More than a social determinant of health: Incarceration as a negative health outcome

The Healthy People 2020 initiative recognizes how the physical, emotional and mental toll of incarceration causes poorer health outcomes because of the health risks and exposures individuals face in the prison environment. However, incarceration in the urban setting is more than the social determinant of health. The social, political, and economic consequences of mass incarceration have disproportionally affected urban communities. By reviewing the research on the health and socio-economic status of incarcerated population prior, during and after imprisonment, I make the argument that prisoners have a predisposition to be incarcerated due the negative social determinants of health present in their natal neighborhoods. I illustrate how the evolution of mass incarceration is in part due to the United States (US) government imprisonment of many non-violent offenders by criminalizing drug abuse in part due to racial discrimination towards men of color, primarily African-American men. I examine how drug abuse as a mental illness has been disregarded by the US Criminal Justice System, and how racism has contributed to this factor. Furthermore, as the drugs policies have disproportionately affected these communities, additional consideration should be given to how the criminalization and demonization of drug abuse and addiction has impinged on the bioethical rights of the members of urban communities. I explain how mass incarceration in the urban setting violates each bioethical principle and how the racial disparities in mass incarceration is a reflection and is an extension of the problems of racism inherent to the US. Ultimately, I conclude that any new legislation passed to end mass incarceration should include policies that help to rehabilitate and to rebuild lives of those affected most by mass incarceration.