The COVID-19 pandemic — and the large number of cases and deaths in jails, prisons, and detention centers — has laid bare the urgent need for decarceration as a public health strategy. This resource includes 8 recommendations and specific actions health departments can take to address the harms of incarceration.
January 25, 2021
The COVID-19 pandemic — and the large number of cases and deaths in jails, prisons, and detention centers — has laid bare the urgent need for decarceration as a public health strategy. This resource includes 8 recommendations and specific actions health departments can take to address the harms of incarceration.
The COVID-19 pandemic — and the large number of cases and deaths in jails, prisons, and detention centers — has laid bare the urgent need for decarceration as a public health strategy. This resource includes 8 recommendations and specific actions health departments can take to address the harms of incarceration.
Heavily policed communities — including Black people, Indigenous people, immigrants, people with disabilities, queer and trans people, people in poor neighborhoods, and sex workers — have long sounded the alarm that incarceration is a public health crisis. Public health consensus and research on this has grown in recent years, documenting how incarceration measurably harms individual, family, and community health. The far-reaching and long-lasting impacts include increased prevalence of chronic health conditions among those impacted — such as hypertension, diabetes, and arthritis — and decreases in life expectancy.
The COVID-19 pandemic has added a layer of unprecedented threat and urgency to this already chronic issue. Because of the characteristic overcrowding, medical neglect, and inadequate sanitation in the nation’s jails, prisons, and immigration detention centers, carceral facilities have become hot spots for COVID-19 outbreaks. The practices required to limit the spread of the virus — such as practicing physical distancing, wearing a mask, and limiting indoor contact with others — are all impossible in carceral settings. It is therefore no surprise that carceral facilities regularly appear in the top ten largest sources of COVID-19 infections nationally.
We know that there is no way for anyone to be truly safe and healthy inside a jail, prison, or immigration detention center, especially during the COVID-19 pandemic. Due to the inability to physically distance and widespread lack of proper sanitation, all incarcerated people are at high risk for contracting the virus. Indeed, early estimates suggest that the case rate of COVID-19 in US prisons is 5.5 times higher than in the US general population. While mass releases are our priority as the primary prevention strategy, we need to simultaneously employ harm reduction strategies to protect those who remain incarcerated.
Health departments can and must take action to curb the dual and overlapping threats of COVID-19 and incarceration. As we move toward collective action from a place of shared moral responsibility and sectoral power, we recognize that health departments and officials have varying amounts of formal jurisdiction over implementing the strategies outlined below.
At the same time, jurisdiction and regulatory scope can change over time depending upon conditions and health crises. COVID-19 offers both impetus and opportunity to move public health work further “upstream” to address the policies, systems, and environments that create health— beyond solely individual-level health behaviors and health care. Moving upstream may require developing a shared analysis within health departments, broadening regulatory scope, and/or championing transformative change. Ultimately, divesting from systems of policing and punishment that harm individuals and communities and instead investing in institutions and systems that promote community well-being (like public health departments, public schools, affordable housing, and quality employment) is more sustainable and will move us closer to health equity and collective liberation.
Based on our work nationally with community organizers on the frontlines of advancing racial justice, community safety, and health equity, the following are key prevention and mitigation strategies for health departments to consider when formulating their powerful role in addressing the harms of incarceration during the COVID-19 pandemic and beyond.