Jail Incarceration Linked to Hike in Premature Deaths: Report

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Illustration courtesy Vera Institute of Justice

An increase in jail incarceration rates is strongly linked to an increase in premature death in the United States, says a new study by the Columbia University Mailman School of Public Health.

The study released Tuesday compared jail incarceration rates obtained from the Vera Institute of Justice and mortality data from the US National Vital Statistics System across 1,094 counties in the United States. The data covered the period between 1987 to 2017 and focused on people under the age of 75.

Researchers found that when jail incarceration rates among counties increased, citizens were more likely to face adverse health issues from being incarcerated or dealing with its aftereffects, “which in turn might be reflected in a county’s overall mortality rate.”

According to the study, the link was specifically applied to infectious diseases, chronic lower respiratory disease, drug use, and suicide.

The study found that there was a 6.5, 4.9 and 2.5 percent increase in mortality rates for infectious diseases, chronic lower respiratory diseases and drug use or suicide, respectively, when and analyzing a one per 1,000 population increase in the local jail incarceration rate.

“Our findings underscore the public health benefits of reducing jail incarceration and the importance of interventions to mitigate the harmful effects of mass imprisonment on community health including community-based treatment for substance use disorder and greater investment in social services,” said Sandhya Kajeepeta, a Ph.D. candidate in the Mailman school and an author of the study.

Researchers also found that an increase in local jail incarceration rates also led to a smaller but still substantial increase in death rates due to heart disease, unintentional injury, cancer, diabetes and cerebrovascular disease.

In an effort to connect incarceration rates to premature death rates, the study proposed three “pathways” showing how jail incarceration can negatively impact a person’s life.

The first pathway includes the direct pathogenic effects of being incarcerated related to minimal health care and unsafe food and drink.

“Not only do jails have disproportionately high rates of infectious disease and expose people to contaminated water and air, but incarceration itself is also a traumatic and often violent experience,” said the report.

The report also observes that incarcerating those who have existing substance abuse problems before being incarcerated are already more at risk of an overdose once being released due to a decrease in tolerance.

“With U.S. correctional facilities reporting some of the highest COVID-19 infection rates in the nation, the pandemic highlights the immediate need for decarceral strategies to massively reduce the number of people held in our nation’s jails and prisons to protect the lives of incarcerated people and control infectious disease spread in the community,” said Kajeepeta.

The second pathway described in the report is described as the racialized psychosocial pathway, pointing to how incarceration can directly affect a person’s mental health, leading to a myriad of other health issues.

“Psychosocial wellbeing reduces the risk of suicide and substance use, which we identified in this study as important drivers of the jail–mortality relationship,” said the report. “High community rates of jail incarceration disrupt social ties and support networks, which are protective for community health.”

The third pathway is referred to as the racialized material or economic pathway, citing that the chances of death by diseases, substance abuse or suicide can be “driven by economic resource deprivation,” said the report.

This is because going to jail often becomes a financial commitment where the incarcerated person gets subjected to fines, fees, interest and more.

“Increased jail incarceration rates lead to large-scale material investments in the criminal legal system, restricting the funding available for investment in social services, including those tied to public health,” said the report.

Existing research already illuminates the fact that local jails spread infectious diseases easily – as seen most recently with the coronavirus.

Incarceration, even for a short amount of time, is also already linked to problems with mental health and substance abuse, often due to the financial impacts of being kept in jail without being able to post bail or the possible loss of job, housing and benefits due to incarceration.

“Exposure to the criminal legal system also has clear disenfranchising and depoliticizing effects, as a driver of job loss and wage inequality, and harms local economies because of the removal of working-age individuals from the labor force,”  said the report.

The link between mass incarceration and premature death also points to the issue of systematic racism, as Black people are already more likely to be incarcerated than their white counterparts.

According to the report, Black people are four times more likely to be incarcerated in a local jail then whites, exposing that many more people to the risk of premature death.

“The use of mortality as our outcome of interest is an extreme outcome that only partly reflects the range of potential community health effects of jail incarceration,” said the study, pointing to the fact that death rates alone don’t illuminate the struggle of post-incarceration life for those who are still living.

“Given the ongoing COVID­19 pandemic, these findings highlight the immediate need to account for jails as drivers of infectious disease spread in the community,” said the report.

The study is the first to investigate the link between jail incarceration and various specific causes of death.

Read the full report here.

Emily Riley is a TCR justice reporting intern.

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