Mass Incarceration

The U.S. system of mass incarceration has numerous negative effects on the health of communities targeted by the drug war. Drug laws impact Black and Latino populations disproportionately to their rates of drug use. Mass incarceration negatively influences civil and human rights, individual and community health, and empowerment, affecting not only the individuals who enter and leave the mass incarceration system but also their families, their communities, and our society. Additionally, legalized discrimination, based on criminal records, increases poverty rates by reducing access to legal employment, housing, loans, education, and social services. These effects render the system of mass incarceration — as a group of sociopolitical forces — a social determinant of health, which the field of public health needs to further integrate into its education, research, practice, and activism. Mass incarceration exacerbates health and power inequities through long-term punishment for non-violent drug use. As an urgent and widespread social injustice, it warrants a strong response from the public health community.

Radical Public Health, based at the UIC School of Public Health, has undergone a group study and discussion of this topic, attempting to enumerate the ways this system manifests as a social determinant of health before, during, and after incarceration. The group is engaging in conversation to highlight the problems with mass incarceration; seek public health solutions for reducing the negative health and social impacts it imposes on Black, Latino, and low-income communities; and advocate for a public health approach to drug use and addiction.

What is mass incarceration?

Mass incarceration is a system of social control and economic exploitation that uses the imprisonment (disproportionately of Blacks and Hispanics) for the benefit of social actors not targeted for incarceration. Mass incarceration has traditionally benefited large employers by supplying a large underemployed and unemployed class to keep wages, benefits, and worker protection enforcements low, maximizing profit. It has benefited politicians displacing blame for social problems onto the victims of those problems. It has benefited the prison industry and its allied services (i.e. labor, food, healthcare, etc.). And it benefited security and business leaders in breaking radical social movements that gained ground in the 1960s and 1970s.

The War on Drugs

About a quarter of all prisoners are imprisoned for non-violent drug charges.1 Drug policy— enforced in the name of public health— aims to reduce the threat that drugs pose to the population, but it has not done so.

In fact it has no observable effect on drug use among the US population, widely speaking.2 Occasional drops in the availability of some drugs have been observed, but only to come back in fashion or in new forms or analogs. People do less cocaine than they did in the 1980s (which cannot be even be clearly attributed to the War on Drugs)4, but that's paired with an increase of use of amphetamines, methamphetamine, prescription opiates and painkillers, and various designer drugs that arise from prohibition. Because of the War on Drugs, we now have a market for dangerous research chemicals among at-risk youth5 and the Mexican Drug Cartel now has submarines and rocket launchers6, so thanks for that.

What is the purpose of criminalizing illicit drugs if forty years of this policy has shown no significant drop in drug use or availability?

The total cost of the War on Drugs ranges from 25 to 50 billion dollars a year.6 And yet there is no evidence-base to support this policy. Why then, is it continued?

The New Jim Crow

Mass incarceration continues the Jim Crow system which segregated the South before the Civil Rights movement, but with the added economic benefit for private corrections corporations, towns and cities where prisons are located, and the allied services that are built around prisons, including healthcare and labor. This is not a single individual or group or party's fault as much as a systemic creation of advanced-capitalist society in a country built on white supremacy.

Aptly, this system has been coined as the "New Jim Crow", partially through Michelle Alexander's book of the same name. She argues, though, that Jim Crow never really went away — it's been sanitized and modified to fit a "post-racial" society. Any apparent racism in the criminal justice system can be dismissed with plausible deniability — if it's not racist 100% of the time, is it still a racist system? The answer is unequivocally yes.9

Race and the Criminal Justice System

Drug use among all racial groups is essentially equal, excluding Asians, and with some variation on type of drug, age, and location.7


Teenage white males surveyed do more marijuana than their black peers, for example, while Blacks of any age are more likely than their white peers do crack cocaine than powder cocaine. However, these differences are inconsequential compared to the actual disparities in sentencing.


Blacks make up 60% of the prison population despite being only 13% of the drug-using population. There are upwards of 700,000 people in local jails for marijuana possession, in addition to the tens of thousands in federal and state prisons.8 The American Public Health Association (APHA) endorsed decriminalization for medical marijuana twenty years ago, to put it in perspective.9 And yet 42% of drug arrests are still for marijuana.10 That's quite the disconnect between the public health and criminal justice system.

Racism and myths about drug use


Drug prohibition historically occurred when racial minorities and marginalized populations begin using the drugs that white majority had been using medicinally or recreationally for years, as was the case with Chinese immigrants using heroin in the 1890s, Southern Blacks using cocaine in the turn of the century, or Mexican immigrants using marijuana in the 1930s and 40s, all of which were legally and widely enjoyed by affluent white populations just decades prior.9

Presently, Blacks are arrested at a rate 2.8 to 5.5 times higher for drug offenses than whites, despite using drugs at the same rate.10 For crack cocaine, though it's viewed as a primarily "Black" drug while powder cocaine is an upper-class "white" drug, the majority (2/3rd) of crack users are white and Hispanic.12 In 1991, it was reported to Congress that 51% of crack cocaine users were white.11 Despite this, 88% of people arrested for crack cocaine offenses are Black.9 And similarly, the mandatory minimum sentences for crack cocaine are far more severe. Until 2010, 5 grams of crack cocaine garnered five years in prison. The same sentence was given for possession of 500 grams of powder cocaine, the "white" drug, leading to the 100:1 disparity. Today it is 18:1.

