Climate-related disasters are becoming more frequent all over the world; however, there is significant variability in the impact of disasters, including which specific communities are the most vulnerable. The objective of this descriptive study was to examine how climate disaster susceptibility is related to the density of incarceration at the county level in the United States. Percent of the population incarcerated in the 2010 census and the Expected Annual Loss (EAL) from natural hazards were broken into tertiles and mapped bivariately to examine the overlap of areas with high incarceration and susceptibility to climate disasters. Over 13% of counties were in the highest tertile for both incarceration and EAL, with four states containing over 30% of these counties. The density of incarceration and climate disaster susceptibility are overlapping threats that must be addressed concurrently through (1) decarceration, (2) developing standardized guidance on evacuated incarcerated individuals during disasters, and (3) more deeply understanding how the health of everyone in these counties is jeopardized when prisons suffer from climate disasters.

Background: Throughout the first year of the COVID-19 pandemic, our research team monitored and documented policy changes in United States (U.S.) prison systems. Data sources included prison websites and official prison social media accounts. Over 2500 data sources relevant to the COVID-19 pandemic in U.S. prisons were located and summarized in to five different categories: 1) prevention, 2) case identification and intervention, 3) movement, 4) social communication and connection, and 5) programming, recreation, and privileges. Results: All state prison systems reportedly enacted multiple policies intended to limit the spread of COVID-19 during the pandemic. Document analysis revealed that the most commonly released policies were restrictions on social contacts and privileges, basic preventive measures (e.g., distribution of masks), and basic case identification measures (e.g., verbal screening and temperature checks). Utilization of social media for policy communication varied significantly across states, though relevant data was more often released on Facebook than Twitter. Conclusions: Together, our work provides foundational knowledge on the wide breadth of policies that were reportedly enacted in the first year of the pandemic that may be used as a base for quantitative work on policy effectiveness and examinations of implementation.

Aims: To examine the use and association of medications for opioid use disorder (MOUD) with treatment completion and retention for criminal justice referred (CJR) admissions to residential treatment. Methods: A retrospective analysis of the Treatment Episode Dataset-Discharge (TEDS-D; 2015-2018) for adults (N = 205,348) admitted to short-term (ST) (30 days) residential treatment for OUD. Outcomes were MOUD in treatment plans, and treatment completion and retention (ST >10 days; LT > 90 days). Logistic regression analyses were conducted separately for ST and LT settings. Results: CJR admissions were less likely to have MOUD than non-CJR admissions (ST, 11% vs. 21%; LT, 10% vs. 24%, respectively) and were more likely to complete and be retained in treatment. In ST settings, MOUD was associated with higher likelihood of treatment completion and retention. In LT settings, MOUD was associated with higher likelihood of treatment retention and lower likelihood of treatment completion. These associations tended to be slightly weaker for CJR admissions, with the exception of treatment completion in LT settings, but the moderating effect size of CJR status in all models was very small. Small differences in the moderating effect of CJR status by race and ethnicity were observed in LT settings. Conclusions: MOUD is greatly under-utilized for CJR patients, and given that MOUD was associated with positive outcomes, there is a critical need to find ways to increase access to MOUD for CJR patients in residential treatment. Race and ethnicity appear to have relatively little impact on outcomes.

Introduction: The devastating overdose crisis remains a leading cause of death in the United States, especially among individuals involved in the criminal legal system. Currently, three classes (opioid agonist, partial agonist-antagonist, and antagonist) of FDA-approved medications for opioid use disorder (MOUD) exist, yet few correctional settings offer any medication treatment for people who are incarcerated. Facilities that do often provide only one medication. Methods: We conducted 40 semi-structured qualitative interviews with individuals receiving MOUD incarcerated at the Rhode Island Department of Corrections. Results: Results from this study indicate that people who are incarcerated have preferences for certain types of MOUD. Individuals' preferences were influenced by medication side effects, route of administration, delivery in the community, and stigma. Conclusion: MOUD programs in the community and in correctional settings should use a patient-centered approach that allows choice of medication by offering all FDA-approved MOUD treatment options.

The global climate crisis is the most significant, potentially irreversible environmental threat to humanity we face. In the last three years, we have experienced the warmest years on global record, and the number of extreme climate-related events is projected to increase. The negative impacts of these events are disproportionate across different populations: Black individuals are 40% more likely than White people to reside in areas with the highest projected increases in extreme temperature-related deaths. One understudied factor that may exacerbate the impact of climate disaster events on individuals is incarceration status. Incarceration is a key facet of structural racism in the United States. The United States contains 25% of the world’s incarcerated population despite making up less than 5% of the world’s overall population, and marginalized individuals are overrepresented in these settings. Carceral systems have historically experienced heightened morbidity and mortality from climate disasters when systems have not evacuated facilities or taken other preventative actions; this was evident in the aftermath of Hurricane Katrina, where residents of Orleans Parish, Louisiana prisons were left in their cells without water, food, and ventilation for days while correctional staff left their posts. In addition, jails and prisons themselves present environmental risk. Prisons contribute to greenhouse gas emissions, and people inside are regularly exposed to contaminated water, hazardous waste, and food insecurity.