We can’t improve minority health without addressing incarceration

Throughout National Minority Health Month this April one of the most significant drivers of poor health among Black and Brown people in America has gone ignored: incarceration.

Millions of people are under correctional supervision, and nearly one-in-two Americans have experienced the incarceration of a close relative, making incarceration and its consequences a common experience in America today.

Incarceration is a social condition that does enormous damage to the health of millions. One 2015 study found that each year of imprisonment corresponds to a two-year life expectancy reduction. The effects of sentencing linger and devastate, whether currently incarcerated or newly released. Studies show that previously incarcerated individuals have higher mortality rates than other citizens and have increased rates of drug abuse, suicidal ideation and HIV prevalence.

Incarceration disproportionately affects people of color, driving a wedge in health disparities by race. Black and Latino people are respectively five and 1.3 times more likely to be in prison than white people. Life expectancy is more than four years lower than the national average in majority-Black neighborhoods.

Incarceration doesn’t just leave lasting damage to incarcerated individuals but affects entire families and communities. For example, having a parent imprisoned is linked to many children’s health and behavioral problems that can persist through adulthood. Having a parent or sibling incarcerated is associated with worsened mental health.

Congress must show more leadership. In a small but meaningful step around public health, the House created Social Determinants of Health (SDOH) Caucus in 2021, which is designed to crowdsource ways in which Congress and the federal government can help facilitate social determinant interventions, a worthy and important cause. But, sadly, its charter doesn’t even include incarceration as a social determinant of health.

This oversight is emblematic of a larger problem. Using a public relations media search tool, there were no mentions of incarceration in connection with National Minority Health Month. Lawmakers and the media must begin to recognize and address the link between mass incarceration, racial justice and health inequities. But unfortunately, for far too long, the harms of mass incarceration and its collateral consequences have been an afterthought.

One way forward is greater collaboration between health care systems and our nation’s 3,000 plus jails and prisons. Currently, there is almost no collaboration — they operate entirely within their own silos. Forming partnerships between civilian and carceral health systems will give incarcerated populations and their loved ones the visibility within our health systems that they deserve and improve continuity of care.

Additionally, incarceration must be framed as a public health issue. As demonstrated by the rapid spread of the COVID-19 pandemic in jails and prison and, subsequently, to the larger public, mass incarceration creates fodder for dangerous disease. Public awareness that incarceration poses a health risk for those both within systems and out would disrupt the conceptualization of incarceration as a “black box.” Hopefully, such awareness would mobilize decarceration efforts and resources to prevent worsened health caused by incarceration.

Given the evidence, incarceration endangers people not just in the immediate, but also long term, plaguing systems-impacted people, along with their families, and the broader community. If we are to truly honor the charge of National Minority Health Awareness Month, to “highlight the important role individuals and organizations can play in helping reduce health disparities,” then it’s time incarceration’s health-harming consequences are brought into the debate.

Evie Lopoo is project manager of research and writing at Columbia University Justice Lab’s Square One Project, cultivating new thinking on responses to crime in America and promote more effective strategies.

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