Crack and powder cocaine are pharmacologically the same.13 Crack cocaine is not instantly addictive.14 Nor does crack use in pregnancy create "crack babies," which are sadly the result of abuse, malnourishment, alcohol abuse, and environmental factors that can't be solely blamed on crack cocaine.15 The difference between the two substances is literally baking soda, and this has cost people their futures and livelihoods, and created a scenario where you can get a higher sentence for personal-use crack than you can for trafficking cocaine.

Effects on the family and community

Mass incarceration affects everyone, not only the people behind bars.

Firstly, it is inter-generational. "[C]ontrolling for income and all other factors, youths in father-absent families (mother only, mother-stepfather, and relatives/other) still had significantly higher] odds of incarceration than those from mother-father families."


Additionally, the prison system increases peoples’ exposure to institutional violence and HIV/AIDS. Incarceration increases rates of depression and mental illness.20 Significantly, some states (not including Illinois) strip away voting rights and make it more difficult for ex-felons to acquire student loans, public housing, and social services. Recidivism is high because the formally incarcerated simply cannot find work.17

Also, it's a terrible investment.

Mass incarceration is first and foremost a human rights issue. Understanding that talking about "cost-benefit" betrays some of the injustice of the system, it's still necessary to point out how incredibly costly and inefficient incarceration is compared to treatment. While it costs $20,000 per year to house an inmate, rehabilitative services cost only $4,000 per year, approximately, and this approach is far less punitive and far more humane.19 The treatment approach works well in Europe, where some countries have decriminalized drugs24 and others have a long history of legalization and harm reduction.25

Critically, a criminal justice system cannot be "just" under capitalism, considering that there is a profit-motive to incarceration and a political motive to the removal of "excess" populations, tied to America's history of race-based oppression and genocide.27 That's one perspective, of course, or we can make the system better through reform. There's a lively debate on whether or not that's possible.

Political Prisoners

The United States also uses prison to crush internal political dissent through incarceration or threat of incarceration. Mumia Abu-Jamal, Robert Hillary King and other members of the Black Panther Party have been incarcerated due to their political agitation, often on false or misrepresented charges. Anarchist activists have also been arrested and imprisoned, including members of the NATO 5. Environmental and animal rights activists like Daniel McGowan have also been imprisoned.

Who makes money off of prisons?

Prisons are often placed in small, rural communities without many employment options. Some prisons are the town's largest employer, as prisons not only need guards, but healthcare services, food services, and labor. There are literal industries and trade shows set up for the creation and upkeep of prisons.29 Using prison labor for manufacturing is also often cheaper than using Chinese labor, and you can still stamp "Made In America" on a product made in a prison.

Additionally, as if by some Faustian bargain, prisoners bring more political representation to small, rural communities without actually being given voting rights.28 In other words, rural, predominantly Republican communities get more representation in Congress with the influx of largely minority prisoners, but the prisoners don’t get a right to vote. It's essentially the 3/5th compromise for a "post-racial" America.

Prison abolition

We can begin to move beyond the idea of prisons as an institution, which is the foundation of prison abolitionism. There are creative responses to conflict in autonomous communities that do not require the criminal justice system such as restorative and transformative justice, which have even been even applied in Rwanda after the genocide to some degree of success.23 As public health professionals, we should probably err on the side of not involving the criminal justice system. See: police brutality.

But most immediately, we need to reform drug laws, speak out on behalf of the incarcerated, and provide support for ex-felons. There are plenty of ways to get involved.

Additional resources

The best place to start with anything prisons or prison abolition is Michelle Alexander's the New Jim Crow. Eugene Jawreki's film The House I Live In is a terrific documentary on the Drug War and it's available streaming on Netflix.

Chicago based organizations involved in this kind of work:
Project NIA
Black and Pink: Chicago
Transformative Justice Law Project
Chicago Anarchist Black Cross (ABC)

See Also:

Racism and whiteness
Drug use and public health

4 DiNaro, J. (1993). Law enforcement, the price of cocaine and cocaine use. Mathematical Computer Modeling, 17(2), 53-64. Retrieved from
9 New Jim Crow
11 Special Report to Congress: Cocaine, at 38, citing National Institute on Drug Abuse, Overview of
the 1991 National Household Survey on Drug Abuse (1991) (NIDA Capsules)
12 Substance Abuse and Mental Health Services Administration, (2006). Illicit drug use tables. Retrieved from website:
13 Morgan, J., & Zimmer, L. (1997). Social pharmacology of smokeable cocaine: Not all it. In C. Reinarman & H. Levine (Eds.), From Crack in America: Demon Drugs and Social Justice
14 Beattie, B. (2005). Putting the crack baby myth to bed. National Review of Medicine, 2(13), Retrieved from
15 Harper, C., & McLanahan, S. (2004). Father abstinence and youth incarceration. Journal of Research on Adolescence, 14(3), 369-397. Retrieved from
19 McVay, D., Schiraldi, V., & Ziedenberg, J. (2004). Treatment or incarceration?: National and state findings on the efficacy of drug treatment versus imprisonment. Prison Policy Institute, Retrieved from
21 Harper, C., & McLanahan, S. (2004). Father abstinence and youth incarceration. Journal of Research on Adolescence, 14(3), 369-397. Retrieved from
22 James, D., & Glaze, L. US Department of Justice, Office of Justice Programs. (2006). Mental health problems of prison and jail inmates. Retrieved from website:
28 Peck, B. (2012, October 26). The census count and prisoners: The problem, the solutions and what the census can do. Retrieved from

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