Older incarcerated individuals comprise the fastest growing demographic in the US prison system. Unhealthy lifestyles among incarcerated individuals and inadequate health care lead to earlier onset ...and more rapid progression of many chronic conditions that are prevalent among community-living older adults. There are limited peer-reviewed epidemiologic data in this area; however, there is growing interest in identifying strategies for housing aging incarcerated individuals, delivering appropriate health care in prisons, and coordinating after-release health care. In this systematic review, we summarize the epidemiologic evidence of the health challenges facing the aging US prison population. Our comprehensive literature search focused on health outcomes, including diseases, comorbid conditions, mental health, cognition, and mobility. From 12,486 articles identified from the literature search, we reviewed 21 studies published between 2007 and 2017. All the studies were observational and cross-sectional, and most (n = 17) were based on regional samples. Sample sizes varied widely, ranging from 25 to 14,499 incarcerated people (median, 258). In general, compared with their younger counterparts, older incarcerated individuals reported high rates of diabetes mellitus, cardiovascular conditions, and liver disease. Mental health problems were common, especially anxiety, fear of desire for death or suicide, and depression. Activities of daily living were challenging for up to one-fifth of the population. We found no empirical data on cognition among older incarcerated individuals. The findings of this review reveal few empirical data in this area and highlight the need for new data to drive policy and practice patterns that address critical health issues related to the aging prison population.
COVID-19 has been an unprecedented challenge in carceral facilities. As COVID-19 outbreaks spread in the US in early 2020, many jails, prisons, juvenile detention centers, and other carceral ...facilities undertook infection control measures such as increased quarantine and reduced outside visitation. However, the implementation of these decisions varied widely across facilities and jurisdictions. We explored how carceral decision makers grappled with ethically fraught public health challenges during the pandemic. We conducted semistructured interviews during May-October 2021 with thirty-two medical and security leaders from a diverse array of US jails and prisons. Although some facilities had existing detailed outbreak plans, most plans were inadequate for a rapidly evolving pandemic such as COVID-19. Frequently, this caused facilities to enact improvised containment plans. Quarantine and isolation were rapidly adopted across facilities in response to COVID-19, but in an inconsistent manner. Decision makers generally approached quarantine and isolation protocols as a logistical challenge, rather than an ethical one. Although they recognized the hardships imposed on incarcerated people, they generally saw the measures as justified. Comprehensive outbreak control guidelines for pandemic diseases in carceral facilities are urgently needed to ensure that future responses are more equitable and effective.
People in United States (US) prisons and jails have been disproportionately impacted by the COVID-19 pandemic. This is due to challenges containing outbreaks in facilities and the high rates of ...health conditions that increase the risk of adverse outcomes. Vaccination is one strategy to disrupt COVID-19 transmission, but there are many factors impeding vaccination while in custody. We aimed to examine the perspectives of former residents in the Federal Bureau of Prisons (BOP) regarding COVID-19 vaccine hesitancy and acceptance. Between September-October 2021, we conducted semi-structured interviews with 21 recently released individuals who were incarcerated before and during COVID-19 and coded transcripts thematically. We assessed perceptions of the vaccine rollout and factors shaping vaccination uptake in custody and after release. The vaccine was available to seven participants in custody, of whom three were vaccinated. Interviewees had mixed attitudes about how vaccines were distributed, particularly with priority given to staff. Most were reluctant to get vaccinated in custody for varying reasons including observing staff declining to be vaccinated, lack of counseling to address specific questions about safety, and general lack of trust in the carceral system. By contrast, twelve got vaccinated post-release because of greater trust in community health care and stated they would not have done so while incarcerated. For residents in the BOP, COVID-19 vaccination was not simply a binary decision, instead they weighed the costs and benefits with most deciding against getting vaccinated. Institutions of incarceration must address these concerns to increase vaccine uptake as the pandemic continues.
Carceral facilities are epicenters of the COVID-19 pandemic, placing incarcerated people at an elevated risk of COVID-19 infection. Due to the initial limited availability of COVID-19 vaccines in the ...United States, all states have developed allocation plans that outline a phased distribution. This study uses document analysis to compare the relative prioritization of incarcerated people, correctional staff, and other groups at increased risk of COVID-19 infection and morbidity.
