Jails and prisons harm the health and well-being of people behind bars. Their communities and the broader public are impacted, too.
Nazish Dholakia, Vera Institute of Justice, Senior Writer
We know that conditions behind bars—from overcrowding to poor nutrition to medical neglect—lead to adverse health outcomes for incarcerated people. But the impact of incarceration on health extends far beyond the millions of people behind bars—it affects families, corrections staff, entire communities, and public health at large. Mass incarceration is not just a criminal justice issue—it is a public health crisis.
Compared to the general population, incarcerated people experience higher rates of chronic medical conditions, such as asthma, hepatitis B, hepatitis C, and HIV/AIDS. Mental health conditions, including depression, anxiety, and substance use disorders, are also common. Incarceration often exacerbates these health conditions—or leads to new ones. For example, people who have been incarcerated are more likely to develop cardiovascular disease at younger ages and have worse outcomes compared to the general population. Research shows the stark impact of incarceration on how long one lives: each year spent in prison is associated with a two-year decline in life expectancy.
Corrections professionals also experience poor health outcomes because of harsh prison conditions. They have rates of post-traumatic stress disorder comparable to those of returning veterans of war and more than double the suicide rate of police officers. Low pay, long hours, insufficient training, and minimal emotional support make hiring and retaining staff a challenge, ultimately affecting the care and programming available within prisons.
The toll on families
The impact that incarceration has on public health is not contained within correctional facilities. First, people with loved ones behind bars face worsened health outcomes. In particular, the incarceration of a loved one has profound consequences for women’s health—both mental and physical. Women with partners who are incarcerated are more likely to experience hypertension, diabetes, heart attack, and stroke.
And the impact of having a parent who is incarcerated is also, unsurprisingly, wide-ranging. Research links parental incarceration with an increased risk of mental health conditions and substance use disorders, with potential long-term risks into adulthood. In fact, one study found that parental incarceration is more detrimental to children’s physical and behavioral health and well-being than divorce or the death of a parent.
Overall, having an incarcerated family member is linked to a decrease in life expectancy—by 2.6 years, according to one study, and by 4.6 years for people who have had three or more immediate family members held behind bars.
Community health, both physical and mental, suffers
Mass incarceration also impacts the health of communities broadly—a fact that was made brutally evident during the COVID-19 pandemic, as jails and prisons became breeding grounds for the virus.
“Substantial epidemiological research shows that mass incarceration raises contagion rates for infectious disease—both for people in jails, and for the community at large,” researchers Sandhya Kajeepeta and Seth J. Prins wrote in the Appeal. Evaluating data from 1987 to 2016, they found that increases in a county’s jail incarceration rate were associated with subsequent increases in county mortality rates.
Jails are revolving doors, with more than 7.6 million jail admissions each year. People may return to their communities after spending days, weeks, months, or years incarcerated, making it clear how the effects of inadequate health care in jails can extend far beyond, contributing to serious public health consequences for entire communities.
People living in communities with high rates of imprisonment are at higher risk of mental health conditions, such as anxiety and depression, and other health issues than those who do not. Incarceration degrades social ties and increases chronic stress, harming the health of entire neighborhoods. And across all of these studies, it’s evident that negative health outcomes disproportionately impact Black people—reflecting the disparities prevalent within the criminal legal system.
The impact of immigration detention
Conditions within immigration detention facilities mirror prison conditions in the United States more broadly, and the Trump administration’s mass detention and deportation plans only serve to make things worse for both people held in immigration detention and their loved ones. People have been warehoused in increasingly overcrowded detention facilities, sent to the detention camp at Guantanamo Bay, deported and imprisoned in El Salvador, and separated from loved ones—with dire mental and physical health consequences for both adults and children. Again, these policies are detrimental to the health and well-being of millions of people.
Research spanning decades makes it clear that what happens within jail cells and prison walls affects us all. A system ostensibly designed to keep us safe is actually harming incarcerated people, their families, corrections staff, entire communities, and the broader public. We are no safer or healthier for it.
Not only do we need to improve health care inside carceral facilities, but we also need to ensure continuity of care after people leave jail and prison. This means investing in robust public health services and community-based alternatives to incarceration, including accessible substance use treatment and comprehensive mental health care services. But ultimately, we need approaches to public safety that keep people out of jail and prison in the first place. Our collective well-being depends on it.
