As we strive towards a healthier country this World Mental Health Day, we must address the reality that there can be no public health so long as America remains beholden to the prison-industrial complex. Yet far from improving the health of incarcerated people or their communities, mass incarceration has reduced the life expectancy of the entire American population by 5 years. The American carceral system is a public health catastrophe at every level, from the scientific racism upon which it is built to the abysmal conditions faced by incarcerated people to its wider effects on the communities most affected by incarceration.
When our government treats entire populations of people like their very existence is a public health threat, state-sanctioned violence against marginalized populations can become synonymous with healing. It is precisely this logic that led to the wrongful conviction of the Central Park Five, to the police murders of Michael Brown, Trayvon Martin, Laquan McDonald, and too many other Black teenagers to list. As we reimagine our systems, we must keep in mind who the “public” in public health has historically excluded.
Nowhere is that exclusion felt more sharply than in the jails and prisons that confine 1.9 million people across the country. Prisons are structurally inhospitable environments, designed to strip human beings of their dignity––and their health. The explosion in prison populations since the 1970s has only worsened conditions for incarcerated people. When skyrocketing arrests cause prisons to operate at double their capacity, incarcerated people are forced to live in close proximity, which the Supreme Court defined as cruel and unusual punishment in 2013. Facilities fall into disrepair, including flawed ventilation systems that cause asthma. These inhumane conditions leave people far more vulnerable to infectious disease. In comparison to the American population as a whole, incarcerated people have twice the rate of HIV, four times the rate of tuberculosis, and five to eight times the rate of hepatitis C.
While hepatitis C is curable, 80 percent of those diagnosed with it in prisons still suffer from it. This is because the prison medical system sits at the intersection of the exploitative health insurance industry and the violent prison-industrial complex. While in 1976, the Supreme Court enshrined healthcare as a right for incarcerated people, service is nowhere near adequate. Indeed, in 40 states, insurance companies charge incarcerated people co-pays for accessing medical care, which are the equivalent of hundreds of dollars to a person receiving mere cents for each hour worked. Many incarcerated people do not seek necessary medical care because of the steep price, making the spread of disease more likely.
The issue goes beyond physical illness–prisons are a central site of the mental health crisis in America. 56 percent of people in state prisons have indications of mental health issues, but only 26 percent have received professional help for these conditions since entering prisons. Whether in the form of solitary confinement, abuse from guards and other incarcerated people, the effects of separation from family, the traumatizing experience of incarceration only causes these issues to worsen.
This public health crisis extends beyond the physical borders of the prison, affecting the families and communities forced to grapple with a loved one in the system. Studies show that the financial and emotional strain of having an incarcerated or formerly family member leads to an increase in the likelihood of depression, high blood pressure, substance abuse issues, and diabetes. As a result, having an incarcerated relative shortens one's life expectancy by 2.6 years. Incarceration does not heal the trauma of acts of violence that affect a community; it adds to the violence through mandating harmful displacement. This is why we need a system that addresses the impacts of harm on a community within the community.
The violent system of incarceration reveals the limits of mainstream understandings of health and disability. Take the term immunocompromised, used so often during the COVID pandemic. We use this term as an adjective: incarcerated people are much more likely to be immunocompromised. But the way their living conditions impacts their health outcomes suggests that the situation might be better described as a verb: prisons, and the political and economic systems that enable them, immunocompromise incarcerated people. The same goes for the term disability: when 40 percent of state prison populations nationwide are disabled (and 50 percent of women's state prisons), we must examine how prisons disable the people they incarcerate. It is for this reason that disability justice is inseparable from ending the prison-industrial complex.
The prison system does not end violence--it produces it for incarcerated people and their communities. But something else is possible. A systemic review of 35 psychology studies showed that restorative justice produced lasting improvements psychological health for both those harmed and those responsible for acts of violence. At Common Justice, we believe in a practice of justice that refuses to see the violence that has marked our past and present as inescapable. Working collaboratively within and across communities, we work to imagine a path towards something different, a space where the systems in power are vitalizing and not immunocompromising, a world with justice and wellness for all.
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