Interview With Epidemiologist and Author Homer Venters, M.D.
Dave:
Our guest this episode literally wrote the book on healthcare in jails and prisons in the United States. That book is titled Life and Death in Rikers Island, but Homer Venters has done so much more for healthcare in jails and prisons since that book was released, including serving on President Biden’s task force for COVID in prisons since the outset of the pandemic.
Dave:
It’s a difficult conversation, healthcare in jails and prisons. There’s almost no sympathy in society at large for caring for people behind bars. And yet, if it is our sacred duty anytime we take away a person’s freedom in a free society, that duty must also entail taking care of their healthcare.
Dave:
The hope in this very difficult conversation is that there are people like Homer Venters who are advocating for it.
Linda:
I want to thank you so much Dr. Venters for allowing us your time today. I personally want to thank you. I don’t think I’ve ever met you personally before, but you did a report when my son died in Baton Rouge, Louisiana in the East Baton Rouge Parish Prison. And I just want to thank you for the completeness and the thoroughness with which you described the conditions that he had to endure in that facility and the work that you’ve been doing all over the country highlighting and really leading on healthcare in jails and prisons.
Linda:
I’m looking forward to having a robust conversation and enlightening some people about something that we kind of quite frankly look away from. So thank you again for being here.
Homer Venters:
Well, thank you. Thanks for the welcome. I’m really thrilled to be here. I was humbled as I am, unfortunately, over and over to be part of that case, to use what are just some very minor technical skills that you have as a doctor or an epidemiologist to kind of document the truth of what happened. And then use the kind of privilege of that position to try and say, “These are the facts as I see them.” And as you said, it’s heartbreaking how common these jail and prison attributable deaths are. And it’s overwhelming how much our public health system in the country has continued and continues to ignore the health and healthcare for people who are behind bars.
Dave:
What better, or frankly worse example could we have to show the callousness and lack of care about providing healthcare for people in jails and prisons than what we’ve experienced over the last two years with COVID in these facilities.
Dave:
We wanted to start by I think highlighting at least according to the COVID Prison Project, which I think is only looking at people who are incarcerated in prisons and not even calculating the people who are moving through jails transiently all the time and getting sick, that nearly 2,900 people have died in prison from COVID. That’s not counting guards and staff. There have been an appalling number of cases. And we were just hoping you could start by reflecting on not only the experience of bringing light to COVID behind bars, but how it has sort of reinforced this callousness that we see for all healthcare of people who are incarcerated or detained.
Homer Venters:
Well, I think that my hope at the outset of COVID, the reason I kind of turned into that work almost full time, was the idea that we would get the CDC and state departments of health interested in this problem behind bars, which happened. And that we could leverage that to build a system where correctional health and the health of people behind bars doesn’t remain so disconnected from standards outside. And now I’ve become a little pessimistic about that after about, I don’t know, 40 or 45 of these COVID inspections around the country.
Homer Venters:
But I think that a couple of the really disparate experiences people have behind bars that continue today, one is that many people get sick and they’re never tested. And this really is not because of lack of access to testing equipment. There have been times and places where there was a shortage, but really, this experience at the beginning that happened where people would be in a housing area, COVID would run through the house, and they would just be left there to their own devices. That experience from March and April of 2020 is not that different than what people experienced in December of 2021 and January of 2022. Just many, many of the people who got sick, never got tested. So it’s not just that.
Homer Venters:
And some of those people got very sick and needed care that they didn’t receive, but they also didn’t get diagnosed with an infection that they contracted behind bars. And they should be. If you have a health problem behind bars, you have the right to care, which should include a diagnosis of what the problem was, especially when it comes from being incarcerated.
Homer Venters:
But the other part of this, which correctional health systems have not even begun to think about is that maybe 10%, 15% of the people who contract COVID are going to have long COVID or post-COVID illness. That is a real and serious problem. The HHS has identified this as a new form of disability, the ICD 10, the codes we use to diagnose illness. We have an ICD 10 code for post-COVID illness. But when I go to jails and prisons, I don’t see that they’ve made any effort to find these folks.
Homer Venters:
Now, if you talk to people who are incarcerated, you’ll find some of them have ongoing symptoms. I start with a question always, how long does it take for your symptoms to get better? And the idea is that that question presupposes that people will get better, but then … So it’s a conservative approach to finding long COVID. But in those conversations, I don’t know, hundreds, maybe over a thousand I’ve had, quite a few people, maybe 10% or 15% report that their symptoms didn’t go away and that’s long COVID. And almost universally, they say nobody’s asked them about that, or nobody’s changed their plan of care based on those symptoms.
