The COVID-19 pandemic was responsible for thousands of deaths in its first year. But the death rate was even higher for incarcerated people in state and federal prisons.
From March 2020 to February 2021, nearly 2,500 incarcerated people in state and federal prisons died of COVID-19, according to data from the Bureau of Justice Statistics.[1] This translates to a death rate[2] of about 1.5 deaths per 1,000 incarcerated people from the virus. By comparison, the CDC estimates a death rate of about 1.25 deaths per 1,000 people for the total US population in 2021, making the death rate 20% higher for incarcerated people than it was for average Americans.
How accurate are figures on COVID-19 prison deaths?
In April 2021, the Bureau of Justice Statistics (BJS) requested data on COVID-19 deaths from the correctional department of each state, as well as the Federal Bureau of Prisons. The department used the data to create the Coronavirus Pandemic Supplement to the National Prisoner Statistics program.
Data in the supplement included deaths where COVID-19 was “suspected or confirmed as the cause or a significant contributing factor”.
The deaths reported may be an underestimation for several reasons.
First, Missouri’s Department of Corrections didn’t provide the requested data for the supplement. As of 2020, Missouri’s state and federal prison population was 23,062, higher than the state median prison population nationwide of 15,674.
Second, Georgia and Pennsylvania didn’t count COVID-19 deaths in the same way as other states that provided data for the supplement. The Georgia Department of Corrections told the BJS it couldn’t access a count of COVID-19 deaths as determined by a medical examiner or coroner. The Pennsylvania Department of Corrections informed the BJS that it didn’t have the number of COVID-19 related deaths as determined by a medical examiner or coroner.
Finally, no data was collected from privately operated prisons under federal contract.
Why are prison populations vulnerable to COVID-19?
The stress caused by the conditions of incarceration (inaccessibility of healthcare, reliance on solitary confinement, and overcrowding, among other things) are likely to contribute to a higher rate of mortality for incarcerated people without a global pandemic.
The spread of infectious diseases in prisons was likely affected by overcrowding. For example, 24 of California’s 35 state prisons exceeded 100% capacity in August 2020. This means that the majority of California state prisons house more people than they were designed to accommodate.
Overcrowding was an issue in federal prisons going back to 2015, when the Office of the Inspector General cited it as a safety and security issue for inmates and staff. That year, the system-wide crowding level[3] of all federal prisons in the US was 23%, meaning federal prisons as an aggregate were 23% overcrowded.
Finally, the share of elderly people in prisons has also risen over time, rendering the prison population more vulnerable to a disease such as COVID-19. The number of incarcerated people aged 55 or older in state prisons increased from 5.1% of the state prison population in 2004 to 12.8% in 2016.
What is the leading cause of death of individuals in prison?
Even prior to the COVID-19 pandemic, illness remained the main cause of death for both state and federal prison populations. In 2019, illness was the reason behind 79% of all prison deaths, which reflects a decrease from 90% in 2000.
The quality of healthcare provided in prisons may have an impact on illness-related prison deaths in general, including the treatment of COVID-19. While national data on healthcare services provided in prisons is limited, individual reports from states suggest that access to healthcare within US prisons remains lacking.
In 2002, a US federal court found that the medical care provided by California state prisons was so deficient that it violated the Eighth Amendment of the US constitution, which outlaws “cruel and unusual punishment”. Due to the state of California’s failure to obey court orders, a judge placed prison medical care under receivership[4] in 2005. As of December 2021, more than 20 years after the class-action lawsuit was first filed, efforts to make California state prisons align with constitutional standards were still ongoing.
In 2021, the Utah State Legislature’s Performance Audit of Healthcare in State Prisons found that incarcerated people with diabetes were not sufficiently kept under observation, and that the gap in time between insulin administration and meals did not align with internal policy.
Also in 2021, a US federal court ruled that the medical care provided at the Louisiana State Penitentiary at Angola, a maximum-security men’s prison, violated both the Eighth Amendment and the Americans with Disabilities Act. The court found that the prison’s medical care was constitutionally lacking in its ability to provide sterile spaces and adequate medical equipment and that its delays in the provision of medical care were both “unnecessary and harmful.”
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[1] This data does not include COVID-19 deaths that occurred in jails.
[2] The Bureau of Justice Statistics calls this figure a crude death rate since it is not adjusted for factors such as sex, racial or ethnic background, and age.
[3] The system-wide crowding level is calculated by dividing the total number of incarcerated people in federal prisons by the total capacity of all federal prisons.
[4] A receiver is a third-party person (or group of people) who has been appointed by a court to monitor property or money typically managed by a defendant, or someone sued in court. According to the US Securities and Exchange Commission (SEC), “the SEC typically recommends the appointment of a receiver in cases in which the SEC fears a company or an individual may dissipate or waste corporate property and assets.” In this case, the court transferred the California Department of Corrections and Rehabilitation secretary’s powers over the California prison medical system to the receiver.
