People in Prison Died of COVID-19 at Twice the Rate of the Public

People in U.S. prisons were dying of COVID-19 at about twice the rate of people outside, even after adjusting for age, sex and race. That was the main finding of a September 2020 report for the National Commission on COVID-19 and Criminal Justice, written by economist Kevin Schnepel.

Update (October 2026): The numbers below are from August 2020 and are historical. A December 2020 follow-up from the Council on Criminal Justice found similar gaps.

Since COVID-19 first appeared in the U.S., prisons across the country have felt the brunt of it. The original version of this article reported that by August 2020, 19 of the 20 largest clusters of active cases in the U.S. were in prisons and jails. With more than 2 million people locked up in the United States, it matters that we understand what this virus does to people in prison.

The report asked two questions:

1. How do COVID-19 cases and deaths in state and federal prisons compare to the general public?

2. How do cases differ from one prison system to another?

Why prisons were hit so hard

People in prison are often on the front lines of pandemics. Many have chronic health problems, like heart disease or diabetes, that make COVID-19 more dangerous. Health care in prison is often poor, and older prisoners face even more risk.

Crowding is the biggest problem. Many federal prisons hold more people than they were built for, so social distancing is nearly impossible. Staff, new prisoners, and visitors also come and go, which spreads the virus.

Raw numbers can mislead

By mid-August 2020, nearly 115,000 people in prisons and jails, counting both prisoners and staff, had reported COVID-19 cases. More than 900 of those cases ended in death. That raw death rate is nearly four times higher than the rate outside prison walls.

But the report found that this raw number does not account for differences in age, sex, and race between people in prison and the general public. Even after adjusting for those differences, the pattern is troubling. People outside prison of the same sex, age, and race were less likely to die from the virus.

Key findings

1. Deaths. Prisons had about 61.8 COVID-19 deaths per 100,000 people. That is about twice the rate for the general public, after adjusting for age, sex, and race.

2. Cases. Prisons had close to 7,000 cases per 100,000 people. That is more than four times the rate for U.S. residents. (The report could not adjust case rates for age, sex, and race.)

3. Big differences between systems. Fourteen states reported no COVID-19 deaths in their prisons. Others saw cases and deaths spike. More research is needed to learn why.

4. Where cases were highest. Most of the prisons with the most active cases fell into one or more of three groups: state-run prisons, prisons in the South, and prisons holding 1,000 or more people. Large prisons in the Midwest had the highest death rates.

5. Limits. The study tracked cases inside prisons. It could not measure how prison outbreaks affected nearby communities.

What it means

The report shows a clear need for better health care in prisons. People in prison were more likely to catch COVID-19 and more likely to have serious complications and die from it. With death rates still rising at the time, the original article argued that something had to be done before it was too late.

Read more about COVID-19 and the criminal justice system.

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