Our country’s public health is at risk. No, it’s not from Ebola or this year’s virulent strain of the flu.
It’s from mass incarceration.
A new report, “On Life Support: Public Health in the Age of Mass Incarceration,” issued by the Vera Institute of Justice, focuses on the alarming impacts of imprisonment on individual and community health. Its conclusion?
Mass incarceration in America has “become one of the major public health challenges of our time. People who cycle through our nation’s courts, jails, and prisons every year experience far higher rates of chronic health problems, infectious diseases, substance use, and serious mental illness than the general population.”
How Did We Get Here?
The U.S.prison population has grown 700 percent since the 1970s. This resulted primarily from the ill-conceived deinstitutionalization of mental health care and the racially targeted War on Drugs—a failed effort we are still pursuing today.
The effects of these so-called societal remedies have been calamitous.
Our prison system is filled to capacity with individuals with mental illness and with low-level, non-violent drug offenders would be better served in a substance abuse treatment center.
Just the Facts
- Mental Illness: More than 70 percent of people in jail with a serious mental illness also have a substance use disorder.
- Women in Prison: Women comprise 7 percent of all prisoners and 13 percent of all local jail populations. On average, 6 percent are pregnant.
- Self-Harm in Prison: Suicide remains a leading cause of death, accounting for one-third of deaths in jails between 2000 and 2009.
- Geriatric Health in Prison: The number of people behind bars aged 55 and older soared 550 percent. In Ohio’s prisons, they have a dementia unit with a waiting list.
- Infectious Disease in Prison: An estimated 17 percent of all people with HIV pass through a correctional facility each year.
- Quality of Care: Solitary confinement and isolation, poor nutrition, lack of ventilation, enforced idleness, overcrowding, and the impact of violence and trauma infringe on the constitutional and human rights of people in prison and jail. At the end of 2013, 17 states had more people in their prisons than their facilities were designed to house. Ohio is one of them.
- Family Structure: There are 2.7 million children under the age of 18 living with at least one parent in prison. Studies have shown that the growth in paternal incarceration has contributed to elevated rates of homelessness among black children by compromising family finances. Imprisonment of a mother is likely to lead to foster care placement.
What Happens After Jail?
Even though the United States is the largest incarcerator of people in the world, the majority of people in our prisons and jails will be released. Those health problems that plague people while incarcerated will follow them into the community.
According to the “On Life Support” report, when you compare a map of New York City with health statistics from the NYC health department, “the highest rates of incarceration and the greatest rates of disease are concentrated in the same neighborhoods.” It’s easy to see that where incarceration is most prevalent there also are disproportionately high rates of infant mortality, HIV, STD, asthma, and hospitalizations due to assault.
So, What Do We Do?
When we incarcerate a large number of our people, we will feel that loss and impact in our communities. Incarceration tears apart families and reduces neighborhood cohesiveness. Better health outcomes among returning citizens depend on better educational and employment opportunities. Also, we must quit punishing people after they have served their time, like denying food stamps and public housing.
The report ends by detailing opportunities in the Affordable Care Act, including expanding Medicaid and behavioral health coverage, and reducing health disparities. The ACA is certainly a step forward, but much more is needed to repair the damage done to generations in our communities.
*All graphics from Vera Institute of Justice report