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Purpose – Prison health is public health. Yet, efforts to protect against as well as slow the spread of COVID-19 are virtually impossible in prison settings where “what we know” may not match with policies. As the COVID-19 pandemic continues, incarcerated people are uniquely at risk as correctional facilities are “super-spreader” sites for prisoners and staff alike. The purpose of this chapter is to explore the impact of COVID-19 in prisons along with the additional personal and social costs associated with the pandemic (e.g., lockdowns, limited visitation, etc.) that can also impact the health status of those “doing COVID time.”

Methodology/Approach – This chapter examines the multifaceted impact of the COVID pandemic on those (in)directly impacted in correctional settings. It is not an empirical work.

Originality/Value – This chapter provides insight into the often taken-for-granted impact of the COVID pandemic on those who live and work in prison settings. The recommendations may be of interest to those who “do the time,” those who work in such settings, and social justice advocates and others involved in policy-making.

This review integrates and builds linkages among existing theoretical and empirical literature from across disciplines to further broaden our understanding of the relationship between inequality, imprisonment, and health for black men. The review examines the health impact of prisons through an ecological theoretical perspective to understand how factors at multiple levels of the social ecology interact with prisons to potentially contribute to deleterious health effects and the exacerbation of race/ethnic health disparities.

This review finds that there are documented health disparities between inmates and non-inmates, but the casual mechanisms explaining this relationship are not well-understood. Prisons may interact with other societal systems – such as the family (microsystem), education, and healthcare systems (meso/exosystems), and systems of racial oppression (macrosystem) – to influence individual and population health.

The review also finds that research needs to move the discussion of the race effects in health and crime/justice disparities beyond the mere documentation of such differences toward a better understanding of their causes and effects at the level of individuals, communities, and other social ecologies.

Purpose – This chapter gives an overview of the impact that the COVID-19 pandemic has had on institutional corrections in the United States and the responses correctional institutions have taken to lessen those impacts.

Methodology/Approach – A review of the extant literature was conducted to gather information on COVID-19 and the institutional corrections systems within the United States.

Findings – The impacts of the COVID-19 pandemic on correctional institutions within the United States were more pronounced due to the demographic characteristics of inmates and facility challenges. Responses to outbreaks or potential outbreaks in jails and prisons in the United States included screening measures, restricted inmate movement and visitation, and decarceration efforts.

Originality/Value – This chapter builds upon literature by discussing the challenges posed to correctional institutions in the United States in the face of the COVID-19 pandemic and summarizing the measures taken to reduce the impact of COVID-19 on inmates, institutional staff, and community members alike.

There is limited research on the mental health of pregnant women in prison in England, mother and baby unit (MBU) applications and associated factors. Eighty-five pregnant women were interviewed in eight different prisons in England, UK. Schedules for the Clinical Assessment of Neuropsychiatry (SCAN) and Edinburgh Postnatal Depression Scale (EPDS) were used to assess mental health; Severity of Dependence Questionnaire (SOD-Q) for drug misuse; Alcohol Use Identification Test (AUDIT) for hazardous drinking and the Structured Clinical Interview for DSM-IV (SCID-II) to identify personality disorder. About 51% of participants had depression and 57% had anxiety. Those with prior social services involvement, diagnosis of personality disorder or history of suicidality were less likely to be admitted to MBUs. The high levels of depression and anxiety can have negative impacts on both the mother and her unborn child. Factors which influence MBU admission suggest those who might benefit most from MBU placement are least likely to be admitted. Other countries offer feasible alternatives to imprisonment for pregnant women and mothers which could be implemented in England.

This chapter explores the role of cultural activity within prison libraries for not only the general wellbeing of prisoners, but also as a form of indirect intervention for addressing unrecognised and/or unaddressed information needs amongst prisoners; particularly important needs of a more sensitive nature often repressed (e.g. remorse, mental health, relationships). Drawing on research to date, the authors discuss the information needs of prisoners, the associated benefits of cultural activity for information need recognition and understanding, and the support role of the prison library; and in relation, identify opportunities for further development of the library as a key change agent in the progressive rehabilitation of prisoners.

In this chapter, we explore the lived experiences of transgender and gender non-conforming (TGNC) prisoners, arguably the most vulnerable minority in the prison estate, using the data from our correspondence study with transgender women and non-binary individuals incarcerated in male establishments in England and Wales. We provide a brief review of the extant literature, describe the English prison system and the regulations concerning transgender prisoners, and analyze two axes of vulnerability of TGNC prisoners: social (stemming from relationships between prisoners) and institutional (resulting from the prison regime). Along the social axes, we find, in contrast with prior research, that our respondents defied the stereotypes of trans prisoners as submissive to males in a hypermasculine prison society and as involved primarily in abusive relationships. Along the institutional axes, we find that, despite the progressive by international standards transgender prison regulations, prisoners were subject to vicissitudes in treatment that negatively affected their ability to express their gender and their health. Focusing on access to gender-affirming items (clothing, prosthetics, make-up) and gender-affirming medical treatment, we develop recommendations for the prison service that could improve the conditions of confinement for TGNC prisoners.

