New York City’s jail system has recently received national attention for its abhorrent conditions and dismal care of people in custody. City records show that, during the month of April 2022, people detained on Rikers Island missed nearly 12,000 medical appointments. Experts attribute these missed appointments to crumbling jail operations, corrections officers failing to escort people to receive care and poorly designed systems – such as making people call to schedule their appointments despite having limited access to phones. These appalling conditions are compounded by the fact that many incarcerated people suffer disparately from chronic illness. And while both international and national standards unequivocally state that incarcerated people are deserving of health care, these rules clearly remain unmet – this year alone, eighteen people have died while incarcerated in New York City jails. Law and policy fixes cannot make our prisons and jails livable spaces for the people who are housed there. It is numbing, shameful, and points to why we must decarcerate.
Both international and national standards outline that people in prisons and jails are deserving of health care. The United Nations’ “Standard Rules for the Treatment of Prisoners,” more commonly known as the “Mandela Rules,” stipulate that health care for those who are incarcerated should be free, provided without discrimination, and of the same standard as that which is provided in the community. In the United States, people in prisons and jails even have a constitutional right to health care, as a 1976 Supreme Court ruling, Estelle v. Gamble, outlined that demonstrating “deliberate indifference” to the medical needs of people who are incarcerated constitutes “cruel and unusual punishment” and therefore violates the Eight Amendment to the Constitution.
Despite these standards, medical neglect is pervasive in prisons and especially, in jails across the country. From 2000 to 2019, 20,413 people died in local jails. Results of a nationwide survey indicate that approximately 68% of people in local jails with a “persistent medical problem” had not received a medical examination since their incarceration and nearly 25% were not provided care following a serious injury. These proportions are much higher in local jails than they are in state or federal prisons.
Several of the eighteen deaths in New York City jails this year have been linked to a lack of physical health care. For instance, George Pagan, who was detained because he could not afford $1,006 bail, was visibly ill but was not provided with the medication that was prescribed to him, nor was he brought to any of his nine scheduled medical appointments in the week leading up to his death. Mary Yehudah, who was only thirty-one years old, passed away due to complications related to diabetes, and likely would have survived had she been provided with the medical testing and treatment she required. This fall, NYC Jails Commissioner Louis Molina issued a directive to catalyze the “compassionate release” of Elmore Robert Pondexter, a father of three who was dying whilst detained on Rikers Island. He later passed away at Bellevue Hospital. It was then found that Commissioner Molina’s directive was made so that Pondexter’s death would be “off the Department’s count.”
The abysmal health care provided in New York City jails is particularly disturbing given that people who are incarcerated suffer disparately from chronic illness. For example, people in prisons and jails have been found to have higher rates of hypertension, asthma, cervical cancer, and hepatitis compared to the general population. The correlation between poor health and incarceration is rooted in systemically unequal access to health care in marginalized Black and Brown communities whose members are policed, arrested and incarcerated at disproportionately high rates. Once people are incarcerated, preexisting health conditions that were fostered by limited access to resources on the outside are exacerbated by medical neglect on the inside. It is even estimated that for each year spent in prison, one’s life expectancy is reduced by two years. Politicians, like Eric Adams, who reduce jail deaths to preexisting illness and ignore deadly conditions behind the walls, are sorely mistaken.
Ultimately, medical neglect in carceral settings is a manifestation of institutional disregard for and devaluation of Black and Brown people in the United States. Taking into account the disproportionate incarceration of people of color, it comes as no surprise that all but one of the sixteen people who died while in custody in New York City jails in 2021 were Black or Latinx. What we do not know is also deeply troubling. In late September of 2022, the United States Department of Justice announced that deaths in prisons, jails, and during arrests had been undercounted this year by nearly 1,000. Given what we already know about racial and ethnic disparities and the state of health care in prisons and jails, it is likely that a disparate number of the lives lost and ignored were those of people of color.
Both jails and prisons remain, in the words of activist and organizer Mariame Kaba, “death-making institutions.” As described by the Prison Policy Initiative, “even before the COVID-19 pandemic, deaths in jail had reached record high numbers, because they continue to be unregulated, under-resourced places where disadvantaged people are sent to languish.” Though suicide is the leading single cause of death in jails, evidencing negligible mental health care on the inside, people who are incarcerated also receive poor physical health care or are denied it altogether.
While calls for reform and oversight have been made, the escalating healthcare crisis in New York City jails must be met with decarceration. If we do not drastically reduce the number of people who are incarcerated and if we do not provide substantive health care throughout marginalized Black and Brown communities, suffering will persist and the death toll, which has already outpaced that of last year, will continue to rise.
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