Selected Publications

People incarcerated in US prisons have been disproportionately harmed by the COVID-19 pandemic. That prisons are such efficient superspreading environments can be attributed to several known factors.

This study aims to characterize the June 2020 COVID-19 outbreak at San Quentin California State Prison and to describe what made San Quentin so vulnerable to uncontrolled transmission.

San Quentin California State Prison is experiencing a rapidly evolving COVID-19 (SARSCoV-2) outbreak with profoundly inadequate resources to keep it from developing into a full-blown local epidemic and health care crisis in the prison and surrounding communities.

In summer 2020, a multidisciplinary team of academics and health professionals conducted an on-site evaluation of the April-May 2020 Novel Coronavirus (COVID-19) outbreak at California Men’s Colony (CMC), located in San Luis Obispo (SLO) County, California.

Our goal is the describe and recommend policies that may protect and promote physical and mental health among people who are incarcerated, including the prevention and control of COVID-19.

In early 2020, the California Prison Receivership (CPR) contracted with the authors of this report to describe the impact of the coronavirus disease 2019 (COVID-19) pandemic on California prisons and to provide recommendations for mitigating the risk posed to the residents and staff who live and work in California Department of Corrections and Rehabilitation (CDCR) prisons.

Approximately two million people are incarcerated in jails and prisons in the Unites States. Mass incarceration disproportionately afects Black and Latino men and other racially and ethnically minoritized groups.

Incarcerated individuals, over 95% of whom are eventually released, experience high burdens of chronic disease and behavioral health and social risk factors. Understanding the health needs of this population is critical to ensuring that general medicine physicians in prisons and in the community are adequately prepared to meet those needs.

Words matter when describing people involved in the criminal justice system because language can have a significant impact upon health, wellbeing, and access to health information and services.

Although incarcerated older adults experience higher rates of chronic disease and geriatric syndromes, it is unknown whether community-dwelling older adults with a history of incarceration are also at risk for worse health outcomes.

The U.S. criminal justice population is aging at a significantly more rapid rate than the overall U.S. population, with the population of older adults in prison having more than tripled since 1990.

The rise in the number of older prisoners in many nations has been described as a correctional ?ageing crisis? which poses an urgent financial, medical and programmatic challenge for correctional health-care systems.

The number of older adults in the criminal justice system is rapidly increasing. While this population is thought to experience an early onset of aging-related health conditions (“accelerated aging”), studies have not directly compared rates of geriatric conditions in this population to those found in the general population.

To determine prevalence of, and outcomes associated with, a positive screen for cognitive impairment in older adults in jail.

To investigate correctional healthcare providers’ knowledge of and experience with advance care planning (ACP), their perspectives on barriers to ACP in correctional settings, and how to overcome those barriers.

In the US, the median age of adults experiencing homelessness and incarceration is increasing. Little is known about risk factors for incarceration among older adults experiencing homelessness. To develop targeted interventions, there is a need to understand their risk factors for incarceration.

Accumulating evidence indicates that behaviors in Alzheimer’s disease and related dementias could result in incarceration. Yet, the proportion of persons diagnosed with dementia and mild cognitive impairment (MCI) before they were incarcerated is largely unknown.

With the number of older adult arrestees and prisoners increasing rapidly, legal professionals increasingly provide front-line identification and response to age-related health conditions (including cognitive and physical impairments) that may affect legal outcomes, such as the ability to participate in one’s defense or stay safe in jail.

As the population ages, police increasingly serve as first responders to incidents involving older adults in which aging-related health plays a critical role.

A lecture on aging-related health conditions pertinent to police work followed by three experiential trainings on how it feels to be “old.”

The COVID-19 pandemic is devastating the health of hundreds of thousands of people who live and work in U.S. jails and prisons. Due to dozens of large outbreaks in correctional facilities, tens of thousands of seriously ill incarcerated people are receiving medical care in the community hospital setting.

Hospitalized incarcerated patients are commonly shackled throughout their duration of treatment in community medical centers to prevent escape or harm to others.

n January 5, 2017, then-President Obama published a commentary in the Harvard Law Review outlining the rationale behind his administration?s efforts to advance criminal justice reform.

