Covid strained an already broken healthcare system behind bars​

inmates must work 18 hours in Tennessee to afford the copay for a medical visit, a new report from The Tennessee Justice Center reveals the extreme barriers to adequate medical care for prisoners. Below are excerpts from the report.

Summary By: Natalie Mattson
Summary By: Natalie Mattson

The Study's Critical Points

Between March and August of 2020, the 10 largest COVID-19 outbreaks in the country were linked to correctional facilities, with the 7th largest occurring at Trousdale Turner Correctional Center in Hartsville, TN.

  • At Trousdale, 53% of inmates, or 1,299, tested positive for coronavirus.

  • At South Central Correctional Facility in Clifton, 81% of all inmates, or 1,144, tested positive for COVID-19. 

  • After the first incarcerated person tested positive on March 23, 2020, Tennessee implemented mass COVID-19 testing for Tennessee Department of Correction (TDOC) staff and inmates in April.

  • As of December 14, 2021, there were 60 total deaths among TDOC prisoners, or 1 death out of every 360 prisoners. 


Among the 50 states, Tennessee ranks 20th for the highest number of state prisoners infected with coronavirus per capita, with 7,290 total cases.

  • There was 1 known case per every 3 prisoners, which was 74% higher than Tennessee overall.

  • Among TDOC staff, 1,546 individuals have been infected, and five have died.

Incarceration-associated health disparities

Incarcerated individuals experience higher rates of chronic and mental health conditions than the general population, and time spent incarcerated is associated with a significant decline in overall health.

  • 14.5% of men and 31% of women in jail have serious mental illness compared to 5% in the general population.

  • Suicide is the leading cause of death in jails and prisons, accounting for nearly half of deaths during incarceration from 2000-2016.

  • 40% of jail deaths occur within the first week of incarceration.

  • 67% of the prison population has substance use disorder, compared to 38% in the general population.

  • Only 15% of those who need treatment receive it while incarcerated.

Barriers to healthcare access for incarcerated individuals

  • In Tennessee, inmates are charged a $3.00 medical copay for physician visits, medication, and other health needs: these copays are paid by inmates who earn 17 cents an hour, meaning they would have to work for nearly 18 hours to afford a medical visit.

  • 20% of state inmates, and 68% of local jail inmates did not receive a medical examination while incarcerated.

Read the full report here.

VISUAL Breakdown

Above: A graphic depicting that only 15% of people received care in Tennessee prisons. 


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