By Anna Browning, JHBL Staff Member
It is well known that physical diagnoses and limitations can negatively impact a patient’s mental health.[1] However, it may surprise some that undue anxiety or depression can be the cause behind developing a serious physical health issue.[2] Studies have shown that mental illness when it goes untreated can significantly increase someone’s risk of becoming physically ill.[3] There is little research done on the health effects of incarceration.[4] Nonetheless, some evidence suggests a relationship between incarceration and health.[5] Additionally, during the processes of trial, sentencing, and admission into prison, many prisoners become depressed.[6] Therefore, given the mental toll that is known to effect those in incarceration, that harm extends further into causing and exacerbating physical health issues.[7].
In a 2020 study examining the experiences of solitary confinement, researchers examined the most prevalent physical effects of incarceration.[8] Specifically, the research revealed that solitary confinement exacerbates the effects of chronic illnesses such as obesity, hypertension, and asthma.[9] In this study, inmates who were subjected to solitary confinement experienced “exacerbating musculoskeletal pain.”[10] This creates a cycle of pain causing the inmate to experience physical and mental limitations in a confinement situation where their existence is already severely restricted.[11] The lack of access to activities in solitary confinement leads researchers to question the physical effects of the inmate’s confinement, which are likely not being treated.[12]
Another study further supports the negative impact that incarceration has on the physical health of inmates by tracking of the body mass index (“BMI”) of adult men throughout the course of their lives.[13] The study found that incarceration increases male BMI by causing weight gain in both current inmates and men with prior prison experiences.[14] The conditions in prisons impose major stress on the inmate’s life, which may be the root cause behind the inmate’s weight gain.[15] Additionally, the increase in distress and depression while incarcerated plays a role in obesity risk because of “either increased consumption of energy dense foods or decreased physical activity.”[16] Once again, a vicious cycle is discovered with obesity increasing the risk of depression, and depression increasing the risk of obesity.[17] People who have not interacted with the prison system may think that prison’s controlled food environment, and the required physical activities would cause inmates’ BMIs to decrease.[18] However, this opinion does not take into account the burden that stress places on the body, causing weight gain.[19]
Through countless studies, it has been confirmed that mental health does play a role in negatively effecting physical health.[20] As discussed in this blog post, both exacerbated musculoskeletal plain and unhealthy BMIs caused by obesity, are examples of the physical health consequences of incarceration.[21] Musculoskeletal pain is exasperated in solitary confinement because of the severe mental and physical restrictions those inmates are under.[22] Adult men who are currently incarcerated or have been incarcerated before are developing unhealthy BMI’s due to the stress of prison causing weight gain.[23] These two examples illustrate that incarceration is the causal link between the mental and physical ailments experienced by inmates.[24] So, what does this mean? It is no secret that the discussion to ending mass incarceration generally revolves around wrongful incarceration, harsh sentences for minor offenses, and the fact that over five million people are “under supervision by the criminal legal system.”[25] However, based on the new research discussed above, it appears there is another reason to add to the discussion: the vicious effects that mental health can have on the physical health of an incarcerated individual. Mass incarceration dehumanizes many people across the United States. Treating an inmate’s physical and mental health conditions is one way to protect an individual’s personhood while they are behind bars.
Disclaimer: The views expressed in this blog are the views of the author alone and do not represent the views of JHBL or Suffolk University Law School.
Anna Browning is a second-year law student, who is interested in Environmental and Family Law and has been working in fitness for the past 3 years as an Orangetheory Fitness Coach.
[1] Jane E. Brody, The Devastating Ways Depression and Anxiety Impact the Body, THE N. Y. TIMES (Oct. 12, 2021), https://www.nytimes.com/2021/10/04/well/mind/depression-anxiety-physical-health.html [https://perma.cc/9FUB-SJDQ] (explaining the effects of mental health on physical wellbeing).
[2] Id.
[3] Id.
[4] Jason Schnittker & Andrea John, Enduring Stigma: The Long-Term Effects of Incarceration on Health, 48 J. OF HEALTH AND SOC. BEHAV., 115, 116 (June 2007) https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=ab69cc746ce9a236ab6d8c7928af795d3f3098e6 [https://perma.cc/3CS9-8MBP] (looking at the health effects of incarceration largely neglected by medical sociology).
[5] Id.
[6] Nigel Walker, Side-Effects of Incarceration, 23 BRIT. J. CRIMINOLOGY, 61,63 (Jan. 1983) https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=2e64d3d0dd1b4ee2b092fe5605530ece3f683c81 [https://perma.cc/6XGJ-5VBQ] (exploring the side effects of incarceration).
[7] See Brody, supra note 1 (explaining mind and the body form “two-way street” ignoring separation of mental from physical illness). See Walker, supra note 6 (emphasizing that depression is understandable reaction to “the prospect of conviction”).
[8] Justin D. Strong et. al., The body in isolation: The physical health impacts of incarceration in solitary confinement, PLOS ONE (Oct. 9, 2020) https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0238510&type=printable [https://perma.cc/D78Z-XG4A] (studying the effects of solitary confinement on inmates mental and physical wellness). Researchers found that “the third most common significant health symptoms [behind anxiety and depression] were somatic concerns.” Id. Somatic concerns are “defined by the BPRS as ‘concerns over present bodily health.’” Id. at 2.
[9] Id. Additionally, “the interaction between the disparate impacts of race and incarceration on health means that mass incarceration itself has been identified as social determinant of health for Black men in the United States.” See Strong, supra note 8.
[10] Id. at 12. The study further explored how symptoms associated with deprivation conditions and symptoms associated with deprivation policies in solitary confinement interact to exasperate physical ailments such as musculoskeletal pain. Id. Many patients attributed their musculoskeletal pain to a variety of problems such as arthritis, bursitis, and sciatica. Id.
[11] See Strong, supra note 8.
[12] Id.
[13] Brian Houle, The Effect of Incarceration on Adult Male BMI Trajectories, USA, 1981-2006, 1 J. RACIAL & ETHNIC HEALTH DISPARITIES 21,21 (March 2014) https://link.springer.com/article/10.1007/s40615-013-0003-1#citeas [https://perma.cc/CEB6-XJR6] (exploring the increase in BMIs of incarcerated male inmates).
[14] Id. at 25.
[15] Id. at 22.
[16] Id.
[17] See Houle, supra note 13, at 22.
[18] Id. at 25.
[19] Id.
[20] See Brody, supra note 1. “In studies that tracked how patients with breast cancer fared, for example, Dr. David Spiegel and his colleagues at Stanford University School of Medicine showed decades ago that women whose depression was easing lived longer than those whose depression was getting worse.” Id.
[21] See Strong, supra note 8. See also Houle, supra note 13.
[22] See Strong, supra note 8.
[23] See Houle, supra note 13.
[24] See Strong, supra note 8. See also Houle, supra note 13.
[25] Ashley Nellis, Mass Incarceration Trends, THE SENTENCING PROJECT (2023), https://www.sentencingproject.org/reports/mass-incarceration-trends/ [https://perma.cc/T7NZ-8CLS] (reporting highlights of the state and federal prison systems and its far-reaching effects).