New research shows that decarceration would produce the greatest public health benefits, including fewer deaths each year, as jail expansion contributes to a range of health burdens.
“It is tough to get nationally representative, individual-level data on incarceration’s health impacts. But researchers are increasingly providing evidence that the criminalization of poverty, addiction and mental health issues has sharp harmful consequences. Jailing in general is associated with higher mortality (death) rates,” according to the Prison Policy Initiative (PPI).
Expansion of jailing increases the risk of communicable and noncommunicable diseases, mortality, and poor maternal health outcomes. Incarceration has also been shown to severely impact mental health and maternal-child health.
A study published in the medical research journal JAMA Network Open highlights additional evidence and reveals implications for local policy. The study, led by Dr. Utsha Khatri, found that people who were incarcerated on a specific day in 2008 had a 39% higher chance of death compared to those who were not incarcerated. Their risk of overdose was also 208% higher. The study also found that deaths countywide rise with the expansion of local jails.
This paper is useful for policymakers because it measures both individual experiences of incarceration and county jail incarceration rates. “County jail rates measure how much a given county relies on jailing as a response to issues of health and safety. How counties use their jails varies widely across the United States; the jail incarceration rate in Nashville is over five times the rate in Minneapolis, to cite just one example. This new study drew county-level jail rates from the Vera Institute’s Incarceration Trends Project dataset and leveraged local variation to better understand how jails impact death rates, breaking out overdose deaths for special attention. One caveat worth noting on the individual-level impacts: Because millions of people flow through local jails each year, the findings in the study may understate the harms of incarceration,” according to PPI.
The paper includes data from the Moral Disparities in American Communities study. “This dataset linkage effort connects restricted records from the Census with data from the National Death Registry. Khatri et al.’s sample is 3.2 million people who responded to the American Community Survey in 2008, including 45,000 people who were incarcerated at the time they were surveyed. Everyone was tracked through the end of 2019 to see if they survived,” according to Prison Policy.
The analysis design of the study compared incarcerated individuals with similar people who were not incarcerated. The authors adjusted for age, race and ethnicity, employment, household income, and educational attainment. “The authors don’t attempt to show higher jail rates or the experience of incarceration as the cause of the increase in deaths they observed; they simply show the strength of the relationship between those variables,” according to PPI.
Because the United States does not track everyone who has been imprisoned, this presents limitations in the study. The resulting data gaps likely cause the authors to underestimate the harmful impact of incarceration on health. This study provides further confirmation that its findings are consistent with other research.
The results from this study are adjusted for both individual and county-level factors, and it is “worth noting that having been incarcerated has a much stronger impact on risk of death than other measures linked to death rates like income, education or indigeneity,” according to PPI.
“Jail construction is expensive and tends to crowd out public investment in other needs like community-based healthcare. Criminalization of addiction doesn’t address problematic substance use, and better community-based treatment options are needed. Moreover, some studies suggest jail construction leads to even more criminalization rather than deterring crime. Decarceration is one of the best tools to combat early deaths caused by this dynamic between criminalization, incarceration, and austerity — what geographer Ruth Wilson Gilmore terms ‘organized state abandonment,’” according to PPI.
