Impacts of Incarceration on Health Focusing on Minority Males: Considerations for COVID-19 and Future Pandemics

• DOI: 10.1177/10439862211045481
• Date: 01 November 2021
• Published date: 01 November 2021
• Subject Matter: Articles

https://doi.org/10.1177/10439862211045481

Journal of Contemporary Criminal Justice

2021, Vol. 37(4) 502 –522

© The Author(s) 2021

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DOI: 10.1177/10439862211045481

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Article

Impacts of Incarceration on

Health Focusing on Minority

Males: Considerations for

COVID-19 and Future

Pandemics

Mary H. Hughes1, and Nicole Prior2

Abstract

Long-standing health and social inequalities associated with minorities have increased

their risk for infection, hospitalization, and death related to COVID-19. This disparity

is further exacerbated with incarcerated individuals, yet little attention, both

prepandemic and presently, has been devoted to collecting up-to-date data. This study

uses the 2004 Survey of Inmates in State Correctional Facilities (SISCF), the most

recent data, to explore the general offender population and self-reported chronic

and medical health conditions to highlight how COVID-19 will impact marginalized

populations. Results from the four binary regression models found that minority

males are more likely to have chronic illnesses which increase in probability with

longer sentences, number of incarcerations, and advancement in age. Our findings

advocate for the development of recent data sets on inmate health, particularly

minority individuals, as well as the construction of more precise health measures to

address these health disparities, including COVID-19.

Keywords

correctional health care, COVID-19, corrections, special populations

Introduction

To date, extensive literature has been collected highlighting the racial disparities

across both the criminal justice system and the continuum of medical care in disease

1University of Arkansas at Little Rock, USA

2East Tennessee State University, USA

Corresponding Author:

Mary H. Hughes, School of Criminal Jusitce and Criminology at University of Arkansas at Little Rock,

2801 South University Ave., Little Rock, AR 72204, USA.

Email: mhhughes@ualr.edu

1045481CCJXXX10.1177/10439862211045481Journal of Contemporary Criminal JusticeHughes and Prior

research-article2021

Hughes and Prior 503

prevalence, prevention, management, and outcomes (Binswanger et al., 2011; Dumont

et al., 2012; B. A. Williams et al., 2012). Comparatively, little attention has been

directed at understanding how these population health disparities directly impact the

criminal justice system, specifically with regard to correctional health care and the

recent emergence of the coronavirus (COVID-19) (Adler & Newman, 2002;

Binswanger et al., 2009, 2011). Although the prevalence of chronic illness and

COVID-19 are seen across all racial and ethnic groups, in general, minority males

receive poorer care when compared to their white counterparts (Binswanger et al.,

2011; Wilper et al., 2009). The Centers for Disease Control and Prevention (CDC)

(2021) has consistently highlighted that race and ethnicity serve as risk markers for

factors that increase the likelihood of having underlying health conditions due to their

connection with socioeconomic status, access to health care, and increased exposure

to illness due to employment. Interestingly, health disparities within the COVID-19

pandemic are beginning to mirror that of pre-existing health gaps seen within the gen-

eral population, specifically groups that have been marginalized by race/ethnicity are

now more likely to be affected by the COVID-19 pandemic.

Despite the known rates of racial disparity, little knowledge exists with regard to

the emerging large-scale health care costs associated with COVID-19 and medical

professionals within correctional settings ability to both mitigate or potentially

exacerbate current health disparities among racial groups. It has been identified that

COVID-19 circulates rapidly inside locked institutions. Thirty-nine out of the 50

largest COVID-19 outbreaks in the United States were within prisons or jails (Wang

et al., 2020). In addition, the death rate for COVID-19 is higher inside jails and

prisons. Specifically, incarcerated people have a five and a half times higher infec-

tion rate and an overall COVID-19 death rate three times higher than nonincarcer-

ated people (Saloner et al., 2020). Recent findings from correctional facility

COVID-19 testing have reported higher prevalence rates of the virus among minor-

ity inmates, which may conceivably be linked to the aforementioned pre-existing

racial health gap (Gibson, 2020). Specifically, incarcerated black inmates displayed

a 3.5 greater COVID-19 prevalence rate, while Hispanic inmates displayed a preva-

lence rate of 5.9 when compared to white inmates (Gibson, 2020). In addition, in

May 2020, black inmates accounted for 60% of the COVID-19 deaths in the New

York prison system despite making up only 50% of the state’s incarcerated popula-

tion (D. R. Williams & Cooper, 2020). Furthermore, compounding the risk for con-

tracting COVID-19, previous exploratory studies focusing on epidemiology have

confirmed that prison inmates, principally minority males, experience higher rates

than the general population of transmission of disease, substance abuse, and chronic

health conditions including hypertension, diabetes, asthmas, and cancer, even when

adjusting for confounders, such as age (Binswanger et al., 2011; Dumont et al.,

2012; Harzke & Pruitt, 2018). The Pew Charitable Trusts (2014) has attributed this

increase in health conditions to challenges faced by correctional staff stemming

from improper staffing, greater disease prevalence, older inmates, and the location

of prison facilities. Consequently, inmates often experience multiple transfers

stemming from health-related rationales once involved in the criminal justice