Why Coronavirus in Jails Should Concern All of Us
New research shows that jails contribute to infectious disease deaths in the greater community.
Sandhya Kajeepeta, Seth J. Prins Mar 24, 2020
This piece is a commentary, part of The Appeal’s collection of opinion and analysis.
Since Rikers Island jail complex reported its first case of coronavirus on Wednesday, the numbers there have risen rapidly: 38 people—staff and prisoners—have now tested positive for COVID-19. The New York City Board of Correction has repeatedly called on the city to immediately release from jail all people at high risk for coronavirus infection and rapidly decrease the jail population. Advocates and activists, too, have been pleading with state and local officials for days to release vulnerable people from jails, citing grave threats to the health of incarcerated people, staff, and the public.
This move can’t come soon enough. Substantial epidemiological research shows that mass incarceration raises contagion rates for infectious disease—both for people in jails, and for the community at large.
In our study recently published in the American Journal of Public Health, we found that increases in a county’s jail incarceration rate were associated with subsequent increases in county mortality rates between 1987 and 2016. In light of the coronavirus pandemic, we took another look at that data and found that infectious disease deaths contributed significantly to this increase. Specifically, increases in a county’s jail incarceration rate were associated with significant increases in county rates of infectious disease deaths.
In this new analysis, we used data on 1,670 counties from 1987 to 2017. We ranked county jail incarceration rates into four equal quartiles (bottom 25 percent to top 25 percent), and found that if a county’s jail incarceration rate increased from the first to the second quartile, its mortality rate due to infectious disease increased by an alarming 9 percent. While death due to HIV drove much of this association, county mortality rates from other infectious diseases also rose. An increase in jail incarceration rate from the first to second quartile was associated with a 4 percent increase in the non-HIV infectious disease mortality rate.
So, even when we are operating under normal conditions, the association between jail incarceration and infectious disease mortality persists. This finding reflects deaths due to flu, pneumonia, and acute bronchitis, for example. This is empirical evidence that jail incarceration is most likely a driver of infectious disease deaths at the population level.
Jails and prisons are sites of disproportionate infectious disease rates. Incarcerated people suffer the most, but so do staff and communities, when jail conditions prevent people from following basic health precautions. A rapid reduction in the number of people in jails can help us slow the spread of coronavirus, “flattening the curve” of infection rates quickly enough to prevent the worst case scenario for public health.