Racial, Ethnic, Sex, and Age Differences in COVID-19 Cases, Hospitalizations, and Deaths Among Incarcerated People and Staff in Correctional Facilities in Six Jurisdictions, United States, March-July 2020

Ashley S D'Inverno; Ranell L Myles; Calla R Jamison; Samantha P Williams; Liesl M Hagan; Senad Handanagic; Lauren A Lambert; Kristie E N Clarke; Jeffery Allen; Olivia Beard; Charles Dusseau; Rachel Feldman; Rebecca Huebsch; Justine Hutchinson; Denise Kall; Jessica King-Mohr; Michael Long; Elizabeth S McClure; Paul Meddaugh; Pam Pontones; Jacqueline Rose; Megan Sredl; Brittany VonBank; Jennifer Zipprich

doi:10.1007/s40615-023-01746-8

Racial, Ethnic, Sex, and Age Differences in COVID-19 Cases, Hospitalizations, and Deaths Among Incarcerated People and Staff in Correctional Facilities in Six Jurisdictions, United States, March-July 2020

J Racial Ethn Health Disparities. 2023 Aug 23:10.1007/s40615-023-01746-8. doi: 10.1007/s40615-023-01746-8. Online ahead of print.

Authors

Ashley S D'Inverno^{1

2}, Ranell L Myles^{3

4}, Calla R Jamison^{5

3}, Samantha P Williams^{3

6}, Liesl M Hagan^{3

7}, Senad Handanagic^{3

7}, Lauren A Lambert^{3

8}, Kristie E N Clarke^{3

9}, Jeffery Allen¹⁰, Olivia Beard¹¹, Charles Dusseau¹⁰, Rachel Feldman¹², Rebecca Huebsch¹³, Justine Hutchinson¹⁴, Denise Kall¹², Jessica King-Mohr¹², Michael Long¹⁰, Elizabeth S McClure¹⁵, Paul Meddaugh¹², Pam Pontones¹⁶, Jacqueline Rose¹², Megan Sredl¹⁵, Brittany VonBank¹³, Jennifer Zipprich¹³

Affiliations

¹ Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA. ADInverno@cdc.gov.
² CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA. ADInverno@cdc.gov.
³ CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA.
⁴ Office of the Director, Centers for Disease Control and Prevention, National Center For HIV, Viral Hepatitis, STD, and TB Prevention, Atlanta, Georgia.
⁵ Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
⁶ Division of Sexually Transmitted Disease Prevention, Centers for Disease Control and Prevention, National Center For HIV, Viral Hepatitis, STD, and TB Prevention, Atlanta, Georgia.
⁷ Division of Viral Hepatitis, Centers for Disease Control and Prevention, National Center For HIV, Viral Hepatitis, STD, and TB Prevention, Atlanta, Georgia.
⁸ Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, National Center For HIV, Viral Hepatitis, STD, and TB Prevention, Atlanta, Georgia.
⁹ Office of the Director, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia.
¹⁰ Federal Bureau of Prisons, Washington, D.C, USA.
¹¹ Indiana Department of Corrections, Indianapolis, IN, USA.
¹² Vermont Department of Health, Burlington, Vermont, USA.
¹³ Minnesota Department of Health, St. Paul, MN, USA.
¹⁴ California Correctional Health Care Services, Elk Grove, CA, USA.
¹⁵ North Carolina Department of Health and Human Services, Raleigh, NC, USA.
¹⁶ Indiana State Department of Health, Indianapolis, IN, USA.

PMID: 37610647
PMCID: PMC10902790 (available on 2025-02-23)
DOI: 10.1007/s40615-023-01746-8

Abstract

Objectives: To examine disparities by sex, age group, and race and ethnicity in COVID-19 confirmed cases, hospitalizations, and deaths among incarcerated people and staff in correctional facilities.

Methods: Six U.S. jurisdictions reported data on COVID-19 confirmed cases, hospitalizations, and deaths stratified by sex, age group, and race and ethnicity for incarcerated people and staff in correctional facilities during March 1- July 31, 2020. We calculated incidence rates and rate ratios (RR) and absolute rate differences (RD) by sex, age group, and race and ethnicity, and made comparisons to the U.S. general population.

Results: Compared with the U.S. general population, incarcerated people and staff had higher COVID-19 case incidence (RR = 14.1, 95% CI = 13.9-14.3; RD = 6,692.2, CI = 6,598.8-6,785.5; RR = 6.0, CI = 5.7-6.3; RD = 2523.0, CI = 2368.1-2677.9, respectively); incarcerated people also had higher rates of COVID-19-related deaths (RR = 1.6, CI = 1.4-1.9; RD = 23.6, CI = 14.9-32.2). Rates of COVID-19 cases, hospitalizations, and deaths among incarcerated people and corrections staff differed by sex, age group, and race and ethnicity. The COVID-19 hospitalization (RR = 0.9, CI = 0.8-1.0; RD = -48.0, CI = -79.1- -16.8) and death rates (RR = 0.8, CI = 0.6-1.0; RD = -11.8, CI = -23.5- -0.1) for Black incarcerated people were lower than those for Black people in the general population. COVID-19 case incidence, hospitalizations, and deaths were higher among older incarcerated people, but not among staff.

Conclusions: With a few exceptions, living or working in a correctional setting was associated with higher risk of COVID-19 infection and resulted in worse health outcomes compared with the general population; however, Black incarcerated people fared better than their U.S. general population counterparts.

Keywords: COVID-19; Correctional Facilities; Disparities; Incarceration.

Grants and funding

CC999999/ImCDC/Intramural CDC HHS/United States