A subtle but significant factor in inequality is America’s use of long prison sentences for nonviolent crimes, which has hit black Americans especially hard. A prominent epidemiologist explains this as a new kind of public health problem.
Beginning in the 1970s, a new epidemic occurred in our nation—affecting tens of millions of Americans over the course of more than three decades. Yet despite its huge scale and powerful effects on our population, almost no one noticed it. Here are some of the things we know about this new epidemic:
• The population involved is diverse: men and women, adults and children, different social classes.
• The onset was very rapid: in thirty-five years the population directly affected by this epidemic increased tenfold, from 250,000 in 1970 to 2.3 million by 2009.
• The effects of the epidemic extend beyond the actual cases: over 30 million have been affected in the last thirty years.
• Young minority men have been affected most severely: although they make up only 3 percent of the U.S. population, young black and Hispanic men constitute over 30 percent of the cases.
• While this epidemic is nationwide, most cases have occurred in the poorest neighborhoods of America’s urban areas—in some communities, over 90 percent of families have afflicted members.
• Individuals who are afflicted are also socially marginalized and often become incapacitated for life—unable to find decent work, get proper housing, participate in the political system, or have a normal family life.
• The children of families affected by this new epidemic have lower life expectancy and are six to seven times more likely to acquire it themselves than the children of families not affected.
Like the sinking of the Titanic, this new event is a disaster—but it is no accident. Indeed, it is the result of laws and deliberate public policies, fueled by the expenditure of trillions of dollars of public funds, and supported by powerful political and economic interests. Although no known biological agent is involved, as with cholera and AIDS, this new epidemic exhibits all the characteristics of an infectious disease—spreading most rapidly by proximity and exposure to prior cases.
This new epidemic is mass incarceration—a plague of prisons.
Mass incarceration? The term seems out of place for America—a nation premised on individual rights and freedom. It conjures up images of brutal foreign tyrannies and totalitarian despots—widespread oppression and domination of individuals under regimes of state power built upon fear, terror, and the absence of effective legal protection. When we think of large-scale systems of imprisonment throughout history, we think of great crimes against humanity—Hitler’s network of diabolical concentration camps or the vast hopelessness of Stalin’s archipelago of slave-labor prison camps. Stalin’s system established a model for mass incarceration whose effects penetrated every corner of Russian society, shaping the experience of millions beyond those in the camps—most immediately the prisoners’ families. More broadly, it created an entire population living under the threat of arrest and arbitrary detention. This model seems foreign to life in our democratic society—a product of different times and faraway places.
The facts about current-day American incarceration are stark. Today, a total of 7.3 million individuals are under the control of the U.S. criminal-justice system: 2.2 million prisoners behind bars, 800,000 parolees, and another 4.2 million people on probation. If this population had their own city, it would be the second largest in the country.
The U.S. prison population grew apace with the general population (averaging about 125 prisoners per 100,000 population) until 1975, when there were about 250,000 people in jails and prisons. Then it climbed sharply, reaching over 2 million prisoners by 2006—a historic peak rate of nearly 750 per 100,000. That is six times the historic rate.
This huge system of imprisonment and the criminal-justice system’s control of millions of Americans is fueled by even more millions of arrests—an average of 10 million per year for each of the last twenty-five years. There were 14 million arrests in 2008 alone. These arrests, together with the use of longer prison sentences, keep state and federal prisons filled with new inmates: over 600,000 enter prison each year, with an average sentence of four to six years. This means that many also exit the system each year. In 2009, 700,000 individuals were discharged from prisons, most reentering the communities from which they came.
But most are also destined to be reincarcerated. Circulating through the infamous revolving door of the system, 67 percent of discharged prisoners will be back inside within three years of their release. A decade after violent crime began to decline sharply nationwide (reaching historic lows in 2006), the growth of the prison system continued. Each week in 2006 saw one thousand prison beds added. In 2007 and 2008, another 100,000 prison beds were added across the nation. Only in 2010, after thirty-five years of relentless growth, did we see the first decline in the U.S. prison population—a sign that this phase of the epidemic may have peaked. The total population of state and federal prisons was 2.2 million in 2011.