This chapter uses Goffman’s concept of total institutions in a comparative case study approach to explore the role of psychotropic drugs in the process of transinstitutionalization.

This chapter interprets psychotropic drug use across four institutionalized contexts in the United States: the active-duty U.S. military, nursing homes and long-term care facilities, state and federal prisons, and the child welfare system.

This chapter documents a major unintended consequence of transinstitutionalization – the questionable distribution of psychotropics among vulnerable populations. The patterns of psychotropic use we synthesize suggest that total institutions are engaging in ethically and medically questionable practices and that psychotropics are being used to serve the bureaucratic imperatives for social control in the era of transinstitutionalization.

Psychotropic prescribing practices require close surveillance and increased scrutiny in institutional settings in the United States. The flows of mentally ill people through a vast network of total institutions raises questions about the wisdom and unintended consequences of psychotropic distribution to vulnerable populations, despite health policy makers’ efforts regulating their distribution. Medical sociologists must examine trans-institutional power arrangements that converge around the mental health of vulnerable groups.

This is the first synthesis and interpretive review of psychotropic use patterns across institutional systems in the United States. This chapter will be of value to medical sociologists, mental health professionals and administrators, pharmacologists, health system pharmacists, and sociological theorists.

While steroid use in the sports context has already been extensively studied by academic researchers, its patterns and implications in the prison context have received scant attention. Why do inmates use androgenic–anabolic steroids (AAS)? How does this use relate to sports activities, in particular fitness training, and what does it mean vis-à-vis the body image that is promoted in this environment? Does it even relate to fitness or sport? How do prison authorities regulate or prevent prisoners' AAS use? This empirical study is based on 28 interviews with 19 inmates and nine staff members (guards, managers) of four Belgian prisons. We showed that steroid use is largely connected with fitness activities and that it has an instrumental, goal-oriented dimension. AAS are used for athletic/performance purposes, e.g. increasing muscular strength. They also help gain or maintain a satisfactory body (self-)image, which has implications on the own identity, prestige and power relations within the prison community. In jail, the body is a major type of symbolic capital that is intended to reinforce status and cope with the difficulties and actual conditions of incarceration. We also observed differences in the perceived legitimacy of the various drugs that are used in prison. While guards are more tolerant towards AAS than other drugs, prisoners are less prone to openly confess to using AAS. Admitting to using AAS would damage the inmate's reputation, the legitimacy of his muscled body, and the subsequent goals of individual power and prestige.

By highlighting the real world experiences of cause lawyers who work on behalf of HIV-infected prisoners (e.g., “activist prisoner lawyering”), this article reports on the often-difficult negotiations over roles (litigator v. activist) that such actors face. The article investigates through the stories of activist prison lawyers, in the words of one such respondent, how “different approaches need to be taken in different settings.” For activist prison lawyers, when a client's life literally hangs in the balance litigation may be the only option. In other instances, using a case to bring public awareness to broader movement objectives may be chosen as a proper course of action. The article elucidates how such negotiations often entail the dilemma of balancing broader goals of the prisoner rights movement with the immediate, indeed sometimes life and death, circumstances facing the individuals and communities they represent. The article concludes with a call for future work on cause lawyers and social movements in other contexts to problematize law as a static, dichotomous variable that either does or does not bring desired institutional or societal change. Viewing law as a dichotomous variable masks the politically significant effects litigation may have for influencing both institutional arrangements and social consciousness over time. Furthermore, the dichotomous conception of law as a catalyst/not a catalyst for social change also glosses over the importance of the meso-level of analysis. By paying attention to the demands of a specific legal context, the immediate circumstances of a specific situation, and the way the former and the latter may be inextricably linked, future studies can make important and nuanced contributions to our understanding of the complex relationship between law, and social change.

Purpose – During the COVID-19 pandemic, Canadian jurisdictions have varied in terms of their reporting of COVID-19 cases among prisoners and prison staff. Engaging with literatures on the policing of criminological knowledge and prison opacity, this chapter examines how multiple approaches to newsmaking criminology including blog posts, op-ed writing, report publishing, and expert commentary can challenge state secrecy in ways that help generate proactive disclosure of additional information about the impact and management of the coronavirus behind prison walls.

Methodology/Approach – The authors explore how “flooding the zone” of public debates on pandemic management with the limited, incomplete data made available by authorities works as a knowledge mobilization and research strategy.

Findings – The analysis in this study reveals how a newsmaking criminology approach can help researchers access previously unpublished information from Canadian prison authorities that is crucial to understanding prison policy, practice, and outcomes related to COVID-19.

Originality/Value – This chapter highlights the value of newsmaking criminology as a means of communicating and mobilizing criminological knowledge, as well as generating data in the service of emancipatory research and advocacy.