Homer Venters:
So we now have a new and unappreciated, undocumented prevalence of a chronic health problem in addition to all these acute issues with managing quarantines and testing and vaccination.
Dave:
That pessimism was so hard to hear because there was this point of leverage, like you described, like maybe people will finally get it, maybe people will finally see the responsibility, or that Linda and I, and I’m sure you share is sacred where anytime you take a person’s freedom away, you have a responsibility for their care custody and control, right? Was there a turning point from that optimism to pessimism or a story or a specific moment?
Homer Venters:
Well, I think for me, and my experience is obviously just nothing compared to the actual experiences of incarcerated people in their families. But for me, it’s really the way I kind of think about it is it’s just a shifting of where I’m going to fight or work for the next five or 10 years. There was a time at the beginning of COVID I was running a little nonprofit. I thought I would grow it up. And as COVID hit, it became clear to me that my skills were better utilized going into places and telling the truth of what was happening spot by spot and making recommendations.
Homer Venters:
And I think that in similar fashion, I don’t know that I deep down emotionally feel more pessimistic. It’s just that I feel like the struggle is going to be more in terms of the tools we’ve used before, like class action litigation and monitoring, shining a light on what’s happening and with some policy reforms, hopefully. But the CDC and most of the state departments of health have not picked up what was thrown down in front of them, which is the shame that they’ve kind of run away from these places and the health of these people. So there’s also this problem that these places are much more understaffed than they were two years ago.
Homer Venters:
I just published a report or filed a report in a prison system where one of the prisons had 67% of the correctional staff lines unfilled, unfilled. So there is nothing about conditions and health that won’t be impacted by those kinds of numbers. And some places it’s 50% or 40%. But before COVID, we would talk about some of the state DOCs that were chronically understaffed, and they’d be like at 30% or 35% or 40%. And now that’s really, a lot of places would say they’re doing pretty well. And so that is going to really impact the health of people who are behind bars.
Linda:
Now that these diagnoses are being widely accepted, the impact on our communities at large, once our people are being re-acclimated back into society, how are they then now going to be able to justify getting healthcare under that ICD if there’s no medical records to prove that they’ve even had COVID in the first place? So that continuum of care is always lacking when you’re seeing these cases in this facility.
Homer Venters:
Yeah. I think that’s a great example. Unfortunately, another of many examples where things that happen to people behind bars stick with them when they go home and them and their families and their communities. And so this is kind of central. I’d say if there’s one theme to my career so far, it’s to identify the health risks of incarceration. That is, if you talk to people who work in correctional health, the first thing they’re going to tell you is, “We give care to people who never got it before, or they didn’t seek it before.” You hear that all time. Sometimes that’s true. But that does not eliminate, or even, and sometimes mitigate the presence of new health risks for people who go into jails and prisons, emigration detention settings, juvenile detention.
Homer Venters:
So people get there and they experience these new risks. And it could be that they stop getting their medicines for their heart disease. But it also could be that they have a mental health or a substance use crisis. And they’re locked in a cell. Or they get COVID and nobody documents it.
Homer Venters:
And with regard to long COVID, all over the country you’ve seen these big tertiary care centers, these big university hospitals seek a lot of federal dollars to put up long haul clinics, COVID clinics. But you know who’s never going to get into those places? People who’ve been incarcerated. And one of the primary reasons that they won’t get in there, there are a lot barriers to them ever getting there, it’s that they never got diagnosed. And so it’s a disservice. It sits with people.
Homer Venters:
When I was at Rikers, we published a lot of data around traumatic brain injury. We went out and we looked for how many people come into the jails with a history of traumatic brain injury. It was about 50%. And then we looked at all the new traumatic brain injuries that happens in the jail itself. And we didn’t … We couldn’t really compare it to anything because no other correctional health systems were tracking this, either as people come in or the new. Certainly they don’t want to track the new traumatic brain injury.
Homer Venters:
But the reason that’s helpful as a comparison is that we also know that traumatic brain injury, when you get hit in the head, there are short, medium, and long term health problems that are very consequential. So if you think about what the CDC and your state department of health do define concussions or mild traumatic brain injuries in sports, if you look at what the VA system does to find it in veterans who have been in combat or otherwise hit in the head, if you look at all of the education around CTE is on dementia long term. And then if you look at the CDC’s website or your state DOH website, I’m pretty sure you wouldn’t find one word or one dollar on all of the times people get hit in the head behind bars.