We conducted a document analysis of the vaccine dissemination plans of all 50 US states and the District of Columbia using a triple-coding method. Documents included state COVID-19 vaccination plans and supplemental materials on vaccine prioritization from state health department websites as of December 31, 2020. We found that 22% of states prioritized incarcerated people in Phase 1, 29% of states in Phase 2, and 2% in Phase 3, while 47% of states did not explicitly specify in which phase people who are incarcerated will be eligible for vaccination. Incarcerated people were consistently not prioritized in Phase 1, while other vulnerable groups who shared similar environmental risk received this early prioritization. States' plans prioritized in Phase 1: prison and jail workers (49%), law enforcement (63%), seniors (65+ years, 59%), and long-term care facility residents (100%).
This study demonstrates that states' COVID-19 vaccine allocation plans do not prioritize incarcerated people and provide little to no guidance on vaccination protocols if they fall under other high-risk categories that receive earlier priority. Deprioritizing incarcerated people for vaccination misses a crucial opportunity for COVID-19 mitigation. It also raises ethical and equity concerns. As states move forward with their vaccine distribution, further work must be done to prioritize ethical allocation and distribution of COVID-19 vaccines to incarcerated people.
The COVID-19 pandemic has underscored the lack of resources and oversight that hinders medical care for incarcerated people in the United States. The US Supreme Court has held that “deliberate ...indifference” to “serious medical needs” violates the Constitution. But this legal standard does not assure the consistent provision of health care services. This leads the United States to fall behind European nations that define universal standards of care grounded in principles of human rights and the ideal of equivalence that incarcerated and non-incarcerated people are entitled to the same health care. In this paper, we review a diverse legal and policy literature and undertake a conceptual analysis of policy issues related to the standard of care in correctional health; we then describe a framework for moving incrementally closer toward a universal standard. The expansion of Medicaid funding and benefits to corrections facilities, alongside a system of comprehensive and enforceable external oversight, would meaningfully raise the standard of care. Although these changes on their own will not resolve all of the thorny health problems posed by mass incarceration, they present a tangible opportunity to move closer to the human rights ideal.
People incarcerated during the COVID-19 pandemic face higher vulnerability to infection due to structural and social factors in carceral settings. Additionally, due to the higher prevalence of ...chronic health conditions among carceral populations, they are also at risk for more severe COVID-19 disease. This study was designed to explore the experiences of people incarcerated in prisons and jails in Maryland during the height of the pandemic.
We conducted semi-structured phone interviews between January 2021 and April 2022 with ten individuals incarcerated in Maryland carceral facilities during the height of the U.S. COVID-19 pandemic and were subsequently released from prison or jail. We transcribed the interviews, coded them, and engaged in content analysis, an inductive analytical approach to developing themes and meaning from qualitative data.
Four themes emerged from participants' descriptions of their experiences: (1) distress from fear, vulnerability, and lack of knowledge about COVID-19 and how to protect themselves, (2) shortcomings of prison and jail administrators and other personnel through lack of transparency and arbitrary and punitive enforcement of COVID-19 protocols, (3) lack of access to programming and communication with others, and (4) absence of preparation for release and access to usual re-entry services.
Participants responded that the prison and jails' response during the COVID-19 pandemic was ill-prepared, inconsistent, and without appropriate measures to mitigate restrictions on liberty and prepare them for release. The lack of information sharing amplified their sense of fear and vulnerability unique to their incarceration status. Study findings have several institutional implications, such as requiring carceral facilities to establish public health preparedness procedures and making plans publicly available.
The COVID-19 pandemic had a large negative impact on people in U.S. prisons. Expedited releases from prison were one strategy used to decrease morbidity and mortality from COVID-19. However, little ...is known about the reentry experiences of those being rapidly released from custody early in the pandemic.
We aimed to examine the perspectives of former residents in the Federal Bureau of Prisons (BOP) regarding release, reentry, and reintegration into their respective communities. We conducted semistructured interviews with 21 recently released individuals primarily recruited through legal aid organizations between September and October 2021. Subjects were incarcerated before and during the early surge in the COVID-19 pandemic. We coded transcripts thematically with domains developed
in which we revised iteratively and inductively based on the data.
Several major themes emerged. Participants reported that they needed to advocate for themselves to take advantage of the early release process. Compared with normal circumstances, they reported a lack of reentry planning and preparation before participants were released. Finally, experiences with reintegration varied but were often more challenging due to COVID-19.
Residents released during COVID-19 reported many challenges with reentry that could have been mitigated by support and guidance from the BOP. Reentry is a process that should begin prelease and continues postrelease to ensure individuals have adequate structural and social supports.
