Addressing the Public Health Crisis of U.S. Carceral Facilities: An Integrated and Equitable Approach

The SARS-CoV-2 virus and resultant coronavirus disease (COVID-19) have caused unprecedented suffering among incarcerated individuals since the beginning of the pandemic. While many believe that widespread vaccination in jails, prisons, and other carceral settings will solve the problem, this perspective underestimates the severity of the situation and mischaracterizes its driver. Vaccines are a necessary but insufficient component to what should be a comprehensive, immediate, and ethical response to COVID-19 in carceral settings across the United States. Vaccination alone cannot address the broader public health crisis of mass incarceration, which threatens the health and shortens the lifespan of those held within jails, prisons, and detention centers. Instead, a robust, integrated, and ethical public health response to mitigate COVID-19 and other brutal conditions within carceral facilities could provide a foundation for better health care access not only in prisons but also for state and national populations in general. Below, we identify three interrelated problems: (1) noncompliance with epidemiological and public health demands, notably a failure to decarcerate in response to COVID-19; (2) the criminal legal system’s isolation from public health oversight and accountability; and (3) the problematic and inequitable distribution of vaccines to incarcerated individuals. We then propose necessary principled measures that federal, state, and local policymakers should take to address the devastating impact that COVID-19 continues to have on incarcerated individuals and their communities.