New data gives a detailed picture of how COVID-19 increased death rates in Florida prisons

A new publication from the UCLA COVID-19 Behind Bars team reveals that COVID-19 reduced the life expectancy of people in Florida prisons by 4 years.

By Emily Widra

People in prison have been 5.5 times more likely to get COVID-19 and have suffered a COVID-19 mortality rate 3 times higher than the general public. Now, new data from UCLA Law's COVID-19 Behind Bars Data Project published this week in preprint reveals the degree to which the death rate from all causes of death -- not just COVID-19 -- increased in Florida state prisons during the COVID-19 pandemic. The findings, outlined below, give us a much fuller picture of how deadly COVID-19 has been in prisons.

More deaths, despite fewer people in prisons

The researchers collected monthly population counts for Florida state prisons from 2015 to 2020. Based on this data, the Florida state prison population decreased by about 10,000 in 2020, a reduction of approximately 11% since 2019. The Florida Department of Corrections attributes this population reduction to "fewer arrests and prosecutions, fewer individuals sentenced to incarceration, and fewer commitments received from county jails," suggesting that while fewer people entered prison, there were no large-scale efforts to release people who were nearing the end of their sentence or those who were at high risk for death related to COVID-19. Despite the slightly smaller prison population, there were more deaths in 2020 (across all causes of death) than in any of the five years prior.

During 2020, there were 42% more "excess deaths" -- from all causes -- in Florida prisons

During 2020, the United States experienced 23% more deaths than expected, but the Florida prison system experienced almost double that: there were 42% more deaths than expected behind bars in Florida. Importantly, not all of these "excess deaths" are officially attributed to COVID-19. According to public health experts, the excess deaths in the United States may be due to undocumented COVID-19 infections, delayed access to health care, or behavioral health crises. The same is likely true in prisons, where healthcare systems frequently neglect medical complaints even during normal times, and where an increase in practices like solitary confinement during COVID-19 has exacerbated mental illnesses.

As the graph below shows, deaths spiked in Florida prisons during the pandemic- and only some were deaths from COVID-19:

Figure 1: Graph showing that deaths in Florida state prisons in 2020 exceeded expectations by more than 42%. Not all of those excess deaths are diagnosed COVID-19 deaths, but most are likely at least indirectly caused by the COVID-19 pandemic.

The life expectancy for people in Florida prison decreased by more than 4 years between 2019 and 2020

The authors calculate that COVID-19 reduced the life expectancy of the Florida prison population by over four years. That is far worse than the CDC estimate that the U.S. general population's life expectancy decreased by about 1 year during the pandemic. (This mortality disparity during COVID-19 is on top of the fact that incarceration itself shortens the lives of people behind bars, as research shows that for every year of incarceration, life expectancy decreases by two years.)

Figure 2: Bootstrapped estimates of life expectancy for Florida state prison population by year, showing that life expectancy of people in Florida state prisons is the lowest it’s been in 5 years — declining by 4 years from 2019 to 2020.

Increased mortality rates in prison population

Across all age groups in Florida state prisons, the all-cause mortality rate increased from 2019 to 2020. Four age categories saw statistically significant increases: mortality rates increased 77% for people 35-44 years old, 49% for people 55-64 years old, 67% for people 65-74 years old, and 61% for those 75 or older. Although prisons are often filled with young people, older adults are making up an increasing proportion of the national prison population. The threat of COVID-19 behind bars disproportionately impacts these older adults who are more likely to already have any number of complex medical conditions.

Conclusions

As we reckon with the consequences of states largely ignoring COVID-19 behind bars, this new data is a reminder to not limit our assessment of the harm to COVID-19 deaths alone. Since the beginning of the pandemic, we have argued that failing to depopulate prisons would not only enable massive viral outbreaks, but that it would also, indirectly, strain medical units in prison and lead to more deaths from a wide variety of illnesses. This data from Florida provides the first quantitative evidence that we and other advocates were right.

The disastrous consequences of COVID-19 behind bars could have been avoided -- or at least reduced -- if states acknowledged that people in prison have conditions that put them at higher risk, social distancing is impossible in prisons, and prison populations needed to be reduced significantly and quickly. Instead, states chose to leave the vast majority of incarcerated people in prison, at the mercy of a virus that thrives in crowded conditions. The consequences have extended far past the number of official diagnosed COVID-19 cases and deaths.