National study on anti-contagion policies is first in the world to show reduction in prison population leads to community-wide public health benefits – ScienceDaily

Extremely high incarceration rates in the United States undermine national public health and safety. Overcrowded and cramped prison quarters fuel the constant risk of epidemics. Add to that the daily movement of 420,000 guards in and out of the facilities and 30,000 newly released people who are likely to inadvertently bring the virus back into communities.

A new study from Northwestern Medicine, Toulouse School of Economics, and the French National Center for Scientific Research has found that the best way to tackle this threat to public safety is through decarceration (i.e. reducing the number of people held in prisons).

“If we can immediately stop imprisoning people for suspected minor offenses and start putting in place a national decarceration program to end mass incarceration, these changes will now protect us from COVID-19 and also benefit long term in American public health and pandemic preparedness, ”said first author Dr. Eric Reinhart, public health anthropologist and medical resident in the Department of Psychiatry and Behavioral Sciences at Northwestern University Feinberg School of Medicine .

The study assessed the association of incarceration in prison and government anti-contagion policies with reductions in the spread of SARS-CoV-2 in the United States. It will be published on September 2 in the newspaper. JAMA network open.

This is the first study to link mass incarceration systems to pandemic vulnerability and international biosecurity (i.e. systems for protection against disease or harmful biological agents). In the event of a pandemic, the amplification of the spread of COVID-19 from one country spills over to other countries, so mass incarceration in the United States poses a threat not only to Americans, but also to others. global public health in general.

Although many previous studies have documented that high incarceration rates are associated with damage to community health, this study of 1,605 US counties is the first to show that incarceration is associated with health benefits. public health at the community level.

American prisons, prisons are “incubators of infectious diseases”

The United States incarcerates people at seven times the average rate among peer countries such as France, Canada, Germany, England, etc., and detains nearly 25% of the global prison population. Due to overcrowded conditions and poor health care, US prisons and prisons have effectively become incubators for infectious diseases in which at least 661,000 cases of COVID-19 have been documented since the start of the pandemic.

Reinhart said this was largely due to the 55% weekly turnover rate in US prison populations, which means crowds of people – totaling around 650,000 each day, of which 75% are awaiting trial and 25% serving short sentences for minor offenses – are held in cramped spaces, then most are released back to their communities shortly thereafter. While in detention, their chances of contracting SARS-Cov-2 increase dramatically, and when they return home, many unknowingly bring the virus back to their friends, family and neighbors.

“The majority of these people should never have been taken to jail,” Reinhart said. “There is no plausible public safety justification for their detention in a large part of the cases, and a significant percentage of those who are jailed will never be convicted of the alleged crimes for which they were detained. In addition, no one – whether or not they have in fact committed a crime – should be subjected to the high risk of coronavirus infection imposed by the poor conditions in these establishments.

“The high rate at which people move from one community to another and the unnecessary short stays in prisons create epidemiological pumps that lead to more and more infections in prisons and communities. This prison churn effectively produces epidemic machines that trigger epidemics both in and beyond prisons, compromising public safety for the entire country. “

“A natural experience”

The COVID-19 pandemic has resulted in large-scale inmate releases, with many prisons being taken out of jail at rates between 20% and 50%, Reinhart said.

“We used this exceptional historical episode during the pandemic to ask, ‘What were the consequences of this large-scale prison release? “This provided the opportunity for a natural experiment,” said Reinhart. “Decarceration in the era of the pandemic was not only associated with benefits for those released, but also for everyone in the community. No study has ever been able to show this before, largely because we had never seen a real-life scenario with such sudden large-scale decarceration as well as a well-documented means – like the cases of Covid- 19 – to retrace its implications for the communities. “

The analysis of 1,605 counties by Reinhart and his co-author Daniel Chen of the Toulouse School of Economics and the World Bank encompassed 72% of the total population of the United States to provide one of the finest large-scale analyzes. anti-contagion policies to date (prison discharge plus 10 policies), including mask warrants, school closures, stay-at-home orders and more.

Reinhart and Chen estimated that an 80% reduction in the US prison population – a level of decarceration achievable simply by pursuing alternatives to prison detention for those detained for suspected non-violent offenses – would have been associated with a reduction 2% of daily COVID-. 19 case growth rate. This effect size was eight times larger in counties with a higher population density than the median, including large urban areas, and was considerably larger when Reinhart and Chen took into account not only changes in prison populations. , but also the estimation of the prison turnover rate.

“While that may seem like a small number,” said Reinhart, “because the daily growth pathways multiply over time, even a reduction of just 2% in the daily growth rates of cases in the United States since the start of the pandemic thus far would result in the prevention of millions of cases. from prison to COVID-19 cases in their home communities – something we have not had access to data to track – so the US prison system’s contribution to global COVID-19 cases in the United States has clearly been huge, ”he said.

Nursing home visitation bans were associated with the largest reduction (7.3%) in the growth rates of COVID-19 cases of any policy analyzed by Reinhart and Chen, followed by school closures ( 4.3%), mask warrants (2.5%), prison visitation bans (1.2% and home orders (0.8%).

Reinhart suggested that these findings also carry political lessons not only for immediate anti-contagion measures, but also for broader public investments aimed at improving conditions in schools and nursing homes.

As COVID-19 cases increase again around the world in relation to the delta variant, Reinhart believes the results of this study “contain useful evidence to inform the development of policies that are most effective to protect the public.” did he declare.

Spread of Prison-Related Diseases and Racial Disparities

The recent related study by Reinhart and Chen on Proceedings of the National Academy of Sciences focused on the ways in which what they call “the epidemiology of prison communities” – how health in prisons and prisons is still interconnected with health in larger communities – particularly affects communities of color in America. Black and Latin neighborhoods experience the highest rates of policing and incarceration, so when prisons amplify disease in communities, it particularly affects these racialized groups, Reinhart said.

“Our previous research has shown that this spread of the coronavirus in the prison community likely represents a significant proportion of the racial disparities we’ve seen in COVID-19 cases across the United States,” Reinhart said. Ultimately, it also hurts all U.S. residents regardless of race, class, or partisan affiliations, as disregarding the health of marginalized people inevitably causes damage – albeit unevenly. – to everyone else in a society as well. “