AJPH First Look, published online ahead of print Feb 28, 2006
April 2006, Vol 96, No. 4 | American Journal of Public Health 589
© 2006 American Public Health Association
DOI: 10.2105/AJPH.2005.083691
INCARCERATION AS A PUBLIC HEALTH CRISIS
April M. W. Young, PhD
Correspondence: Requests for reprints should be sent to April M. W. Young, PhD, Collins Center for Public Policy, 150 SE 2nd Ave, Suite 709, Miami, FL 33131 (e-mail: ayoung{at}collinscenter.org).
Thank you for the special issue dedicated to prisons and health (October 2005). In addition to calling attention to the many complex health and social issues relevant to the experience of imprisonment, this issue calls upon us to recast incarceration as the public health crisis it is.
For me, working for nearly 3 years in Overtown, the most distressed neighborhood in Miami, Fla, has meant bearing witness to the impact of mass incarceration upon a community and its inhabitants. In a Community Voices study of men’s health in Overtown to be published soon (A. M. W. Young and S. Fryberg, Community Voices, unpublished study, May 2005), 66% of the adult male participants report having been incarcerated. To know this statistic is to recognize that Overtown’s collective history is constituted of a widely shared prison experience. To understand this is to realize that Florida’s punitive and nonrehabilitative approach to corrections has traumatized hundreds of Overtown residents and crippled an entire community.
The Overtown study reveals strong correlations between incarceration and negative psychosocial health outcomes, including higher incidences of illegal drug, tobacco, and alcohol use; perceptions of greater HIV infection risk; poorer self-assessments of mental and physical well-being; and lesser access to health care services. The community-level impact of such high rates of incarceration is perhaps evident in the concentrated poverty, high unemployment, dysfunctional civic institutions, blighted edifices, and neglect of public services and infrastructure that characterize the neighborhood.
There is a need for policy reform that is mindful of both the negative impact of incarceration on individual lives and the systematic damage caused by incarceration to the already marginal communities from which most inmates are drawn. However, reforms in policy and practice will require a repeal of the vengeful, retributive approach that would jail a homeless man for violating the Hurricane Wilma curfew only to dump him back on the street 7 days later—still without shelter but more socially and psychologically disoriented than before. Kudos again to the guest editors of the prison health issue for suggesting that we move away from retributive thinking, and instead cultivate a sense of urgency about the health of individuals and communities devastated by incarceration.
Copyright © 2006 by the American Public Health Association
