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

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

Analyzing COVID-19 Rates Between Residents and Staff in Correctional Facilities: A Telemedicine Opportunity

To evaluate the relationship of COVID-19 infection rates between residents and staff members in prison facilities. We collected historical data on daily COVID-19 counts for California, Florida, and Wisconsin residents and staff. We analyzed 78,250 COVID-19 cases among residents and 25,392 cases among staff. Strong positive associations were found in the rates of COVID-19 cases between residents and staff, suggesting telemedicine can help reduce outbreaks

Longitudinal Pre-Exposure Prophylaxis (PrEP) Acceptability, Initiation and Adherence among Criminal Justice-Involved Adults in the USA: The Southern PrEP Cohort Study (SPECS) Protocol

INTRODUCTION: HIV prevalence among criminal justice (CJ)-involved adults is five times higher than the general population. Following incarceration, CJ-involved individuals experience multilevel barriers to HIV prevention. Pre-exposure prophylaxis (PrEP) is a widely available, daily medication efficacious in preventing HIV. Little is known about PrEP knowledge, acceptability, initiation and sustained use among CJ-involved persons or about how these outcomes vary by multilevel factors. The Southern Pre-Exposure Prophylaxis Study (SPECS) will investigate barriers and facilitators for PrEP initiation and sustained use among CJ-involved adults, building a foundation for PrEP interventions for this underserved population. METHODS AND ANALYSIS: SPECS uses a mixed-methods sequential design, including a multisite, prospective cohort study in three southern states-North Carolina, Florida and Kentucky-and subsequent qualitative interviews. HIV-negative adults clinically indicated for PrEP with CJ-involvement in the past year (n=660; 220 per site)-will be recruited for four quantitative interviews separated by 6 months, with 18 months of follow-up. Interviews will measure CJ involvement, substance use, sexual behaviours, PrEP acceptability and use, healthcare access and utilisation, support systems and psychological and emotional well-being. We will estimate probabilities of PrEP acceptability and use in a CJ-involved population using descriptive and multivariable analyses. After the follow-up, a subsample that never initiated PrEP, initiated but did not sustain PrEP or sustained PrEP will be asked to participate in a qualitative interview to contextualise their experiences and decisions around PrEP. An inductive approach will guide qualitative analyses. ETHICS AND DISSEMINATION: PrEP initiation and sustained use rates are unknown among CJ-involved adults. This research will identify individual, social and structural factors that predict PrEP initiation and use. Data generated from the study have the potential to guide research and the development and tailoring of PrEP interventions to CJ-involved populations and provide context to HIV-related outcomes for those with CJ experiences

Overlapping Crises: Climate Disaster Susceptibility and Incarceration

Climate-related disasters are becoming more frequent all over the world; however, there is significant variability in the impact of disasters, including which specific communities are the most vulnerable. The objective of this descriptive study was to examine how climate disaster susceptibility is related to the density of incarceration at the county level in the United States. Percent of the population incarcerated in the 2010 census and the Expected Annual Loss (EAL) from natural hazards were broken into tertiles and mapped bivariately to examine the overlap of areas with high incarceration and susceptibility to climate disasters. Over 13% of counties were in the highest tertile for both incarceration and EAL, with four states containing over 30% of these counties. The density of incarceration and climate disaster susceptibility are overlapping threats that must be addressed concurrently through (1) decarceration, (2) developing standardized guidance on evacuated incarcerated individuals during disasters, and (3) more deeply understanding how the health of everyone in these counties is jeopardized when prisons suffer from climate disasters

Epidemiology of Coronavirus Disease 2019 in US Immigration and Customs Enforcement Detention Facilities

The US is facing a humanitarian crisis as tens of thousands of people are held in detention centers under Immigration and Customs Enforcement (ICE). Practices undertaken by ICE, such as detainment, deportation, and searches, adversely affect the physical and mental health of those who are undocumented. Immigration and Customs Enforcement facilities have been characterized as unsanitary, unsafe, and inhumane by a recent whistleblower. Home to moldy, uncleaned bathrooms and limited personal hygiene supplies and medical services, facilities pose health risks to people even beyond the context of a global pandemic. Human rights advocates have called for the release of people detained and the suspension of deportation flights. Thus far, ongoing deportation flights have led to documented spread of coronavirus disease 2019 (COVID-19) in more than 11 countries. Herein, we describe the COVID-19 burden among people detained by ICE compared with the US population

Breakthrough SARS-CoV-2 Infections in Prison after Vaccination

The coronavirus disease 2019 (Covid-19) pandemic has uniquely affected prisons and jails across the country. The incidence of Covid-19 among incarcerated persons is nearly six times that among nonincarcerated community members.1 The Centers for Disease Control and Prevention, the National Academy of Medicine, and the American Medical Association have recommended prioritization of prison and jail populations for deployment of Covid-19 vaccines, but vaccine rollout has varied across these settings,2 and few studies have been conducted on the effectiveness of vaccination efforts in congregate housing. Most of such studies have been performed in skilled nursing facilities, where vaccine effectiveness has been measured at 63 to 64%

Suicides in state prisons in the United States: Highlighting gaps in data

Objectives Our objectives were to document data availability and reporting on suicide mortality in state prison systems. The United States leads the world in mass incarceration, a structural determinant of health, but lacks real-time reporting of prison health statistics. This absence is particularly notable in suicides, a leading cause of death that carceral policies play a key role in mitigating. Methods Suicide data for each state prison system from 2017–2021 were gathered through statistical reports, press releases, and Freedom of Information Act requests. We graded states based on data availability. Results Only sixteen states provide updated, frequent, granular, freely provided suicide data. An additional thirteen states provided frequently updated data but that had little granularity, was incomplete, or was not freely provided. Eight states provided sparse, infrequent, or outdated data, and thirteen provided no data at all. Conclusions The 2000 Death in Custody Reporting Act requires that states provide these data freely, yet the majority of states do not. There is a need for reliable, real-time data on suicides, suicide attempts, and conditions of confinement to better understand the harms of the carceral system and to advocate for change

Infectious disease surveillance in U.S. jails: Findings from a national survey

While infectious diseases (ID) are a well-documented public health issue in carceral settings, research on ID screening and treatment in jails is lacking. A survey was sent to 1,126 jails in the United States to identify the prevalence of health screenings at intake and characteristics of care for ID; 371 surveys were completed correctly and analyzed. Despite conflicting Centers for Disease Control (CDC) guidance, only seven percent of surveyed jails test individuals for HIV at admission. In 46% of jails, non-healthcare personnel perform ID screenings. Jails in less urban areas were more likely to report healthcare screenings performed by correctional officers. Survey findings indicate that HIV, HCV and TB testing during jail admissions and access to PrEP are severely lacking in less urban jails in particular. Recommendations are provided to improve ID surveillance and address the burden of ID in correctional facilities