Deaths among incarcerated individuals have steadily increased in the U.S., exceeding 5000 in 2014. Nearly every state has a policy to allow patients with serious life-limiting illness to apply for release from prison or jail to die in the community (“early medical release”).

The continued use of solitary confinement has sparked international public health and human rights criticisms and concerns. This carceral practice has been linked repeatedly to a range of serious psychological harms among incarcerated persons.

Extreme heat poses a distinct risk to the 2.1 million incarcerated people in the United States, who have disparately high rates of behavioral health conditions. Suicide is a leading cause of death among people in prisons.

In February 2016, on his 69th birthday, Albert Woodfox was freed from prison after he had spent more than 40 years in solitary confinement. I met Mr. Woodfox in 2006 when I served as his legal case?s medical expert. He was the last incarcerated member of the ?Angola 3,? three Black prisoners confined to solitary for decades.

Competing interests: We have read and understood BMJ policy on declaration of interests and declare the following interests: BW has served as an expert witness and as a court consultant in legal cases related to prison conditions of confinement.

Solitary confinement is a widespread practice in US correctional facilities. Long-standing concerns about the physical and mental health effects of solitary confinement have led to litigation, legislation, and community activism resulting in many prison systems introducing policies or implementing legal mandates to reduce or eliminate its use.

In the face of the continually worsening COVID-19 pandemic, jails and prisons have become the greatest vectors of community transmission and are a point of heightened crisis and fear within the global crisis.

Coronavirus disease 2019 has swept through prisons in much the same way it has nursing homes: after being introduced by staff or newly arrived residents, it spreads efficiently, including to many with medical vulnerabilities. Yet, many correctional workers lack basic protections.

The COVID-19 pandemic is devastating the health of hundreds of thousands of people who live and work in U.S. jails and prisons. Due to dozens of large outbreaks in correctional facilities, tens of thousands of seriously ill incarcerated people are receiving medical care in the community hospital setting.

COVID-19 is ravaging US prisons. Prison residents and staff must be prioritized for vaccination, but a rapidly mutating virus and high rates of continued spread require an urgent, coordinated public health response.

The US imprisons more of its population than almost any other nation, a phenomenon known as ?mass incarceration.? Of the 2 million incarcerated Americans, more than 157?000 are held by the Federal Bureau of Prisons, the largest corrections agency in the nation.

Mass incarceration is a sociostructural driver of profound health inequalities in the United States. The political and economic forces underpinning mass incarceration are deeply rooted in centuries of the enslavement of people of African descent and the genocide and displacement of Indigenous people and is inextricably connected to labor exploitation, racial discrimination, the criminalization of immigration, and behavioral health problems such as mental illness and substance use disorders.

Over the last 40 years, the United States has experienced an ?epidemic? of incarceration, in which millions of Americans have spent days to years of their lives in jails or prisons. During this time, correctional medicine has undergone major changes.

Between 1993 and 2013, the number of state prison
inmates in this country who are age 55 years or
older increased approximately fourfold. Nearly 1 in 10
individuals incarcerated in U.S. prisons is serving a
life sentence. If current trends hold, it is projected
that by 2030 the number of incarcerated older adults
in the United States will exceed 400,000.

The large and continued growth of the older adult population within U.S. prisons affects not only criminal justice policy and correctional health practice, but also gerontology. Amidst the unfolding COVID-19 crisis, associated knowledge and skills surrounding older adulthood will be critical to assuring the needs of older adults incarcerated in prisons are met during their detention.

In the 1970s and 80s, the U.S. experienced a national crime wave which gave rise to a “tough on crime” abandonment of rehabilitation in most jails and prisons and ushered in an era of mass incarceration. Despite an emphasis on institutional security and control in the following decades, U.S. jails and prisons became increasingly dangerous and unsafe.

Living and working conditions in many US correctional facilities are damaging to the health of incarcerated people and correctional staff. In response, experts have called for efforts to improve the health of incarcerated people, and correctional systems have invested in “officer wellness” programs.

Solitary confinement is a widespread practice in US correctional facilities. Long-standing concerns about the physical and mental health effects of solitary confinement have led to litigation, legislation, and community activism resulting in many prison systems introducing policies or implementing legal mandates to reduce or eliminate its use.