October Blog 2: Action Toward Health Equity – Prison Population

October 14, 2018

Submitted by Institute for Public Health 2018 Annual Conference Speaker, Samantha Stangl, MSW, Programs Manager, The Clark-Fox Family Foundation

Author Fyodor Dostoyevsky once famously said “The degree of civilization in a society can be judged by entering its prisons.” By that standard the United States has a lot of work to do. According to The Sentencing Project, the population of our jails and prisons has increased by a staggering 500% since 1970, with an estimated 2.2 million people incarcerated today. In addition, approximately 4.6 million Americans are currently under state supervision and control via probation and parole, bringing the total correctional population to 7 million people. This shocking number does not include the 10-12 million people who cycle in and out of our jails each year. The rates at which the United States incarcerates its citizens surpasses any other country in the entire world.

The cost of incarcerating and supervising so many of our citizens is much more than dollars and cents, although the estimated $1 trillion spent annually on criminal justice certainly cannot be ignored. The real cost of mass incarceration is the children, families, and communities left in its wake. There are nearly 50,000 children in the state of Missouri who have a parent incarcerated, which is higher than the entire population of Chesterfield. Nationally, this number grows to around 2.7 million children who experience parental separation via the criminal justice system. For context, there are 16 states in this country with populations smaller than that.

Children who experience parental incarceration are at a higher risk of physical and mental health challenges such as asthma, anxiety, and PTSD. These children are also much more likely to drop out of high school and are six times more likely to end up in jail or prison than children who never have a parent incarcerated. The risk of parental incarceration is not equal for all children in our community, however. Mass incarceration is a substantial driver of health and economic inequity for communities of color and families with few resources.

The lifetime risk of incarceration for white males in the United States is 1 in 17. For Latino men there is a much higher risk of 1 in 6. For African American males however, the lifetime risk of incarceration is 1 in 3. Although African Americans comprise just 13.4% of the total population of the U.S., they make up nearly 40% of our jail and prison population.

Incarceration also disproportionately impacts low-income members of the community. In 2014, more than half (57%) of incarcerated men and nearly three-quarters (72%) of incarcerated women had incomes of less than $22,500 prior to incarceration. For individuals impacted by incarceration the job prospects and economic opportunity post-incarceration is even more dismal. According to the Prison Policy Initiative “formerly incarcerated people are unemployed at a rate of over 27% — higher than the total U.S. unemployment rate during any historical period, including the Great Depression.”

Unemployment post-incarceration stems from a lot of issues including the sheer volume of employers who require criminal background checks pre-employment, and often implement blanket felony bans on hiring for their companies. Also contributing to the economic plight of prior incarcerated individuals are the nearly 50,000 types of collateral consequences someone can face after they have served their time and/or completed community supervision requirements. These collateral consequences can limit the type of job someone can have, the funding available to pursue higher education, and can even place restrictions on where someone can live.

In addition to harming the economic prospects of individuals and families, mass incarceration directly contributes to health inequity in our community. It is estimated that nearly 90% of individuals entering jail are uninsured, and 80-90% lack health care coverage at the time of release. While incarcerated, individuals have very limited access to medical services, oftentimes paying co-pays of $3-$10 for a visit. With prison wages averaging between 14 and 63 cents an hour, inmates in some states must spend up to 72 hours’ worth of wages just to see a medical provider.

Although 65% of people incarcerated meet the DSM-IV standards for alcohol or drug abuse addiction, only 11% of inmates with substance abuse disorders receive any type of treatment during incarceration. Mental health treatment fares no better in our jails and prisons. The Bureau of Justice Statistics estimates that at least 50% of inmates have some sort of mental health condition, yet treatment and care is woefully hard to access. These factors contribute to the shocking mortality risk for individuals impacted by incarceration. It is estimated that every year spent in prison reduces life expectancy by two years. Even more devastating is the research that demonstrates that former prisoners are 12 times more likely than the general public to die of any cause in the two weeks following release and 129 times more likely to die of a drug overdose.

Each year, nearly 650,000 people come home from prison and millions more come home from jail stays. It is to the detriment of our communities to continue to ignore the public health crisis of incarceration and to continue to perpetuate the intergenerational cycle of harm this system causes. Criminal justice reform has a tremendous amount of momentum all over the country, with some states de-incarcerating as much as 35% in the last ten years. It’s well past time for us to bring change to Missouri, because frankly, our children are relying on us to do better.

Samantha Stangl MSW, is the programs manager for the Mass Incarceration Community Education Initiative at Clark-Fox Family Foundation. She will be a speaker at the Institute for Public Health Annual Conference on Oct. 31.