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Over 2 million individuals are incarcerated in the US criminal justice system. More than half of incarcerated Americans are also parents of minors. Parental incarceration can lead to a higher risk of mental illness and enduring trauma in children, as well as other problematic cognitive, developmental, and educational outcomes. Examining parental incarceration through a racial equity lens is critical, as people of color make up 67% of the incarcerated population despite making up only 37% of the US population. Further, gender-related equity issues pose important challenges for families with incarcerated parents. Here, we discuss prison-based psychosocial interventions designed both to build parenting skills and to improve parent well-being within a racial and gender equity lens. We hypothesize that effective services in these areas are essential components in a broad strategy designed to mitigate the potential negative effects suffered by families and children of incarcerated parents of color as a result of their imprisonment.

Research about the prevalence of dementia among older adults in the incarceration system is currently lacking, and further investigation is warranted. Considering the high level of healthcare needs, unique behavioural issues and difficulty to rehabilitate within the system due to its punitive approach and lack of effective rehabilitation programs, further investigation is warranted to characterize and determine the number of incarcerated older adults with dementia. The purpose of this study is to estimate the prevalence of individuals with dementia in the prison system while also describing the incarceration, demographic and offence-related characteristics of this unique population.

South Carolina (SC) Alzheimer’s Disease and Related Dementias Registry (1992–2016) and South Carolina Department of Corrections (SCDC) data (Fiscal years 1992–2019) were cross-referenced. The prevalence of Alzheimer’s disease and related dementias (ADRD) cases in the corrections system was calculated using South Carolina Alzheimer's Disease (SC AD) SC ADRD Registry and SCDC data. Pearson’s correlation coefficients were calculated to determine strength and direction of relationships between year of incarceration and frequency of ADRD cases both prior to and after incarcerations, respectively. Significant differences by age group, race, gender and dementia type were determined using a two-tailed pooled t-test and Bonferroni approach where appropriate. Count data for types of crimes committed are also presented.

The linkage showed that there were 2,171 individuals within the SC AD Registry who have been in the corrections system, about 1% of those in the Registry. Of these individuals, 1,930 cases were diagnosed with ADRD after incarceration and 241 prior to incarceration. In 2016, 317 individuals with ADRD were incarcerated. For ages 55 and above in South Carolina, the prevalence of ADRD is 6.7% in the general, non-incarcerated population compared to 14.4% in the incarcerated population. Additional results showed that those diagnosed with ADRD between 55 and 65 years of age had a significantly lower mean age at first incarceration (34.6 years of age) than those diagnosed between 66 and 74 years of age (55.9 years of age), indicating that those incarcerated earlier in life had an earlier dementia diagnosis. Additionally, African Americans had a significantly lower mean age at first incarceration (43.4 years of age) than Whites (46.2 years of age) and females had significantly lower mean age at first incarceration (42.9 years of age) than males (45 years of age). When investigating trends, results showed a significant positive linear association between year and frequency of ADRD diagnoses (p-value < 0.05) for those with ADRD diagnosis prior to incarceration and a significant decreasing linear association (p-value < 0.0001) in the number of individuals with an ADRD diagnosis after corrections. Findings also showed that a large percentage of older adults with ADRD in prison did not commit a violence offence.

This study links a population-based Alzheimer’s disease registry and state-wide corrections data to estimate the prevalence of individuals with dementia in the prison system. This linkage presents an opportunity to fill in significant gaps and contribute to the body of literature on dementia among people in prison in the USA.

This study aims to describe the COVID-19 risk mitigation strategies implemented in California prisons and the impact of these policies on the mental health of incarcerated women.

The authors conducted semi-structured qualitative interviews with ten women who were over the age of 50 and/or had a chronic illness and had been incarcerated in California prisons during the COVID-19 pandemic. The authors also interviewed ten health-care providers working in California jails or prisons during the pandemic. Interviews were analyzed using a grounded theory coding framework and triangulated with fieldnotes from ethnographic observations of medical and legal advocacy efforts during the pandemic.

Participants described being locked in their cells for 23 hours per day or more, often for days, weeks or even months at a time in an effort to reduce the spread of COVID-19. For many participants, these lockdowns and the resulting isolation from loved ones both inside and outside of the prison were detrimental to both their physical and mental health. Participants reported that access to mental health care for those in the general population was limited prior to the pandemic, and that COVID-19 risk mitigation strategies, including the cessation of group programs and shift to cell-front mental health services, created further barriers.

