Incarceration and COVID-19 racial disparities

A new study finds that jails function as disease multipliers that affect public health and disproportionate policing of marginalised communities may explain a large proportion of COVID-19 disparities.

According to the study published in Proceedings of the National Academy of Sciences of the United States of America, each individual cycled through Cook County Jail in Illinois in March 2020 was, on average, associated with five additional COVID-19 cases in their home ZIP codes by August 2020, and that 86 per cent of cases attributable to the jail were borne by majority-black and/or majority-Hispanic ZIP codes.

"Jail cycling in March accounted for 21 per cent of COVID-19 racial disparities in Chicago by August, suggesting that jails function as disease multipliers that affect public health and that disproportionate policing of marginalised communities may explain a large proportion of COVID-19 disparities," as per the findings.

Black and Hispanic communities are disproportionately affected by both incarceration and COVID-19. The epidemiological relationship between carceral facilities and community health during the COVID-19 pandemic, however, remains largely unexamined.

Using data from Cook County Jail, the scientists examine temporal patterns in the relationship between jail cycling (i.e., arrest and processing of individuals through jails before release) and community cases of COVID-19 in Chicago ZIP codes. "We use multivariate regression analyses and a machine-learning tool, elastic regression, with 1,706 demographic control variables. We find that for each arrested individual cycled through Cook County Jail in March 2020, five additional cases of COVID-19 in their ZIP code of residence are independently attributable to the jail as of August."

A total 86 per cent of this additional disease burden is borne by majority-Black and/or -Hispanic ZIPs, accounting for 17 per cent of cumulative COVID-19 cases in these ZIPs, 6 per cent in majority-White ZIPs, and 13 per cent across all ZIPs. Jail cycling in March alone can independently account for 21 per cent of racial COVID-19 disparities in Chicago as of August 2020.

Relative to all demographic variables in the analysis, jail cycling is the strongest predictor of COVID-19 rates, considerably exceeding poverty, race, and population density, for example --arrest and incarceration policies appear to be increasing COVID-19 incidence in communities.

"Our data suggest that jails function as infectious disease multipliers and epidemiological pumps that are especially affecting marginalized communities. Given disproportionate policing and incarceration of racialised residents nationally, the criminal punishment system may explain a large proportion of racial COVID-19 disparities noted across the United States."

High rates of incarceration in crowded detention facilities have been documented as a significant population-level risk factor for the transmission of infectious diseases such as HIV, influenza, tuberculosis, viral hepatitis, and yet other diseases. Such facilities function as disease incubators, providing sites for easy viral and bacterial replication with a ready supply of tightly packed bodies that are rendered even more vulnerable by inadequate healthcare, poor living conditions, and associated comorbidities.

As a result, notably overcrowded prisons, jails, and immigrant detention facilities under a system of mass incarceration in the United States effectively constitute infectious disease multipliers. Given the daily inflow/outflow of staff and detainees, these disease reservoirs--cultivated through disregard for the welfare of incarcerated people -- also function as epidemiological pumps that fuel continued disease penetrance in surrounding communities. We refer to this dynamic as "carceral-community epidemiology" to emphasize that health in carceral facilities is in continuous biosocial interrelation with community health, national public health, and global biosecurity.

During the COVID-19 pandemic, American jails and prisons have predictably emerged as the world's leading sites of COVID-19 outbreaks. Prior to the resumption of the school year, carceral facilities constituted 90 of the top 100 clusters in the United States as of September 1, 2020. As of March 2021, they featured more than 626,000 publicly documented cases--almost certainly a substantial undercount due to the absence of oversight to ensure adequate testing protocols, data accuracy, and public reporting. This crisis was not unanticipated.

Amid long-standing political acceptance of mass incarceration in the United States, which houses nearly 25 per cent of the world's incarcerated people despite only representing 4.2 per cent of the global population, early warnings from public health experts were followed by delayed and inadequate policy action to alter arrest and incarceration practices in response to pandemic conditions.

Furthermore, while US jail populations initially declined in late spring and summer months, they have since rebounded toward pre pandemic levels, increasing by 10 per cent in the final months of 2020. In this context, it is notable that while a considerable amount of appropriate attention has focused on the risks to which incarcerated individuals are being subjected during COVID-19, comparatively little scientific, media, and policy attention has highlighted the risks that carceral epidemics pose not only to incarcerated people but also to the health of the public at large.

( With inputs from ANI )