Putting Desert in Its Place

Based on an impressive array of studies, Paul Robinson and his coauthors have developed a new theory of criminal justice, which they call “empirical desert.†The theory asserts that, because people are more likely to be compliant with a legal regime that is perceived to be morally credible, a criminal justice system that tracks empirically derived lay views about how much punishment is deserved is the most efficient way of achieving utilitarian goals, or at least is as efficient at crime prevention as a system that focuses solely on deterrence and incapacitation. This Article describes seven original studies that test the most important hypotheses underlying empirical desert theory. The authors’ conclusions, which throw doubt on much of empirical desert theory, include the following: (1) while consensus on the ordinal ranking of traditional crimes is relatively strong, agreement about appropriate punishments — which arguably is the type of agreement empirical desert requires in order to work — is weak; (2) the relationship between people’s willingness to abide by the law and the law’s congruence with their beliefs about appropriate punishment is complex and not necessarily positive; further, any noncompliance that results from the law’s failure to reflect lay views about desert is probably no greater than the noncompliance triggered by a failure to follow lay views about the role utilitarian goals should play in fashioning criminal dispositions; (3) while the relative crime control benefits of a desert-based system and a prevention-based system are hard to evaluate (and are not directly examined here), people are willing to depart from desert in cases that do not involve the most serious crimes if they believe that preventive goals can be achieved in some other way. The Article ends by discussing the implications of these findings for criminal justice policy, especially with respect to determinate and indeterminate sentencing

A latent class analysis of stigmatizing attitudes and knowledge of HIV risk among youth in South Africa

Background: The current study aims to investigate how the ability to accurately gauge risk factors associated with contracting HIV while taking into consideration various individual and community level socio-demographic characteristics (e.g., race and poverty) predicts the nature of stigmatizing attitudes toward persons with HIV. Methods: Data from a sample of 1,347 Cape Town area youth who participated in the Cape Area Panel Study (CAPS) Wave 2a were used. Latent Class Analysis was conducted to ascertain whether response patterns regarding knowledge of HIV contraction suggest the presence of subgroups within the sample. Results: Findings indicate that there are four latent classes representing unique response pattern profiles regarding knowledge of HIV contraction. Additionally, our results suggest that those in South Africa who are classified as "white," live in more affluent communities, and have more phobic perceptions of HIV risk are also more likely to have the most stigmatizing attitudes toward those who are HIV positive. Conclusion: Implications of these findings include extending HIV knowledge, education, and awareness programs to those who are not traditionally targeted in an attempt to increase levels of knowledge about HIV and, consequently, decrease stigma

Solitary Confinement and Health

Individuals released from prison experience a higher risk of death compared to non-incarcerated individuals. The transition back into the community postrelease is characterized by instability related to social and economic factors that contribute to poor access to housing, employment, and health care

Mass Incarceration as a Social-Structural Driver of Health Inequities: A Supplement to AJPH

Mass incarceration in the United States is a civil rights, human rights, and public health crisis that is the result of social, political, and economic forces, rooted in enduring legacies of slavery and oppression along lines of race and class. We conceptualized this issue because we believe that the theories, methods, and ethical tenets of public health have a distinct role to play in contributing to a growing movement to end mass incarceration and its multilayered harms on health

Incarceration, drug use, and infectious diseases: a syndemic still not addressed

Substantial progress has been made in reducing HIV and, to a lesser extent, hepatitis C virus (HCV) incidence among people who inject drugs (PWID) globally. However, specific populations of PWID, particularly those who are incarcerated, are often overlooked or left out of interventions designed to reduce HIV and HCV transmission

Invited Perspective: Uncovering Harmful Exposures in Carceral Environments

In a research letter in this issue, Rempel et al. compared community water systems that serve the Kern Valley State Prison (KVSP) and three comparable rural communities in California that rely solely on groundwater sources. They found that for each of the four systems, arsenic concentrations in drinking water periodically exceeded the legal limit in violation of Safe Drinking Water Act regulations. The communities neighboring the prison benefited from local and federal remediation efforts. Yet, for people who were incarcerated, interventions such as free bottled water were often restricted

MOUD Provision in Correctional Settings During Time of COVID-19 : Prevention and Solutions

Correctional settings can be vectors of infectious diseases due to overcrowding, unsanitary living conditions, and very little capacity to engage in social distancing. In the US, COVID-19 outbreaks were first identified in the New York City and Cook County jails, with infection rates far exceeding community rates. Each day new cases are being identified across the country in correctional facilities. People who are incarcerated are at increased risk of experiencing severe COVID-19 symptoms because of the increased prevalence of other underlying illnesses. Jails and prisons have begun initiating facility-level policies to help stop the spread of COVID-19. As a result, correctional agencies have reoriented staff to stem transmission in their facilities. This could translate into limited resources for other programming such as medications for opioid use disorder (MOUD) programs. In this commentary, we highlight risk mitigation practices for delivering MOUD in correctional settings during COVID-19 and note how to ensure quality of care while still preparing for the possibility of future pandemics

Exploring Healthcare Experiences for Incarcerated Individuals Who Identify as Transgender in a Southern Jail

Purpose: To document the health-related experiences and needs of jail detainees who self-identified as transgender women. Methods: Semistructured interviews with 10 transgender women of color were conducted in a county jail in a mid-sized southern city between 2015 and 2016. Interviews were recorded and transcribed, and later analyzed using a general inductive approach. Results: Participants experienced high levels of abuse and harassment, solitary confinement, mental health issues, and lack of access to hormone treatment. Participants described discrimination (both by other inmates-particularly while in special housing units-and correctional officers); harsh correctional conditions, which exacerbated mental health issues; and a marked lack of access to healthcare, including hormone treatments. Conclusion: Policy changes are needed to address housing and placement issues, and to increase access to healthcare for transgender women jail detainees. Training is needed for jail staff and medical care professionals in correctional settings to better understand the unique needs and experiences of transgender people

Ethical Considerations for COVID-19 Vaccine Trials in Correctional Facilities

The first phase 3 coronavirus disease 2019 (COVID-19) vaccine trials began in July 2020. China, Britain, and the US have experimental vaccines ready to move into large-scale human testing. In the US, the Vaccine and Treatment Evaluation Units, HIV Prevention Trials Network, AIDS Clinical Trials Group, and HIV Vaccine Trials Network have merged resources into Operation Warp Speed, as each phase 3 trial is anticipated to enroll 30 000 participants. Recruitment for the first US trial involving the Moderna vaccine is targeting participants “at high risk of SARS-CoV-2 infection.” However, even though 39 of the 50 largest US outbreaks have occurred in correctional facilities and the case rate of SARS-CoV-2 infection in prisons (3521 per 100 000) has been 5.5 times higher than the general population, one key setting in which US investigators will not be recruiting participants for trials of COVID-19 vaccines are prisons and jails. This omission is an example of unintended consequences of well-intentioned policies