The criminal justice system is one of the chief systems affecting Black American health. The country’s prison system and over-policing strategy is not just a way to keep criminals off the streets, it is a large, for-profit institution that gains strength by perpetuating an endless cycle that is almost impossible to break. The prison industrial complex of this country is particularly compelling as a challenge to Black American wellness because it so disproportionately and intentionally affects Black people above any other group. Especially now, as there is a nationwide push to abolish the police, it is crucial to understand why police brutality and racism are public health issues. Because the U.S. incarcerates many more of its citizens than other developed democracies, many researchers have cited it as partly responsible for the widening gap between health of the U.S. and other countries.

The ratio of white to Black imprisonment rates is 1 to 7, largely a result of the War on Drugs and its targeting of young, disadvantaged, inner-city members of minority groups. Michael Tonry and Matthew Melewski highlight the role of racist crime control policies on subjugating Black Americans in their article, stating that had incarceration rates remained at 1970 levels (around 130 per 100,000) or at 1980 levels around 200 per 100,000], “fewer black men would have suffered the pains of imprisonment, resulting stigma, and reduced employment prospects,” and there would be “many fewer broken black families, fewer negative role models for black boys, more marriageable black men,” and “less deterioration in poor black communities.”  The prison industrial complex can be seen as an extension of the plantation and acts of racial violence, fostering normalization of violence against Black bodies, inhumane servitude and normalization of Black deaths .These are only a few of the effects of mass incarceration on Black people, Black men and boys in particular. While other young men are out building their futures, Black men are at odds with a racist system.

Prisons do not only affect the individual, but families and communities as a whole. Aside from obvious health barriers including lack of proper food, hygiene, health care and the fact that prisons and jails are overcrowded with people in poor health receiving inadequate care, being in such an environment has the capacity to breed extreme and irreversible psychological damage. Nearly one in three Black men will be imprisoned in their life, and nearly half of Black women have an immediate or extended family member in prison. Research has found very harmful effects on physical and mental health of inmates after release, as well as negative health impacts on the partners and children of incarcerated men. Incarceration contributes to familial and community fractures and gives no opportunity for rehabilitation. Furthermore, prominent health disparities faced by Black Americans, including HIV risk and preterm birth/maternal health problems, can be linked to mass incarceration, highlighting not only the intersectionality but also the pervasiveness of the issue. A study on mass incarceration and public health revealed a significant positive association between Louisiana jails’ Black individuals incarcerated and estimated risk of preterm birth, suggesting that mass incarceration may be an underlying factor of the inequities in reproductive health outcomes of Black women in Louisiana. 

In order to address the health issues plaguing Black Americans both inside prison and as a catalytic effect of it, the direct health of imprisoned people must be tended to, as well as addressing the long-standing system of racist mass incarceration. From a public health perspective, society as a whole will benefit when prisoners are treated with respect and dignity and provided with quality care both in prison and among returning to society. John V. Jacobi, professor of health law and policy, advocates for the importance of comprehensive health care in order to reduce the risk of severe chronic illnesses, infectious diseases, mental illnesses and more among prisoners and those around them once they are released. He argues that, in order to gain the widespread support of an inherently selfish society, empathy must be combined with “protection of ourselves,” and the desire to want the best for society. Poor prison health services fail at their obligations to treat prisoners, but they are also missing the opportunity to address a public health threat to society through issues like misdiagnosis, poor administration of medications and interruptions in treatment. Prisons are dubbed the “new asylums,” as about 700,000 people with mental illness are placed in American jails each year and there may be twice as many people suffering from mental illness in jails than in mental hospitals. Additionally, prison health systems foster the creation of drug resistant strains of tuberculosis and HIV. Implementing higher quality physical and mental health care in prisons would decrease the associated risks of such illnesses and maternal/birth outcomes, promote better mental health and facilitate a smoother reentry into society.

While improving health care and treatment of prisoners is a place to start, it is not nearly sufficient to address the insidious, systemic issue of mass incarceration that disproportionately targets Black Americans. Because young Black boys and men have a much higher chance of being incarcerated than their white counterparts, one of the most important strengths to combat the issue comes at the educational level, directly targeting the school-to-prison pipeline. School completion rates for Black men are 47 percent, and “Black children continue to be inducted into a school-to-prison pipeline that begins with segregated schools, suspensions, detentions, and their disproportionate placement in special education.” In order to combat this problem, developing racial literacy and cultural humility in schools is crucial. This comes from critical self reflection of teachers and learning about systems of injustice, along with disseminating this information to students in digestible and creative ways through the use of dialogue, critical texts, journaling and helping to develop their understanding around the topics of racism, discrimination and prejudice. 

While the education level is one of the fundamental areas for intervention to reduce the effects of mass incarceration on the health of Black Americans, there are many other areas of intervention that all fall under the notion of restorative justice, championed by Angela Davis. Instead of taking prisons for granted and viewing them as the only way to deal with crime/criminals, our country needs to invest in better schools, neighborhoods, community centers, recreational facilities, rehabilitation and more. We must transform “the social and economic conditions that track so many children from poor communities, especially communities of color, into bad schools that look more like juvenile detention centers than they look like schools.” The dehumanization that accompanies incarceration perpetually violates human rights, detrimentally impacting the physical and mental health of Black people and communities. Moving towards a society that treats prisoners and ex-prisoners with compassion rather than as outcasts is crucial in breaking the cycle of disproportionate incarceration, and begins with teaching empathy and compassion as a fundamental feature of society. 

The system of mass incarceration clearly disproportionately harms Black Americans in a multitude of ways. Reducing harm requires multi-tiered, robust intervention methods including improvement of health facilities within prisons, changing the way we treat ex-prisoners and most importantly, targeting the structural issues that contribute to the prison industrial complex, mainly the school-to-prison pipeline and normalization of violence against Black people.

Maya Mokh can be contacted at

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