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

AuthorMary H. Hughes,Nicole Prior
Date01 November 2021
Publication Date01 November 2021
Journal of Contemporary Criminal Justice
2021, Vol. 37(4) 502 –522
© The Author(s) 2021
Article reuse guidelines:
DOI: 10.1177/10439862211045481
Impacts of Incarceration on
Health Focusing on Minority
Males: Considerations for
COVID-19 and Future
Mary H. Hughes1, and Nicole Prior2
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.
correctional health care, COVID-19, corrections, special populations
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.
1045481CCJXXX10.1177/10439862211045481Journal of Contemporary Criminal JusticeHughes and Prior
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

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