Carceral Health Care

This review examines the U.S. carceral system’s impact on health, describing how incarceration shaped by systemic racism and mass sentencing drives public health harm through overcrowded, understaffed, and often medically inadequate environments. It explores unique health risks faced by incarcerated populations, including high rates of infectious and chronic diseases, substance use disorders, and mental illness. The article addresses the ethical tensions of “dual loyalty,” reviews care challenges for vulnerable subpopulations (older adults, women, and transgender persons), and calls for health equity reforms. Recommendations include expanding Medicaid during incarceration, building reentry care coordination, and mandating independent oversight. The authors frame these efforts within the growing movement for “abolition medicine” and structural justice in health care.

This review examines the U.S. carceral system’s impact on health, describing how incarceration shaped by systemic racism and mass sentencing drives public health harm through overcrowded, understaffed, and often medically inadequate environments. It explores unique health risks faced by incarcerated populations, including high rates of infectious and chronic diseases, substance use disorders, and mental illness. The article addresses the ethical tensions of “dual loyalty,” reviews care challenges for vulnerable subpopulations (older adults, women, and transgender persons), and calls for health equity reforms. Recommendations include expanding Medicaid during incarceration, building reentry care coordination, and mandating independent oversight. The authors frame these efforts within the growing movement for “abolition medicine” and structural justice in health care.