There has been little qualitative research on the mental health effects of the COVID-19 pandemic on incarcerated populations. This paper provides insight into the mental health effects of both the COVID-19 pandemic and COVID-19 risk mitigation strategies for the structurally vulnerable older women incarcerated in California prisons.

Objectives – Given the multitude of barriers faced by incarcerated and formerly incarcerated individuals, we contribute to prior literature through our exploration of the relationship between Social Determinants of Health (SDOH) and Adverse Childhood Experiences (ACE) scores among a sample of incarcerated individuals (women) in San Bernardino County.

Methods – We performed a secondary data analysis on the original, self-reported data collected in 2011 from 336 female participants serving sentences in the San Bernardino County Jail System. Multivariate linear regression analysis was performed to examine the association between ACE scores and select covariates.

Result – Higher ACE scores were associated with participants characterized as younger, low income, and unemployed and were significant among incarcerated women whose biological father has been in trouble with the law and those with an incarcerated household member. Additionally, participants with higher ACE scores were raised in more unstable neighborhoods.

Conclusions – The study demonstrates strong evidence that ACE scores are interrelated with individual-level characteristics, family stability, and SDOH, and impact the health outcomes and life experiences of vulnerable populations.

The purpose of this commentary is to draw upon available literature and practices related to COVID-19 and management of older incarcerated adults in Australia to highlight key matters for better risk management and care of this population during this and future infectious disease pan/epidemics.

The present commentary draws on current policies, practices and literature regarding the health, needs and management of older incarcerated adults in Australia to discuss risk, care and early release for this population during the COVID-19 pandemic.

Incarcerated persons experience poorer health and accelerated age-related decline compared to those in the general community. The present situation offers the opportunity to fill knowledge and practice gaps, including policies for staff training, identification of dementia and cognitive decline, assessment of mobility issues, addressing barriers to health-seeking, possibilities of medical or compassionate release, risk assessment and release protocols and post-release needs.

While Australian prisons have acknowledged the vulnerability of older persons, more focused adaptation of COVID-19-related policies to consider adults as young as 45 years are needed. Appropriate ethical identification and management of cases in this population is needed, as is discussion on issues of decarceration and medical release. Re-conceptualisation of incarcerated adults as “citizens in need of care”, rather than as “offenders to be secured”, will be beneficial. Robust, local evidence is needed to assist decision-making.

This is a comprehensive, focused review of relevant evidence, policies and practices for a growing subpopulation of prisoners worldwide with complex needs and particular vulnerability to the COVID-19.

This study aims to examine steps taken by correctional staff to prevent COVID-19 from spreading through correctional facilities and explores strategies used by incarcerated individuals to reduce their own risk of contracting COVID-19 during confinement.

Data were drawn from interviews with 327 individuals incarcerated after March 16, 2020, in Midwest1, Midwest2 and Southeast state using a questionnaire developed for this purpose. All study participants were actively involved in a randomized controlled trial of a behavioral health reentry intervention and the human subjects board approved the supplement of this study on COVID-19; interviews were conducted from April 15 to November 19, 2020.

Overall, 9.89% of participants contracted COVID-19. Most (68.50%) individuals learned about COVID-19 from television compared to official correctional facility announcements (32.42%). Participants wore face masks (85.02%), washed hands (84.40%) and practiced physical distancing when possible (66.36%). Participants reported that facilities suspended visitation (89.60%) and volunteers (82.57%), provided face masks (83.18%), sanitized (68.20%), conducted temperature checks (55.35%) and released individuals early (7.34%).

Longitudinal observational study on the implementation and effectiveness of public health guidelines in prisons and jails may identify best practices for containing the infectious disease. Maximizing transparent communications, as well as COVID-19 prevention and mitigation efforts, are critical to achieving universal best practices for virus containment and amplifying public health.

Data presented indicate the early adoption of many Centers for Disease Control guidelines by individuals and correctional facilities, although broad variation existed. Data support the identification of containment strategies for feasible implementation in a range of correctional spaces.

The US prison population has recently reached an all-time high, with women representing the fastest growing subpopulation. Correctional health-care system in the USA remains fragmented and nonuniform in practice, particularly in women’s health care, with poor transitions between incarceration and release. This study aims to examine the qualitative health-care experiences of women while incarcerated and their transition into the community health-care setting. Additionally, this study also examined the experiences of a subset of women who were pregnant while incarcerated.

After obtaining institutional review board approval, adult, English-speaking women with a history of incarceration within the past 10 years were interviewed using a semi-structured interview tool. Interview transcripts were analyzed using inductive content analysis.

