Carceral-community epidemiology, structural racism, and COVID-19 disparities

Abstract

Black and Hispanic communities are disproportionately affected by both incarceration and COVID-19. The epidemiological relationship between carceral facilities and community health during the COVID-19 pandemic, however, remains largely unexamined. Using data from Cook County Jail, we examine temporal patterns in the relationship between jail cycling (i.e., arrest and processing of individuals through jails before release) and community cases of COVID-19 in Chicago ZIP codes. We use multivariate regression analyses and a machine-learning tool, elastic regression, with 1,706 demographic control variables. We find that for each arrested individual cycled through Cook County Jail in March 2020, five additional cases of COVID-19 in their ZIP code of residence are independently attributable to the jail as of August. A total 86% of this additional disease burden is borne by majority-Black and/or -Hispanic ZIPs, accounting for 17% of cumulative COVID-19 cases in these ZIPs, 6% in majority-White ZIPs, and 13% across all ZIPs. Jail cycling in March alone can independently account for 21% of racial COVID-19 disparities in Chicago as of August 2020. Relative to all demographic variables in our analysis, jail cycling is the strongest predictor of COVID-19 rates, considerably exceeding poverty, race, and population density, for example. Arrest and incarceration policies appear to be increasing COVID-19 incidence in communities. Our data suggest that jails function as infectious disease multipliers and epidemiological pumps that are especially affecting marginalized communities. Given disproportionate policing and incarceration of racialized residents nationally, the criminal punishment system may explain a large proportion of racial COVID-19 disparities noted across the United States.

Keywords: carceral-community epidemiology; inequality; mass incarceration; public health; racial disparities.

Fig. 1.

Estimated relationships between SARS-CoV-2 case rates and detainees released per capita from multivariate regression analysis including controls––proportion of black residents, proportion of Hispanic residents, poverty rate, public transit utilization rate, population density, and cumulative SARS-CoV-2 case rates as of the week starting March 29. Source: authors’ analysis of data from Cook County Jail, City of Chicago (55), 2018 ACS (56). Whiskers present 95% CIs of the association between COVID-19 case rates and detainees released per capita from multivariate regression analyses.

Fig. 2.

Estimated relationships between cumulative SARS-CoV-2 case rates and detainees released per capita from multivariate regression analysis including controls––proportion of black residents, proportion of Hispanic residents, poverty rate, public transit utilization rate, population density, and cumulative SARS-CoV-2 case rates as of the week starting March 29. Source: authors’ analysis of data from Cook County Jail, City of Chicago (55), 2018 ACS (56). Whiskers present 95% CIs of the association between cumulative COVID-19 case rates and detainees released per capita from multivariate regression analyses.