Inadequate reentry support has significant impacts on the health and well-being of recently released individuals and contributes to the broader context of achieving health equity for minitorized groups who are disproportionately overrepresented in prisons. Policy and practice reform is needed to address the time-sensitive, life-threatening challenges individuals face when transitioning from prison to community.
COVID-19 has greatly impacted the health of incarcerated individuals in the US. The goal of this study was to examine perspectives of recently incarcerated individuals on greater restrictions on ...liberty to mitigate COVID-19 transmission.
We conducted semi-structured phone interviews from August through October 2021 with 21 people who had been incarcerated in Bureau of Prisons (BOP) facilities during the pandemic. Transcripts were coded and analyzed, using a thematic analysis approach.
Many facilities implemented universal "lockdowns," with time out of the cell often limited to one hour per day, with participants reporting not being able to meet all essential needs such as showers and calling loved ones. Several study participants reported that repurposed spaces and tents created for quarantine and isolation provided "unlivable conditions." Participants reported receiving no medical attention while in isolation, and staff using spaces designated for disciplinary purposes (e.g., solitary housing units) for public health isolation purposes. This resulted in the conflation of isolation and discipline, which discouraged symptom reporting. Some participants felt guilty over potentially causing another lockdown by not reporting their symptoms. Programming was frequently stopped or curtailed and communication with the outside was limited. Some participants relayed that staff threatened to punish noncompliance with masking and testing. Liberty restrictions were purportedly rationalized by staff with the idea that incarcerated people should not expect freedoms, while those incarcerated blamed staff for bringing COVID-19 into the facility.
Our results highlighted how actions by staff and administrators decreased the legitimacy of the facilities' COVID-19 response and were sometimes counterproductive. Legitimacy is key in building trust and obtaining cooperation with otherwise unpleasant but necessary restrictive measures. To prepare for future outbreaks facilities must consider the impact of liberty-restricting decisions on residents and build legitimacy for these decisions by communicating justifications to the extent possible.
El Águila Real (Aquila chrysaetos) es una rapaz amenazada a nivel nacional, que se distribuye desde el norte del país hasta el centro de México. Sin embargo, existen escasos reportes de su presencia ...dentro del rango de distribución en México, como es el caso para Coahuila. Hicimos observaciones en campo en la región sureste de Coahuila durante el periodo de 2017 al 2023, complementada con una revisión de los registros de monitoreo en campo en diferentes bases de datos. Con estos registros, generamos una modelación de idoneidad ambiental para Aquila chrysaetos utilizando el algoritmo MaxEnt para identificar zonas prioritarias para la conservación que no se encuentran dentro de un área natural protegida. Los registros encontrados de individuos de A. chrysaetos evidenciaron en gran medida que la mayor probabilidad de ocurrencia se encuentra en la parte noroeste y sureste de Coahuila en zonas de matorral desértico y pastizal natural. El modelo de idoneidad climática indicó que las zonas prioritarias para conservación se ubicaron adyacentes a las áreas naturales como Maderas del Carmen, Sierra de Arteaga, Sierra de Zapalinamé, Ocampo y Don Martín. Nuestra modelación de la idoneidad climática para A. chrysaetos nos permitió identificar zonas prioritarias para la conservación que no se encuentran dentro de un área natural protegida, lo que implica que estas zonas idóneas para que habite A. chrysaetos sean consideradas prioritarias para la conservación de la especie.
The Golden Eagle (Aquila chrysaetos) is a nationally threatened raptor, which is distributed from the north of the country to central Mexico. However, there are few reports of its presence within the distribution range in Mexico, as is the case for Coahuila. We carried out field observations in southeastern Coahuila during the period from 2017 to 2023, complemented by a review of field monitoring records in different databases. With these records, we generated environmental suitability modeling for the Golden Eagle using the MaxEnt algorithm to identify priority areas for conservation that are not located within a protected area. Monitoring records of the Golden Eagle largely demonstrated that the highest probability of occurrence is found in the northwest and southeast portion of Coahuila in areas of desert scrub and natural grassland. The climate suitability model indicated that priority areas for conservation are located adjacent to protected areas such as Maderas del Carmen, Sierra de Arteaga, Sierra de Zapalinamé, Ocampo and Don Martín. Our modeling of climatic suitability for the Golden Eagle allowed us to identify priority areas for conservation that are not located within a natural protected area, which implies that these areas suitable for the Golden Eagle to inhabit should be considered priority areas for the species’ conservation.
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