pho­to­graph by mike groll/​ap photo

beyond crime and pun­ish­ment by jason silverstein

It is one of the great ironies of Amer­i­can soci­ety: pris­on­ers are con­sti­tu­tion­ally guar­an­teed health­care, but for­mer pris­on­ers are not. The prison health para­dox is one dra­matic way to think about the health dis­par­i­ties of impov­er­ished minori­ties in the United States. In 2010, Eve­lyn Pat­ter­son found that “prison appears to be a health­ier place than the typ­i­cal envi­ron­ment of the non­in­car­cer­ated black male pop­u­la­tion.” Indeed, dur­ing incar­cer­a­tion, black-​white mor­tal­ity dif­fer­ences van­ish. But once released, we see some­thing else entirely. The mor­tal­ity rate sky­rock­ets. The dead­liest time is the first two weeks after release, when for­mer inmates have a 12.7 times higher risk of death than the gen­eral pop­u­la­tion and a 129 times higher risk of drug overdose.

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The peo­ple most likely to suf­fer the neg­a­tive health effects of incar­cer­a­tion are also the peo­ple most likely to already suf­fer from health dis­par­i­ties. Because African Amer­i­cans are incar­cer­ated at a rate higher than whites, racial health dis­par­i­ties are ulti­mately wors­ened by the effects of incar­cer­a­tion. In their Du Bois Review piece, Schnit­tker, Mas­sol­gia, and Uggen remind us that the mass in mass incar­cer­a­tion “is indeed ‘mass’ in the sense that it is now large enough to affect an entire demo­graphic group.” In Michelle Alexander’s The New Jim Crow: Mass Incar­cer­a­tion in the Age of Color Blind­ness, we learn that more African Amer­i­can men are impris­oned today than enslaved in 1850. Incar­cer­a­tion does not only threaten the long-​term health of indi­vid­u­als, but entire com­mu­ni­ties. In a jus­tice sys­tem plagued by racial bias, incar­cer­a­tion threat­ens the health of an entire race.