The authors completed 21 full interviews and identified six themes that were both the most significant and most novel: “feeling stigmatized and insignificant,” “care as punishment,” “delay in care,” “exceptions to the rule,” “fragmentation of care” and “obstetric trauma and resilience.”

Women face numerous barriers and hardships when accessing basic and reproductive health-care services while incarcerated. This hardship is particularly challenging for women with substance use disorders. The authors were able to describe for the first time, partially through their own words, novel challenges described by women interacting with incarceration health care. Community providers should understand these barriers and challenges so as to effectively reengage women in care upon release and improve the health-care status of this historically marginalized group.

Research shows that the physical locations of correctional facilities often contribute to environmental hazards. Research also shows that correctional facilities are often sited near hazardous or undesirable land(s). In combination, incarcerated individuals may be at increased risk of experiencing negative health consequences because of exposure to various environmental harms. This is especially alarming as incarcerated individuals lack the capacity to decide where they are detained. In these cases, health issues that may have developed while detained may extend beyond incarceration. Furthermore, incarcerated individuals are not protected by the Environmental Protection Agency’s Environmental Justice policies.

Using a case study approach, the authors examine two specific correctional facilities in the USA to not only demonstrate the various environmental harms that incarcerated individuals encounter but also highlight carceral spaces as sites of environmental violations.

Additionally, the authors address the negative health consequences incarcerated individuals report because of exposure to these harms. They also argue that creating safer communities requires more than reducing crime and preventing criminal victimization. Creating safer communities also includes promoting environmental safety and protection from hazards that cause sickness and disease.

This work contributes to an emerging and growing body of literature that examines the intersection of carceral studies and environmental justice.

Older incarcerated persons are an especially vulnerable segment of the prison population, with high rates of multimorbidity. This study aims to determine the impact of the COVID-19 pandemic on older incarcerated persons’ mental and physical health.

Participants were 157 currently-incarcerated persons age ≥50 years who were enrolled in an ongoing longitudinal study before the pandemic. Anxiety symptoms (seven-item generalized anxiety disorder questionnaire), depressive symptoms (eight-item patient health questionnaire) and self-rated health (SRH) were assessed during in-person interviews completed before the pandemic and via mailed surveys during the pandemic (August–September 2020). A mediation model evaluated the relationship among anxiety, depression and SRH.

Participants were 96% male, racially diverse (41% White, 41% Black, 18% Hispanic/Other), with average age 56.0(±5.8) years. From before to during the pandemic, anxiety symptoms increased (worsened) (from 6.4 ± 5.7 to 7.8 ± 6.6; p < 0.001), depressive symptoms increased (worsened) (from 5.5 ± 6.0 to 8.1 ± 6.5; p < 0.001) and SRH decreased (worsened) (from 3.0 ± 0.2 to 2.6 ± 0.2; p < 0.001). The total effect of worsening anxiety symptoms on worsening SRH (−0.043; p < 0.001) occurs entirely because of worsening depressive symptoms, i.e. the direct effect was statistically non-significant −0.030 (p = 0.068).

Older incarcerated persons experienced worsening mental health during the COVID-19 pandemic which was associated with worsening SRH. These findings have implications for health-care costs and services needed to care for this vulnerable group.

This is the first study to evaluate change in older incarcerated persons’ mental health from before the COVID-19 pandemic to during the pandemic.

This participatory health research project of researchers and women prisoners examined housing and homelessness as perceived by incarcerated women to understand this public health concern and help guide policy. The paper aims to discuss these issues.

A participatory research team designed and conducted a survey of 83 incarcerated women in BC, Canada. Using descriptive statistics, the authors examined socio-demographic factors related to social support networks and family housing and women’s housing preference upon release.

In total, 44 percent of participants reported no family home upon release while 31 percent reported lost family ties due to their incarceration. Most vulnerable subpopulations were women aged 25-34, aboriginal women and those with multiple incarcerations. Housing preferences differed between participants suggesting needs for varied options. Further implementation, evaluation and appraisal of social programs are required.

This study surveyed one correctional facility: future research could utilize multiple centers.

Addressing housing instability among released incarcerated individuals is important fiscally and from a public health lens. Improved discharge planning and housing stability is needed through policy changes and social programs. A social support network, “Women in2 Healing,” has developed from the research group to address these issues.

Housing stability and recidivism are closely linked: providing stable housing options will lessen the social, fiscal and medical burden of individuals returning to crime, substance abuse, illness and poverty.

Housing instability addresses an important social determinant of health and focussing on incarcerated women builds upon a small body of literature.