Having described the unprecedented scale of imprisonment in America, we may still ask: is America’s use of imprisonment really a justifiable (and effective) solution to an epidemic of crime? Indeed, with crime rates at historic lows, one might even conclude that all this imprisonment is a good thing. Or is it a problem in its own right? How can we assess the significance of mass incarceration in America?
Here is where the tools of epidemiology can help. By looking more closely at the data on imprisonment in the United States through the lens of public health, we can begin to parse the prison epidemic. Is crime really the source of epidemic-level imprisonment, or is something else driving this phenomenon? As is always the goal in public health, can we also understand enough about mass incarceration to learn how to contain and eradicate this modern plague?
DEFINING MASS INCARCERATION
Incarceration—punishment by imprisonment—is based on a set of laws established by a state or nation to ensure public safety by the separation and isolation of criminals from society.
By contrast, mass incarceration results from policies that support the large-scale use of imprisonment on a sustained basis for political or social purposes that have little to do with law enforcement. Hitler, Stalin, and Pol Pot all employed mass imprisonment, each presiding over a process that arrested and incarcerated millions. Such systems are often part of massive programs of slave labor or forced resettlement, in which high death rates are a typical by-product. And some examples of mass incarceration are explicitly part of a program of ethnic cleansing or genocide—a tool of policy that intends the extermination of entire populations. But now, for the first time, we see mass incarceration in a democratic society.
The judicial mechanisms that states employ to accomplish programs of mass incarceration include laws and strategies of enforcement explicitly designed to imprison large populations. Methods include expansion of the list of criminal offenses punishable by prison terms, as well as harsher sentencing practices that impose long prison terms for crimes not previously prosecuted at all: being Jewish in Nazi Germany, or being an enemy of the state in Stalin’s Russia.
This expansion of the use of incarceration (creating a vastly larger prison system) is almost always accompanied by worsened prison conditions, with more dangers to inmates’ health and safety. In addition, the rapid growth of a larger prison system creates an expanded and more powerful system of “correctional” administration, which tends to have self-perpetuating features. These systems then add more and larger prisons, with better-endowed and more powerful correctional, police, and prosecutorial agencies at every level of government.
THE EPIDEMIOLOGICAL CHARACTERISTICS OF MASS INCARCERATION
What makes all epidemics important to public health is their large scale and the great loss of life or disabilities that are left in their wake. As we saw with the sinking of the Titanic, cholera in London, and AIDS in the Bronx, understanding epidemics includes understanding the many nonbiological, social factors that frequently determine who lives and who dies. These can be issues of social convention (“women and children first”), of moralistic and punitive attitudes (defining drug use as a moral issue and resisting framing addiction as a public health issue), or of turning a blind eye to social policies gone awry (as in the case of the consequences of the war on drugs).
Failure to identify and address these underlying factors stands in the way of letting us cope effectively with any preventable disease and reduce the death and suffering it causes. Indeed, in the case of AIDS and drug addiction, we see matters worsen, with the epidemic expanding to new populations even as we develop effective medical treatments for individual cases.
Normally, imprisonment is not seen as a disease, or even a serious problem for anyone but the inmate. Yet an epidemiological analysis of mass incarceration reveals that it meets all the important criteria for being an epidemic, a collective phenomenon that is more than the sum of its individual cases. These criteria include its rapid growth rate, large scale, and self-sustaining properties.
RAPID GROWTH RATE
Mass incarceration easily meets the first criterion for status as an epidemic—the rapid growth of new cases (increased incidence) over a short period of time. In the past thirty-five years, the United States has increased its incarcerated population tenfold. For almost a hundred years, from 1880 to 1975, the rate of imprisonment stayed flat, averaging 100–150 individuals imprisoned for every 100,000 members of the population. Beginning in the 1970s, laws and enforcement policies were put in place that caused the rate to multiply five times over the course of thirty years, to more than 750 individuals imprisoned for every 100,000 members of the population today. This growth rate is unprecedented in our nation’s history.
