Prison population reductions and COVID-19: A latent profile analysis synthesizing recent evidence from the Texas state prison system (preprint)

ABSTRACT

ImportancePeople in prison are particularly vulnerable to infectious disease due to close living conditions and the lack of protective equipment. Public health professionals and prison administrators seek information to guide best practices regarding prison population to capacity rates for the COVID-19 outbreak. ObjectiveUsing latent profile analysis, we sought to characterize Texas prisons on levels of COVID-19 cases and deaths among incarcerated residents, and COVID-19 cases among prison staff. DesignThis observational study was a secondary data analysis of publicly available data from the Texas Department of Criminal Justice (TBDJ). Data were downloaded and analyzed on July 24, 2020. This project was completed in collaboration with the COVID Prison Project. SettingOne-hundred and three prisons in the state of Texas. ParticipantsThe unit of analysis is the individual prison units that comprise the TDCJ. ExposuresNone Main Outcomes and MeasuresLatent profiles on levels of incarcerated resident COVID-19 cases, staff COVID-19 cases, and incarcerated resident COVID-19 deaths. ResultsWe identified relevant profiles from the data a low outbreak profile, a high outbreak profile, and a high death profile. Additionally, current prison population and level of employee staffing predicted membership in the high outbreak and high death profiles when compared to the low outbreak profile. Conclusions and RelevanceHousing persons at 85% of prison capacity may minimize the risk of infection and death related to COVID-19. Implementing this 85% standard as an absolute minimum should be prioritized at prisons across the US. KEY POINTSO_ST_ABSQuestionC_ST_ABSIs there a population to capacity ratio for prisons to successfully reduce the number of COVID-19 infections and deaths among its incarcerated populations? FindingsThe prisons that were most effective in reducing prison outbreaks and deaths operated at 85% of their current capacity. MeaningPrisons should operate at 85% of capacity or less to successfully minimize the harmful effects of COVID-19 on incarcerated populations.