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Nicole Coffey Kellett is a professor of anthropology at the University of Maine at Farmington. This column reflects her views and expertise and does not speak on behalf of the university. She is a member of the Maine chapter of the national Scholars Strategy Network, which brings together scholars across the country to address public challenges and their policy implications.
Throughout the 25 years visiting my friend in prison, I was struck by the health conditions of those who were incarcerated as well as those of their family members. I repeatedly heard stories of premature deaths and perpetual mental and physical health ailments, distinct from those I encountered in my everyday life far from the prison gates. Prison not only negatively impacts individuals’ health, but our society contributes to the illness of the most marginalized due to unstable housing, low paid work, lack of insurance and unmet physical and mental health needs. This leads to incarceration further eroding health, perpetuating a vicious costly cycle.
Overall, the United States incarcerates more individuals than any other country in the world. In Maine, the average cost to taxpayers of incarcerating one individual per year is $115,000 to $117,000.
The American Public Health Association has tied poor health outcomes in the United States with mass incarceration. Compared to the general U.S. population, incarcerated individuals have a higher prevalence of acute and chronic health conditions. These include higher rates of infectious diseases, substance use and mental health disorders, traumatic brain injuries, heart-related illnesses, hypertension, diabetes, asthma, stroke, among others, along with overall lower life expectancy and premature death.
The higher prevalence of these health conditions among incarcerated people has been partially attributed to pre-incarceration structural challenges such as poverty and unstable housing, which can make individuals susceptible to health-harming conditions. Financial precarity is highly present in Maine. The United Way found that in 2023 40% of households in Maine fell below a threshold for financial survival and 28% of those working the 20 most common jobs in Maine could not afford basics.
Marginalized individuals are overrepresented in U.S. prisons and jails including those without stable housing; people with disabilities; individuals with mental illness and those with substance use addiction. About 50 percent of incarcerated individuals lack health insurance upon the time of their arrest compared to 11.6% within the general population aged 18 to 64 in 2024.
Prisons and jails are known to compromise health due to poor sanitation, limited heating and ventilation, low quality diets and medical neglect. Incarceration can also seriously degenerate mental health through overcrowding, isolation units, violence, sexual assault, separation from family and overall stress. For each year spent in prison there is an associated two-year decline in life expectancy. In Maine, health care is provided by Wellpath, one of the largest private correctional health-care companies with $40 billion market value. Currently Wellpath is facing dozens of lawsuits nationally due to its poor care provisions and declared bankruptcy in 2024.
The health implications of our incarceration system reverberate throughout society. Children of incarcerated parents are two to three times as likely to have learning disabilities, anxiety, depression, substance use issues and behavioral problems, with potential long-term risks in adulthood. Research has shown having an incarcerated parent is more detrimental to a child’s health than divorce or death of a parent. Having an incarcerated family member is connected to a loss of life expectancy of 2.6 years and a loss of 4.6 years for having three or more incarcerated family members.
Moreover, the average life expectancy of a correctional officer is about 16 years less than the national average at around 59 years, related to workplace stress, high rates of suicide, and PTSD.
One manner of addressing this public health crisis here in Maine is to support LD 1962, An Act to Establish the Corrections Ombuds in the state of Maine. A correctional ombuds could provide an unbiased window into the medical care in incarcerated settings to suggest improvements.
We can also reestablish parole in Maine by supporting LD 1941, An Act to Implement Recommendations of the Commission to Examine Reestablishing Parole. Parole saves taxpayer money as the cost of supervised community confinement is less than half of incarceration. Parole incentives rehabilitation, improves reentry planning, and is fair and equitable by offering the same opportunities as those from other states.
Jiddu Krishnamurti stated, “It is no measure of health to be well adjusted to a profoundly sick society.” We must wake up from our mental and moral adjustment and divest from incarceration and reinvest in societal determinants of health for the wellbeing and safety of all.