Prisons and COVID-19 Spread in the United States.

Objectives. To empirically evaluate the relationship between presence of a state or federal prison and COVID-19 case and death counts. Methods. We merged data on locations of federal and state prisons and of local and county jails with daily case and death counts in the United States. We used a selection-on-observables design to estimate the correlation between prisons and COVID-19 spread, controlling for known correlates of COVID-19. Results. We found empirical evidence that the presence and capacities of prisons are strong correlates of county-level COVID-19 case counts. The presence of a state or federal prison in a county corresponded with a 9% increase in the COVID-19 case count during the first wave of the pandemic, ending July 1, 2020. Conclusions. Our results suggest that the public health implications of these facilities extend beyond the health of employees and incarcerated individuals, and policymakers should explicitly consider the public health concerns posed by these facilities when developing pandemic-response policy. (Am J Public Health. Published online ahead of print July 14, 2021: e1-e8. https://doi.org/10.2105/AJPH.2021.306352).