LARGE MAGNITUDE
The very large scale of incarceration in America defines its great public health significance, with tens of millions affected. The magnitude of our prison system has effectively made this country the world champion of incarceration. Today, the United States has the highest rate of imprisonment of any nation in the world—possibly the highest rate in the history of any nation. By comparison, European countries average less than one-fifth of the American rate, and many average only one-tenth of it. The U.S. rate of incarceration is the highest in the world—about 750 per 100,000—a rate more than seven times that of European Union countries and greater than that of Russia or South Africa.
The number affected by long-term incarceration in state and federal prisons is dwarfed by the number of those arrested and held, even briefly, in local jails—another 14 million each year. In total since 1975, about 35 million Americans have been arrested and jailed or imprisoned, probably more than all Americans incarcerated for all offenses in the previous hundred years.
In addition there is the “collateral damage” of mass incarceration: the children, wives, parents, siblings, and other family members of those incarcerated over the course of the last thirty-five years. In 1960, a school-age child in Harlem or in the South Bronx had a 2 percent to 4 percent chance of having a parent imprisoned before reaching age eighteen. Today, that chance is more than 25 percent in many communities. Though innocent of any crime, the children of prisoners are also punished by the far-reaching effects of our system of mass incarceration, just as surely as if they themselves had been convicted.
With an average of about two children for about half of all inmates, over 25 million American children have by now been directly exposed to parental incarceration. Concentrated in the mostly urban neighborhoods targeted for mass arrests, they are the residents of the prison system’s “feeder communities,” where parents, siblings, uncles, aunts, cousins, close friends, and neighbors have all been incarcerated. In these communities, the epidemic of incarceration affects everyone—more damaging than the drugs that were the original rationale for so many of the arrests. In these communities, incarceration has become the norm, spawning successive generations of prison orphans and gang members.
It is no secret these feeder communities are largely black and Hispanic. An estimated 50 percent of all the extended black and Hispanic families in the United States by now have had a member incarcerated in the last thirty-five years; for the poorest in both groups, that number approaches 100 percent. For example, in Washington, D.C., more than 95 percent of African American men have been in prison at some point.
PERSISTENCE AND SELF-SUSTAINING CAPABILITIES
Another hallmark of any epidemic is its persistence, due to factors that allow it to sustain its large scale and grow ever larger. Mass incarceration has shown this ability to reproduce itself (as infectious or communicable diseases do) by several mechanisms that keep people “infected” and create new cases in a way that has sustained its heightened prevalence over many years. Part of this is related to the vast apparatus created to administer the criminal-justice system; part is related to the new laws that mandate longer sentences and keep the prisons full of older inmates for longer periods; part is due to the rules governing release and reentry—parole policies that lower the threshold for violations and ensure recidivism; and part is the result of lasting damage done to the families and the social fabric of the communities from which most prisoners are drawn.
Over the past thirty years, the nation’s prison industry has grown exponentially to accommodate a growing prison population. Currently the prison industry supports one full-time employee for every one of the 2.3 million people behind bars.
Not surprisingly, this huge American “industry” has huge political clout—with the expansion of prosecutorial and correctional workers’ power, the growing number of lobbyists for these groups, and the many vendors who build and service prisons. Add in the financial dependence of many communities on prison industries in their localities and prison budgets are hard to touch.
Despite studies showing that there are, in fact, few long-term economic benefits of this “industry” for the localities that host them, prisons are often seen as an economic lifeline, especially in poor rural communities that have lost many industries to globalization over the last two decades. In New York State, for instance, fully half of the state’s prison beds were once located in the upstate home districts of three powerful Republican state senators. In California, the correction officers’ union in 2008 helped defeat a bill that would have moved $1 billion from the prison system to drug treatment, paying for rehabilitation and relapse-prevention programs rather than prison time. The enormous and powerful prison-industrial complex that America has created is a growth industry, and it fights to sustain its “market share,” always bringing new “services” under its auspices—most significantly, mandated drug treatment.
