by improving healthcare or expanding compassionate release.
• New BJS report reveals staggering number of preventable deaths in local jails, by Alexi Jones, February 13, 2020
  In 2016, over 1,000 people died in local jails - many the tragic result of healthcare and jail systems that fail to address serious health problems among the jail population, and of the trauma of incarceration itself.
• Cruel and unusual punishment: When states don’t provide air conditioning in prison by Alexi Jones, June 18, 2019
  13 states in the hottest parts of the country lack universal A/C in their prisons. We explain the consequences.
• The steep cost of medical co-pays in prison puts health at risk by Wendy Sawyer, April 19, 2017
  For some incarcerated people, a visit to the doctor can cost almost an entire month’s pay, deterring people from seeking the care they need.
• Food for thought: Prison food is a public health problem by Wendy Sawyer, March 3, 2017
  We connect the dots between prison food, nutrition, and public health. The takeaway? Prison food is not just gross; it is often nutritionally inadequate.
• We know how to prevent opioid overdose deaths for people leaving prison. So why are prisons doing nothing? by Maddy Troilo, December 7, 2018
  Treatment programs offer promising results for recently incarcerated people, but prisons aren’t using them.
• Incarceration shortens life expectancy by Emily Widra, June 26, 2017
  Each year in prison takes 2 years off an individual’s life expectancy. With over 2.3 million people locked up, mass incarceration has shortened the overall U.S. life expectancy by 5 years.
• The life-threatening reality of short jail stays by Bernadette Rabuy, December 22, 2016
  New BJS data shows suicide is still the leading cause of death in local jails. And most suicides occur shortly after jail admission.
• BJS report: Drug abuse and addiction at the root of 21% of crimes by Wendy Sawyer, June 28, 2017
  Responding to substance use with punishment, rather than as a public health problem, is one of our most harmful criminal justice policy failures.
• The parallel epidemics of incarceration & HIV in the Deep South by Emily Widra, September 8, 2017
  HIV disproportionately impacts communities that are already marginalized by poverty, inadequate resources, discrimination — and mass incarceration.
• Unpacking the connections between race, incarceration, and women’s HIV rates by Wendy Sawyer and Emily Widra, May 8, 2017
  Current research points to an unexpected contributor to the high rates of HIV infection among Black women: the mass incarceration of Black men.
• Police, courts, jails, and prisons all fail disabled people by Elliot Oberholtzer, August 23, 2017
  Disabled people are overrepresented in all interactions with the criminal justice system, and at all points, the system is failing them.
• Aging alone: Uncovering the risk of solitary confinement for people over 45 by Lucius Couloute, May 2, 2017
  As prisons continue to get grayer, policymakers must understand that denying older people access to sunlight, exercise, and human interaction is both inhumane and fiscally irresponsible.
• New York State’s elderly prison boom: An update by Maddy Troilo, November 1, 2018
  Despite recent positive reforms, New York’s elderly prison population continues to grow.
• Analysis shows people in NYC jails would be better served in the community by Bernadette Rabuy, November 16, 2016
  A recent analysis finds that the most frequently incarcerated in New York City jails struggle with mental illness and are locked up for low-level offenses.
• It’s time for Massachusetts to stop shackling incarcerated women who are giving birth by Leah Sakala, December 12, 2013
  This testimony helped Massachusetts become the 21st state to pass legislation to end the inhumane practice of shackling mothers who are pregnant or giving birth while incarcerated.
• “Do no harm” or “Do no expense”?: Ohio’s prisoners are dying from inadequate medical care by Peter Wagner, November 24, 2003
  Ohio Department of Corrections’ health care budget cuts and poor oversight is compromising the quality of care.
• Incarceration is not a solution to mental illness by Peter Wagner, April 1, 2000
  Originally published in the April 2000 issue of Mass Dissent.

Related issues

Drug policy

One of the worst criminal justice policy failures — responding to drug use with punishment rather than care — also puts public health at risk.

Collateral consequences

Tens of millions of people are dealing with the “collateral consequences” of punishment: effects such as homelessness that last long after someone has served their sentence. These harms also impact public health.

Communication and contact

Visits and phone calls mitigate the harmful effects of prolonged isolation behind bars. But jails and prisons make staying in touch difficult, particularly for poor families.

Research Library

Didn’t find what you were looking for? We also curate a database of virtually all the empirical criminal justice research available online. See the sections of our Research Library on public health, mental health, and conditions of confinement.

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