Prison cell spatial density and infectious and communicable diseases: a systematic review

Abstract

ObjectiveTo summarise the extent and quality of evidence on the association between prison cell spatial density (a measure of crowding) and infectious and communicable diseases transmission among prisoners.DesignSystematic review.Data sourcesEmbase, PubMed, Medline, Scopus, Web of Science, PsycINFO, PsycExtra, ProQuest Databases, ProQuest Dissertations and Theses Global, Index to Legal Periodicals, InformitOnline, Cochrane Library, Criminal Justice Abstracts and ICONDA were searched to 31 December 2018.Eligibility criteriaStudies that reported on the association between prison cell spatial density (measured in square feet or square metres of cell floor area per person) and infectious and communicable diseases in juvenile and adult populations incarcerated in a correctional facility.Data extraction and synthesisA review protocol was developed in consultation with an advisory panel. Two reviewers independently extracted data and used the Australian National Health and Medical Research Council’s (NHMRC) checklist to critically appraise individual studies. An assessment of the overall body of the evidence was conducted using the NHMRC’s Evidence Scale and Statement Form.ResultsA total of 5126 articles were initially identified with seven included in the review from Pakistan (2003), Chile (2016), Nigeria (2012, 2013) and the USA (1980s). Infectious and communicable disease outcomes included pneumococcal disease/acute pneumonia,Mycobacterium tuberculosis, latent tuberculosis infection, infectious skin conditions and contagious disease reporting to the prison clinic. Five articles reported statistically significant positive associations but were countered by associations possibly being explained by chance, bias or confounding factors. Heterogeneity prevented meta-analysis.ConclusionOverall, the body of evidence provides some support for an association between prison cell special density and infectious and communicable diseases, but care should be taken in the interpretation and transferability of the findings. Future research and policy responses should adequately consider prospective mediating factors implicated in associations between cell spatial density and health effects.

Covid-19, prison crowding, and release policies

“…Our systematic review last year, despite finding the quality of most studies was poor or fair, yielded mostly consistent evidence that cell spatial density was associated with outcomes of infectious diseases, including tuberculosis, pneumococcal disease, and infectious dermatoses 8…”

“…We identified nine mediating factors for transmission of infectious disease related to cell spatial density: age, education level, pre-existing medical conditions (particularly chronic disorders), risk behaviours such as intravenous drug use, environmental ventilation, duration of incarceration, cell allocation, access to prison health service, and prison release to increase spatial separation among remaining prisoners 810…”

“…To prevent covid-19 outbreaks in our prisons and to protect those in custody, staff, and the wider community we also need more immediate action. This is especially pressing for overcrowded prisons; 59% of all countries worldwide having prison occupancy levels exceeding their officially reported capacity,7 and crowding is linked to adverse health outcomes and transmission of infection 18…”

“…However, no consensus exists on how to measure prisoner overcrowding 8. Prison cell spatial density (cell floor area per person) is the preferred metric since other measures such as “current prisoner population divided by reported prison capacity” or “number of square metres of the total prison floor area per person” are amenable to manipulation by prison authorities 89…”

Covid-19, Pemenjaraan Berlebihan, Dan Potensi Katastrofe Kemanusiaan

“…Berbagai penelitian turut mengkonfirmasi hal ini, terutama tentang rentannya penyebaran penyakit-penyakit infeksi. Simpson, et.al (2019) menyimpulkan adanya keterkaitan antara kepadatan ruang sel dengan penularan penyakit. Penelitian yang dilakukan oleh Lembaga Bantuan Hukum Masyarakat (LBHM) memperlihatkan selama tahun 2017, dari 83 kasus kematian yang diidentifikasi di tempat-tempat penahanan seperti tahanan kepolisian, Rutan dan Lapas, penyebab kematian narapidana karena sakit mencapai 60.2%, diikuti bunuh diri sebesar 21.7%, dan karena kekerasan sebanyak 10.8%.…”