In recent years, budget crises in many states have led to the first decline in incarcerations in thirty years, via the early release of some nonviolent offenders and a politically mandated drop in arrests. In New York, this has resulted in a 20 percent decline in the prison population. But many of the sentencing policies that first built and filled these prisons continue unabated (fourteen states increased prison populations in 2010), with the focus of law enforcement increasingly shifting to lower-level offenses (e.g., marijuana arrests are up 5,000 percent in the last decade).
U.S. prison budgets are also unprecedented in American history, representing the diversion of public treasure from other great needs—education, health care, Social Security for the aged. Averaging over $25,000 per inmate or about $60 billion annually, most of the money comes from state budgets. With several billion more to build all these prisons, we have created a large privatized “correctional industry,” which, among other offensive aspects, offers new investment opportunities on Wall Street for operating “for-profit” prisons. With so many vested interests in maintaining the prison-industrial complex, it is no wonder the system has become self-perpetuating.
Another way in which the plague of prisons has become self-sustaining, according to new, cutting-edge research by criminologists including Todd Clear, is by destabilizing communities. Clear has documented that crime rates in Florida communities with high incarceration rates can be traced directly to increases in imprisonment. In other words, what started out as a punishment for crime—prison—has now become a source of the very crime it seeks to control.
Clear argues that massive levels of arrest and imprisonment concentrated in certain communities damage the social bonds that sustain life, especially for poor communities. By corroding or destroying this most common basis of social capital, mass incarceration sets up a perverse relationship: punishment leads to increased crime, as it replaces the moral mechanisms of family and community. These are the forces that normally function to assert social control, over young males especially, by the use of noncoercive means involving family and community.
Furthermore, because so much money is diverted to incarceration, other public services that might play a role in keeping down crime in these communities are defunded in favor of funding to build and maintain more prisons. Programs including health care, job training, retirement benefits, housing, and community development have all suffered a loss of public revenues, even as funding allocated for mass incarceration has grown exponentially. All these are worsened by the economic downturn that began in 2008 and which further restricts ex-prisoners’ options.
Longer sentences also build incarceration rates and create a chronic condition of social incapacitation for those imprisoned, as they face severe restrictions on their rights and opportunities after release from prison. Individuals who enter prison and become a case in the criminal-justice system today have a 50 percent or more chance of remaining under the system’s control for life with recurrent arrests and periods of incarceration.
Like the story of global warming and climate change, this epidemic of mass imprisonment includes many “inconvenient truths”—critical realities we do not care to know about—such as its sheer size, huge social disparities, and monumental costs. But unlike climate change, the scale and consequences of mass incarceration derive from relatively recent events and a deliberate set of public policies that continue to be defended as being in the public interest. Unlike many other afflictions, a deadly new virus or bacteria did not cause this epidemic. It is self-inflicted and has required the expenditure of a great fortune, more than $1 trillion in public funds over its thirty-five-year course.
Paradoxically, despite its enormity and great significance for tens of millions of our citizens, America’s mass incarceration remains largely invisible. Denial is the norm for the public at large, even in the face of the profound effects imprisonment has on the lives of so many American families.
Compared to the burning issues of the present day—the economy, health care, overseas wars, and the threat of terrorism—imprisonment, even mass imprisonment, is only a marginal political issue at best. Via constant exploitation in the media—with scores of TV shows about crime and punishment aired each week—we by and large maintain the ability to look the other way, actively evading any moral responsibility for this system’s existence. Perhaps that is because the story is almost always about “public safety,” protecting us and our families, not the far more consequential and damaging epidemic of punishment we sponsor.
A public-health approach to mass incarceration offers a new way to examine this phenomenon and the role of the laws and public policies that with or without intention, now sustain our vast and socially damaging system of prisons and prisoners.
Adapted from A Plague of Prisons: The Epidemiology of Mass Incarceration in America