COVID-19 Exposes Inequities in Criminal Justice System

The COVID-19 pandemic has cast a harsh light on the many inequities that exist within the nation’s public health system, including problems within the correctional health system, according to a commentary published in the Journal of Public Health Management and Practice (JPHMP).

Ans Irfan, MD, MPH, a professional lecturer and Doctor of Public Health student at the George Washington University Milken Institute School of Public Health (Milken Institute SPH) and his coauthors examine the health care infrastructure within correctional systems and the disproportionate burden of this inadequate health care system on vulnerable populations. The COVID-19 crisis has amplified the strain on health care provided in the nation’s prisons and jails, according to the commentary, which was posted April 20 on JPHMP Direct.

“The problems in our correctional health system have long predated the COVID-19 crisis, but the pandemic has certainly worsened them,” Irfan said. “There are numerous areas that need to be addressed, but chief among them is mental health and substance use. There are incredibly high rates of mental illness and substance use in justice-involved populations and the correctional health system has continually underperformed in providing the level of health care services necessary to meet their needs.”

Irfan points out that many people with an untreated addiction or other health problems will leave a correctional facility only to get sick or overdose during the risky period immediately following release. The commentary raises a cautionary note about the trend of enacting emergency release programs for potentially thousands of incarcerated people in response to the COVID-19 pandemic. 

“While these programs are well-intentioned, they pose a huge risk to those who might have unmet mental health or substance use-related issues. This concern shines a spotlight on the need to improve the quality of health care delivered in correctional settings and the critical need for more robust reentry services for people post-release,” said Irfan, who is also a Robert Wood Johnson Foundation Health Policy Scholar. “Reforms to these systems have been long needed but haven’t received the political support and urgency to warrant significant legislative action. Moreover, the COVID-19 pandemic presents a unique opportunity to not only implement legislation to prevent the spread of the virus, but also improve on the underlying correctional health system that would have benefits that would last long after the pandemic passes.” 

Irfan published the commentary, “COVID-19 Amidst Carceral Contexts: The Overton Window of Political Possibility and Policy Change,” along with lead author Cynthia Golembeski, Brie Williams and Homer Venters. The commentary was also shared by the London School of Economics as a blog post.