Incarceration’s impact on communities and people of color

At a day-long workshop, held at the School of Nursing, public health and criminal justice experts addressed how health and well-being are affected not only during incarceration, but after release, as well.

By Natalie Pompilio

Kempis “Ghani” Songster spent 30 years in prison. At Penn’s School of Nursing Wednesday morning, he described the physical and mental toll he’d seen caused by mass incarceration: prisoners who lost their spark and seemingly fell into trances commonly called “the autistic thing;” more than 600 of his fellow inmates—of all ages—dead from cancer in a 25-year-period, perhaps tied to toxic drinking water; people with diabetes who, already denied healthy food, stuffed themselves with sugar as they gave up hope.

Songster, 45, had a circulation problem for years—but it was never properly looked at until his release, he said. 

“When I went to my first medical appointment at Rising Sun Medical Center, I’d never been treated that way before, treated like a human being, treated by somebody who really took pride in their work and wanted to see what was wrong with me,” said Songster, who was released in December 2017, in light of a Supreme Court ruling declaring it unconstitutional to sentence juveniles to life. “That wasn’t someone just trying to tell me, ‘You look OK’ and just give me a Motrin.”

Songster was one of the keynote speakers of a day-long workshop focused on the effects of incarceration on the health and well-being of people and communities of color. The program was sponsored by the National Academies of the Sciences, Engineering, and Medicine with support from Penn Nursing; Aetna Foundation; The Colorado Trust; Kaiser Permanente; Kresge Foundation; the U.S. Department of Veterans Affairs’ Office of Health Equity; and the U.S. Health Resources and Services Administration.

The event included three panels of moderated discussions between professionals from the fields of public health and criminal justice. The event concluded with an address by Philadelphia District Attorney Larry Krasner and reflections from health equity promoters including Antonia Villarruel, the Margaret Bond Simon Dean of Nursing.

Songster and the program’s other keynote speaker, Jim Parsons, provided a framework for the day. The U.S. is home to about 5 percent of the world’s population, yet one-quarter of the world’s prisoners, said Parsons, vice-president and research director at the non-profit Vera Institute of Justice. Statistics show the population of incarcerated Americans is disproportionately composed of minorities and those from low-income households.  

The incarcerated population is less healthy than the general population. Those behind bars are more likely to struggle with addiction and to have mental illnesses made worse by practices like solitary confinement. The rate of HIV/AIDS and Hepatitis C is also significantly higher. 

“It might be easy to think that the health impacts of incarceration are isolated behind prison walls. However, as we all know, the vast majority of people come back from prison and jail and they bring the negative health outcomes and the harms that prison and jails cause home with them with them,” Parsons said. “The [Centers for Disease Control and Prevention] defines social determinants of health as the circumstances in which people are born, grow up, live, work, and age that effects public health and I think we have to see mass incarceration … as one of them.”

Songster—who is now working with Amistad Law Project, a public interest law center working to free others sentenced to “death by incarceration”—said there are people who believe those who are incarcerated deserve to suffer because they’ve done something wrong. He urged society to change the construct, to ask “not what punishment a person deserves but what do we deserve as a society, what kind of justice system do we deserve,” to ask “not whether a person deserves to die but do we deserve to kill.”

“For mass incarceration to exist in our midst, for it to become so normal, it begs the question: What is happening to us?” Songster asked. “What is happening to us as a species, this desensitization, the numbness to what’s going on? It has to raise some serious questions about our collective psyche. What we have made peace with? Is that healthy for us?” 

Krasner talked about efforts his office was making to keep non-violent and low-level offenders out of jail, including changing the cash bail system and offering sentences below state recommending levels for guilty pleas. They’ve seen results, he said: He believes the city’s jail population could be in the low 4,000s by the end of year. Not long ago, it topped 8,000.

“There are changes happening in Philadelphia,” he said. “But I guess you are figuring that out.”

Wrapping up the day, Villarruel said Songster’s words prompted her to ask herself, “What is our happy ending and what is it we want for ourselves?” 

“I found the answer to that a little bit later: We’re looking for a human environment, one built with compassion,” she told the group of professionals from multiple fields. “When I think about the work that I heard today … I see again that we’re on parallel tracks, the issues of trying to build healthy communities, to engage citizens, those healing environments, are something we ought to be doing together.”