A Cluster Randomized Clinical Trial
What Can Be Done to Break the Link Between Disability and Incarceration?
Data Reveals High Rate of Incarceration Among Disabled People and Opportunities for Intervention
Produced in conjunction with the Population Aging Research Center at the University of Pennsylvania.
Thirty years after the Americans with Disabilities Act, conversations about mass incarceration in the United States rarely include mention of disability. People with disabilities are more likely to end up in prison and prisons can make disabilities worse. How can we break this link and reverse this social and economic exclusion of disabled people?
In a recent study I conducted with LDI Associate Fellow Stacey Bevan and Senior Fellow Courtney Boen, we examined the 2016 Survey of Prison Inmates administered by the Bureau of Justice Statistics. We found that disabled people are vastly overrepresented in prisons and were more likely than nondisabled people to have previously resided in punitive and therapeutic institutions.
Many People in Prisons Have Disabilities
While roughly one quarter of the general population in the United States are disabled, disabled people make up around two-thirds of the 2016 state and federal prison population, with 40% reporting a psychiatric disability and 56% reporting a nonpsychiatric disability. Our study found striking disparities by race-ethnicity and gender, with Black, Hispanic, and multiracial disabled men especially overrepresented in prisons. While men make up the vast majority of the state and federal prison population, disability prevalence is much higher among incarcerated women.
Prior to Incarceration, Many Disabled People Lived in Therapeutic Institutions
We found that disabled incarcerated people are more than twice as likely as nondisabled incarcerated people to have previously resided in therapeutic institutions, such as psychiatric hospitals, residential treatment facilities, and group homes (46% vs. 20%). While these institutions may be intended to provide care and be more humane than punitive institutions, they can still reinforce social exclusion and oppression. The finding points to a critical need to understand why institutions that confine disabled people are creating such a strong pathway to prison.
Opportunities to Reduce Social and Legal Exclusion
Opportunities to intervene occur at three critical times:
- Before incarceration: To reduce imprisonment and reincarceration rates, improvements are needed to support the social and financial well-being of disabled people. These policies include expanding health care access, improving community care, expanding the social safety net, and funding public health infrastructure. Connecting disabled people to appropriate and accessible community resources, including employment, housing, and holistic care, can also reduce incarceration risks.
- During incarceration: Prisons need to provide comprehensive and quality health care and consider the specific health care and access needs of disabled people. Considerations should include reducing the disproportionate segregation of disabled people in solitary confinement. They also include complying with prisoners’ legal right to medical therapies, mobility aids, interpreters, and care assistance. Regulations are needed to hold prisons accountable for providing these services.
- After incarceration: Many social and health benefits are terminated when an individual enters the prison system and are difficult to reinstate when they leave. Federal, state, and local level policies could ease the post-release transition. For example, federal policies could allow for special enrollment periods for formerly incarcerated people who are eligible for Medicare. Or states who do not allow formerly incarcerated people to enroll could change their policies regarding Medicaid eligibility so that formerly incarcerated people could enroll. Prisons also need to implement institutional policies/processes to provide assistance with (re)enrollment in SSI, SSDI, Medicare, or Medicaid as well as housing and transportation assistance. This process would best be facilitated alongside formerly incarcerated peers who have lived experience reintegrating into society.
Policy and political actions aimed at decarceration and reducing social and legal exclusion of disabled people are needed. Our findings suggest that interventions are needed to improve punitive and therapeutic institutions and reduce inequities at the intersections of disability, race-ethnicity, and gender. Scholars, policymakers, and advocates must prioritize the well-being of disabled people and work to redress inequities sustained by the prison system and other carceral institutions.
The article, “The Links Between Disability, Incarceration, And Social Exclusion” was published in October 2022 by Laurin Bixby, Stacey Bevan, and Courtney Boen in Health Affairs.
PhD Student, Sociology, School of Arts and Sciences; Master’s Student, Statistics and Data Science, The Wharton School
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