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Lancet ; 397(10286): 1691-1693, 2021 May 08.
Article in English | MEDLINE | ID: covidwho-1597383
JAMA Netw Open ; 4(9): e2123405, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1391522


Importance: Mass incarceration is known to foster infectious disease outbreaks, amplification of infectious diseases in surrounding communities, and exacerbation of health disparities in disproportionately policed communities. To date, however, policy interventions intended to achieve epidemic mitigation in US communities have neglected to account for decarceration as a possible means of protecting public health and safety. Objective: To evaluate the association of jail decarceration and government anticontagion policies with reductions in the spread of SARS-CoV-2. Design, Setting, and Participants: This cohort study used county-level data from January to November 2020 to analyze COVID-19 cases, jail populations, and anticontagion policies in a panel regression model to estimate the association of jail decarceration and anticontagion policies with COVID-19 growth rates. A total of 1605 counties with data available on both jail population and COVID-19 cases were included in the analysis. This sample represents approximately 51% of US counties, 72% of the US population, and 60% of the US jail population. Exposures: Changes to jail populations and implementation of 10 anticontagion policies: nursing home visitation bans, school closures, mask mandates, prison visitation bans, stay-at-home orders, and closure of nonessential businesses, gyms, bars, movie theaters, and restaurants. Main Outcomes and Measures: Daily COVID-19 case growth rates. Results: In the 1605 counties included in this study, the mean (SD) prison population was 283.38 (657.78) individuals, and the mean (SD) population was 315.24 (2151.01) persons per square mile. An estimated 80% reduction in US jail populations, achievable through noncarceral management of nonviolent alleged offenses and in line with average international incarceration rates, would have been associated with a 2.0% (95% CI, 0.8%-3.1%) reduction in daily COVID-19 case growth rates. Jail decarceration was associated with 8 times larger reductions in COVID-19 growth rates in counties with above-median population density (4.6%; 95% CI, 2.2%- 7.1%) relative to those below this median (0.5%; 95% CI, 0.1%-0.9%). Nursing home visitation bans were associated with a 7.3% (95% CI, 5.8%-8.9%) reduction in COVID-19 case growth rates, followed by school closures (4.3%; 95% CI, 2.0%-6.6%), mask mandates (2.5%; 95% CI, 1.7%-3.3%), prison visitation bans (1.2%; 95% CI, 0.2%-2.2%), and stay-at-home orders (0.8%; 95% CI, 0.1%-1.6%). Conclusions and Relevance: Although many studies have documented that high incarceration rates are associated with communitywide health harms, this study is, to date, the first to show that decarceration is associated with population-level public health benefits. Its findings suggest that, among other anticontagion interventions, large-scale decarceration and changes to pretrial detention policies are likely to be important for improving US public health, biosecurity, and pandemic preparedness.

COVID-19/epidemiology , Communicable Disease Control/methods , Jails/organization & administration , Prisoners/statistics & numerical data , Cohort Studies , Communicable Disease Control/legislation & jurisprudence , Communicable Disease Control/statistics & numerical data , Humans , Pandemics , SARS-CoV-2 , United States
Proc Natl Acad Sci U S A ; 118(21)2021 05 25.
Article in English | MEDLINE | ID: covidwho-1223142


Black and Hispanic communities are disproportionately affected by both incarceration and COVID-19. The epidemiological relationship between carceral facilities and community health during the COVID-19 pandemic, however, remains largely unexamined. Using data from Cook County Jail, we examine temporal patterns in the relationship between jail cycling (i.e., arrest and processing of individuals through jails before release) and community cases of COVID-19 in Chicago ZIP codes. We use multivariate regression analyses and a machine-learning tool, elastic regression, with 1,706 demographic control variables. We find that for each arrested individual cycled through Cook County Jail in March 2020, five additional cases of COVID-19 in their ZIP code of residence are independently attributable to the jail as of August. A total 86% of this additional disease burden is borne by majority-Black and/or -Hispanic ZIPs, accounting for 17% of cumulative COVID-19 cases in these ZIPs, 6% in majority-White ZIPs, and 13% across all ZIPs. Jail cycling in March alone can independently account for 21% of racial COVID-19 disparities in Chicago as of August 2020. Relative to all demographic variables in our analysis, jail cycling is the strongest predictor of COVID-19 rates, considerably exceeding poverty, race, and population density, for example. Arrest and incarceration policies appear to be increasing COVID-19 incidence in communities. Our data suggest that jails function as infectious disease multipliers and epidemiological pumps that are especially affecting marginalized communities. Given disproportionate policing and incarceration of racialized residents nationally, the criminal punishment system may explain a large proportion of racial COVID-19 disparities noted across the United States.

COVID-19/epidemiology , Health Status Disparities , Jails/statistics & numerical data , Public Health/statistics & numerical data , Racism/statistics & numerical data , COVID-19/ethnology , COVID-19/prevention & control , COVID-19/transmission , Chicago/epidemiology , Humans , Incidence , Prisoners/statistics & numerical data , SARS-CoV-2 , Socioeconomic Factors
Health Aff (Millwood) ; 40(1): 177, 2021 01.
Article in English | MEDLINE | ID: covidwho-1007101

COVID-19 , Humans , SARS-CoV-2
Health Aff (Millwood) ; 39(8): 1412-1418, 2020 08.
Article in English | MEDLINE | ID: covidwho-526700


Jails and prisons are major sites of novel coronavirus (SARS-CoV-2) infection. Many jurisdictions in the United States have therefore accelerated the release of low-risk offenders. Early release, however, does not address how arrest and pretrial detention practices may be contributing to disease spread. Using data from Cook County Jail-one of the largest known nodes of SARS-CoV-2 spread in the United States-in Chicago, Illinois, we analyzed the relationship between jailing practices and community infections at the ZIP code level. We found that jail-community cycling was a significant predictor of cases of coronavirus disease 2019 (COVID-19), accounting for 55 percent of the variance in case rates across ZIP codes in Chicago and 37 percent of the variance in all of Illinois. Jail-community cycling far exceeds race, poverty, public transit use, and population density as a predictor of variance. The data suggest that cycling people through Cook County Jail alone is associated with 15.7 percent of all documented COVID-19 cases in Illinois and 15.9 percent of all documented cases in Chicago as of April 19, 2020. Our findings support arguments for reduced reliance on incarceration and for related justice reforms both as emergency measures during the present pandemic and as sustained structural changes vital for future pandemic preparedness and public health.

Communicable Disease Control/organization & administration , Coronavirus Infections/epidemiology , Infectious Disease Transmission, Vertical/statistics & numerical data , Pneumonia, Viral/epidemiology , Prisoners/statistics & numerical data , Prisons/organization & administration , Public Health , COVID-19 , Chicago , Female , Humans , Illinois , Infectious Disease Transmission, Vertical/prevention & control , Male , Pandemics/statistics & numerical data , Vulnerable Populations