Mass Incarceration and Public Health

Since the 1960s, the rate of incarceration in the United States has increased fivefold. As a result, a higher percentage of Americans are imprisoned than are citizens of any other country. African Americans and, to a lesser extent, Hispanics have been especially affected by this trend because they are far more likely than whites to be imprisoned unfairly and to receive unduly harsh sentences.

Unfortunately, prisons are a perfect environment for breeding disease. Most who enter prison come from poor communities where infectious diseases such as hepatitis, HIV disease, and tuberculosis are common. These diseases spread easily in overcrowded, unsanitary, prisons, where access to proper health care (let alone condoms) is rare. In addition, the stresses of prison life—including overcrowding, loss of privacy, incessant noise, constant threats of violence, and, especially, the use of solitary confinement—foster both mental illness and substance abuse.

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Mass incarceration affects the health not only of prisoners but also of their families and communities. Diseases contracted in prison can easily spread to others after prisoners are released. In addition, the stress of having a family member in prison increases wives’ and girlfriends’ risk of heart attacks, strokes, obesity, and poor overall health and increases children’s risk of depression, obesity, substance abuse, and poor overall health. For these and other reasons, many advocates have called for better health care and living conditions in prisons, better services for prisoners’ families, and an end to the policies that resulted in mass incarceration.