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COVID-19 in the California State Prison System: an Observational Study of Decarceration, Ongoing Risks, and Risk Factors.
J Gen Intern Med. 2021 Jul 21 [Online ahead of print]JG

Abstract

BACKGROUND

Correctional institutions nationwide are seeking to mitigate COVID-19-related risks.

OBJECTIVE

To quantify changes to California's prison population since the pandemic began and identify risk factors for COVID-19 infection.

DESIGN

For California state prisons (March 1-October 10, 2020), we described residents' demographic characteristics, health status, COVID-19 risk scores, room occupancy, and labor participation. We used Cox proportional hazard models to estimate the association between rates of COVID-19 infection and room occupancy and out-of-room labor, respectively.

PARTICIPANTS

Residents of California state prisons.

MAIN MEASURES

Changes in the incarcerated population's size, composition, housing, and activities. For the risk factor analysis, the exposure variables were room type (cells vs. dormitories) and labor participation (any room occupant participating in the prior 2 weeks) and the outcome variable was incident COVID-19 case rates.

KEY RESULTS

The incarcerated population decreased 19.1% (119,401 to 96,623) during the study period. On October 10, 2020, 11.5% of residents were aged ≥60, 18.3% had high COVID-19 risk scores, 31.0% participated in out-of-room labor, and 14.8% lived in rooms with ≥10 occupants. Nearly 40% of residents with high COVID-19 risk scores lived in dormitories. In 9 prisons with major outbreaks (6,928 rooms; 21,750 residents), dormitory residents had higher infection rates than cell residents (adjusted hazard ratio [AHR], 2.51 95% CI, 2.25-2.80) and residents of rooms with labor participation had higher rates than residents of other rooms (AHR, 1.56; 95% CI, 1.39-1.74).

CONCLUSION

Despite reductions in room occupancy and mixing, California prisons still house many medically vulnerable residents in risky settings. Reducing risks further requires a combination of strategies, including rehousing, decarceration, and vaccination.

Authors+Show Affiliations

Department of Biomedical Data Science, Stanford University, Stanford, CA, USA.Stanford Health Policy and the Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.Stanford Health Policy and the Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA., San Luis Obispo, CA, USA.Division of Public Administration, Center for Research and Teaching in Economics (CIDE), Aguascalientes, Aguascalientes, Mexico.Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.Stanford Health Policy and the Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.Stanford Health Policy and the Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA. Stanford Law School, Stanford, CA, USA.Stanford Health Policy and the Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA. jeremygf@stanford.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

34291377

Citation

Chin, Elizabeth T., et al. "COVID-19 in the California State Prison System: an Observational Study of Decarceration, Ongoing Risks, and Risk Factors." Journal of General Internal Medicine, 2021.
Chin ET, Ryckman T, Prince L, et al. COVID-19 in the California State Prison System: an Observational Study of Decarceration, Ongoing Risks, and Risk Factors. J Gen Intern Med. 2021.
Chin, E. T., Ryckman, T., Prince, L., Leidner, D., Alarid-Escudero, F., Andrews, J. R., Salomon, J. A., Studdert, D. M., & Goldhaber-Fiebert, J. D. (2021). COVID-19 in the California State Prison System: an Observational Study of Decarceration, Ongoing Risks, and Risk Factors. Journal of General Internal Medicine. https://doi.org/10.1007/s11606-021-07022-x
Chin ET, et al. COVID-19 in the California State Prison System: an Observational Study of Decarceration, Ongoing Risks, and Risk Factors. J Gen Intern Med. 2021 Jul 21; PubMed PMID: 34291377.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - COVID-19 in the California State Prison System: an Observational Study of Decarceration, Ongoing Risks, and Risk Factors. AU - Chin,Elizabeth T, AU - Ryckman,Theresa, AU - Prince,Lea, AU - Leidner,David, AU - Alarid-Escudero,Fernando, AU - Andrews,Jason R, AU - Salomon,Joshua A, AU - Studdert,David M, AU - Goldhaber-Fiebert,Jeremy D, Y1 - 2021/07/21/ PY - 2021/06/03/received PY - 2021/06/30/accepted PY - 2021/7/22/entrez PY - 2021/7/23/pubmed PY - 2021/7/23/medline KW - COVID-19 KW - SARS-CoV-2 KW - exposures KW - incarcerated populations KW - infections KW - prisons JF - Journal of general internal medicine JO - J Gen Intern Med N2 - BACKGROUND: Correctional institutions nationwide are seeking to mitigate COVID-19-related risks. OBJECTIVE: To quantify changes to California's prison population since the pandemic began and identify risk factors for COVID-19 infection. DESIGN: For California state prisons (March 1-October 10, 2020), we described residents' demographic characteristics, health status, COVID-19 risk scores, room occupancy, and labor participation. We used Cox proportional hazard models to estimate the association between rates of COVID-19 infection and room occupancy and out-of-room labor, respectively. PARTICIPANTS: Residents of California state prisons. MAIN MEASURES: Changes in the incarcerated population's size, composition, housing, and activities. For the risk factor analysis, the exposure variables were room type (cells vs. dormitories) and labor participation (any room occupant participating in the prior 2 weeks) and the outcome variable was incident COVID-19 case rates. KEY RESULTS: The incarcerated population decreased 19.1% (119,401 to 96,623) during the study period. On October 10, 2020, 11.5% of residents were aged ≥60, 18.3% had high COVID-19 risk scores, 31.0% participated in out-of-room labor, and 14.8% lived in rooms with ≥10 occupants. Nearly 40% of residents with high COVID-19 risk scores lived in dormitories. In 9 prisons with major outbreaks (6,928 rooms; 21,750 residents), dormitory residents had higher infection rates than cell residents (adjusted hazard ratio [AHR], 2.51 95% CI, 2.25-2.80) and residents of rooms with labor participation had higher rates than residents of other rooms (AHR, 1.56; 95% CI, 1.39-1.74). CONCLUSION: Despite reductions in room occupancy and mixing, California prisons still house many medically vulnerable residents in risky settings. Reducing risks further requires a combination of strategies, including rehousing, decarceration, and vaccination. SN - 1525-1497 UR - https://www.unboundmedicine.com/medline/citation/34291377/COVID-19_in_the_California_State_Prison_System:_an_Observational_Study_of_Decarceration,_Ongoing_Risks,_and_Risk_Factors. L2 - https://dx.doi.org/10.1007/s11606-021-07022-x DB - PRIME DP - Unbound Medicine ER -
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