Social Practice of Mass Imprisonment

  • Date: Jan 01 1991
  • Policy Number: 9123

Key Words: Jails Prisons Prisoners, Prisoners

The American Public Health Association,

Realizing that there are now more than one million people incarcerated in prisons and jails in the United States, and four million people living under the jurisdiction of the criminal justice system;and

Noting that the rate of imprisonment in the US is the highest in the world at 426 currently incarcerated of every 100,000 residents, and that in the last decade the number of prisoners in the USA has more than doubled while the population has grown by 10 percent and the crime rate has decreased by 3.5 percent;1-3 and
Affirming that APHA has a long history of concern and activity aimed at correcting inadequacies in health conditions in correctional institutions, and is aware that prison health and community health are intimately related elements of public health in the US with 11 million individuals released annually from custody to community;1,4 and

Recognizing that prisons disproportionately confine sick people, with mental illness, substance abuse, HIV (human immunodeficiency virus) disease among other illnesses; and that prisoners are subject to further morbidity and mortality in these institutions, due to lack of access and/or resources for health care, overcrowding, violence, emotional deprivation, and suicide;5-7 and

Recognizing that US justice is meted out unequally to White and those who are not White, rich and poor: that prisoners are increasingly drawn from people who are homeless, the people who are poor, and members of racial minorities. Nearly one in four Black men aged 20-29 is under the control of the criminal justice system, and people of color receive more severe sentences than Whites for the same crime;1,3,8,9 and

Believing that the hundreds of billions of dollars spent and borrowed by the government for the operation and construction of prisons are dollars which might otherwise fund solutions to social and health problems which trouble our nation and fuel our criminal justice system;9,10 and

Noting that APHA has long-defined drug abuse as a public health problem rather than a criminal justice problem;13 and

Recognizing that the Association has called for drug treatment to be available for all who request it; and

Knowing that alternatives to incarceration — such as treatment of drug addiction and mental illness, diversion, intensive supervision, work furlough and release, halfway houses, fines, probation, restitution and community service — are available at less human and monetary expense, 5-60 percent of the cost of imprisonment; 11,12 therefore

  1. Condemns the social practice that sanctions mass imprisonment rather than defining and changing those conditions that engender and accompany criminal behavior, including drug addiction, unemployment, homelessness, poverty, and illiteracy;13 and
  2. Encourages federal and local and state governments to develop and utilize alternatives to incarceration to their fullest extent; and
  3. Calls for immediate solutions to prison overcrowding as well as an end to the explosion in prison construction, expansion, and human incarceration which consumes resources which are urgently needed for other federal, state, and local social needs; and
  4. Supports the evaluation, on a national level, of root causes of criminal behavior, and the high rate of incarceration of Americans, including minority populations in particular.


  1. National Institute of Justice, Bureau of Justice Statistics 1989 & 1990.
  2. US Census Bureau.
  3. Mauer M: Americans Behind Bars: A Comparison of International Rates of Incarceration. Washington, DC: The Sentencing Project, 1991.
  4. APHA resolutions nos. 7106, 7315, 7921, 9016, 9017.
  5. King W, and Whitman W: Morbidity and mortality among prisoners, an epidemiologic review. J Prison Health 1981;1:1.
  6. Raba B, Obis W: The health status of incarcerated urban males, Results of admission screening. J Prison Health 1983;3:1.
  7. Fitzgerald R, et al: Health problems in a cohort of male prisoners at intake and during incarceration. J Prison Health 1984;4:2.
  8. Ochi RM: Racial discrimination in criminal sentencing. The Judges’ Journal, Winter, 1985.
  9. Corrections Yearbook, Criminal Justice Institute, Inc., NY, 1990.
  10. Lichtenstein M, Kroll R: The Fortress Economy. American Friends Service Committee, 1990.
  11. Irwin J, Austin J: It’s About Time; Solving America’s Prison Crowding Crisis. National Council on Crime and Delinquency, 1987.
  12. Report of the Blue Ribbon Commission on Inmate Population Management, California Legislature, Sacramento, 1990.
  13. APHA Policy Statement No. 8817(PP): A Public Health Response to the War on Drugs: Reducing Alcohol, Tobacco and Other Drug Problems among the Nation’s Youth. APHA Public Policy Statements, 1948 to present, cumulative. Washington, DC: APHA, current volume.