Effects of the COVID-19 pandemic on people in prison: a review of the research evidence
Background
People experiencing incarceration (i.e. living in prisons) were particularly likely to have been impacted by the COVID-19 pandemic. This group of people, may already have inequalities compared to the general population. For example, they may have difficult family backgrounds, have experienced homelessness, have limited education, a lack of access to healthcare, and experience a range of health issues (e.g. physical and mental illnesses). Living in prisons meant that they were also more susceptible to infectious diseases like the virus causing COVID (SARS-CoV-2). This is due to many factors including living in confined, crowded spaces, challenges with social distancing and less access to personal protective equipment. The pandemic interventions also resulted in things like lengthy isolation in cells, suspension of family visits and cancellation of educational courses, which contribute to a decline in mental health.
While there are likely to be inequalities in health compared to the general population, the range of impacts and the effects on the pre-existing inequalities that these people may have, when compared to the general population, was unknown.
Objective of the research
To assess the effect of the COVID-19 pandemic on people experiencing incarceration (PEI), focusing particularly on clinical outcomes compared with the general population.
Design
To conduct a systematic review of published research. The population included were adults experiencing incarceration, aged 18 and over, worldwide, during the COVID-19 pandemic.
Results
55 studies met the inclusion criteria, and most were from the USA. Compared with the general population, PEI were usually found to have higher rates of SARS-CoV-2 infection and poorer clinical (health) outcomes. Conflicting data were found regarding vaccine uptake and COVID testing rates compared with the general population. The mental health of these people also declined during the pandemic. Subgroups, such as ethnic minorities and older PEI, were more badly affected.
Conclusion
PEI have poorer COVID-19 clinical outcomes than the general public. Further high-quality research is required to assess continuing effects of the pandemic on PEI. Prioritisation of resources for this vulnerable group should be a focus of national policy in the event of future pandemics.
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