Homer Venters:
Those people are all still going home to their families. They’re trying to get back into relationships. They’re trying to get back into school. They’re trying to find a job. All of these problems that accrue to an individual after you’ve been hit in the head, they make life and social interaction difficult, that sets you and your family and your community up for higher prevalence or likelihood of dementia later on. These institutions, these clinics, the CDC or state DOHs don’t really have anything dedicated to even looking at that problem.
Homer Venters:
And so it’s a great example of the hypocrisy, and I would say it’s just rank hypocrisy driven by systemic racism around whose health are we protecting.
Linda:
Exactly. Who do we feel is worthy of that care, right? And I know you mentioned dementia and people coming and later in life after they’ve been incarcerated. But what about those individuals who are lifers, those individuals who are in the correctional system now and in need of long term care in their care in the facility? What are you finding with those types of issues? Because I know with COVID, it really hit hard on our elderly population. And there’s an elderly population, very large elderly population in jails. Well, in prisons, mostly with those who have been sentenced to life sentences. So what can you speak on about how … I mean, I know it was all just crazy, right? I mean just neglect across the board. But that long term care for those individuals who are quite frankly going to be ending their lives in a correctional facility.
Homer Venters:
Yeah. I think that if you look at state prison systems, especially, you may find that most of them have one unit or one little place for people who have either end of life or hospice or palliative care issues. And those units, everybody will talk about how amazing they are, how the people who get to those units get better care or they’re treated more humanely. And I’d say most of the time that’s true.
Homer Venters:
But what you wouldn’t get and what we never get in a correctional setting is what’s the denominator, what’s the number of people who need it. Right? All we get is enumerators. You gave out this many pills, you did this many things that you think are good. But you never get the denominator so that we can assess how much of the need did you address.
Homer Venters:
And so certainly behind bars now, in state prisons especially, we have a huge number of people who have, and I’ve just been involved in a … I am involved in a case, looking at this in a prison system where people who are medically complex, who have a lot of health, serious health issues and who also have some form of disability. So we know if we … and this is something that’s been opined on by the Pew Charitable Trust, by lots of nonprofits for a decade or more, this growing group of older and more ill patients behind bars.
Homer Venters:
But from a practical standpoint, if you’re in a prison system where you have to walk from your housing area to somewhere else to get your medicine if you’re on a daily medicine, or even if you have to walk somewhere else because you’re out of your keep on person medicine and you need to put in a slip for a referral, or you need to get somewhere for sick call or chronic care, all of those things are virtually impossible if you can’t go on your own, if you can’t get there, or in some places for people in wheelchairs then there’s nobody to push your wheelchair.
Homer Venters:
So these problems that are associated with falls, that are associated with worsening chronic health problems because people have an exacerbation of their asthma, their COPD, their heart disease, or they can’t get anywhere to get care, these problems are getting dramatically worse. And what we see is that infirmaries, which are units that were usually designed for evaluation of acutely ill people, now get used to kind of house people long term who have dementia, who have very serious long term health problems.
Homer Venters:
So the kind of needs that people have in a skilled nursing facility or a long term care setting often go unmet behind bars. So patients, I’ve certainly written about this in some of my reports, but patients who need help with their ADLs, patients who can’t get up and walk to the toilet, fall down and injure themselves, they lay unchanged in their own urine and feces for long periods of time and develop really debilitating and sometimes deadly sores and infections.
Homer Venters:
These problems are expanding dramatically behind bars because we have so many older people that states have not figured out don’t really pose a public safety risk, and also nobody has forced them to identify how they’re going to provide a standard of care for them that we expect in the community.
Homer Venters:
And the final group I think that is really important to pull in here is people who have longstanding disability, either hearing impairment, vision impairment. We have a lot of people with those two specific problems that don’t get any or many of the accommodations that they need.
Homer Venters:
And so I think that it’s a pretty grim circumstance for people behind bars who have complex health problems and some amount of disability. And that’s why, because the state departments of health are again pretty uninvolved in this and the CDC certainly is, it’s often litigation. There’s very few places where I’ve seen a department of correction proactively say, “Okay, let’s figure out the problem,” the true extent of the problems. What is the denominator?
Dave:
I think we need to sort of set the table around just what the misconceptions are around what healthcare behind bars is and what it looks like. I think you-
Linda:
That’s a great point.
Dave:
I think you’ve done a really good job of sort of articulating how what needs for care there are behind bars that don’t match your usual urgent care center or your emergency room or your primary care provider’s office. But I think we also need to dispel the notion that these are gleaming infirmaries where neatly starched, scrubbed nurses are there to attend to the every need of the health spot.
Homer Venters:
The care we find behind bars is often grossly deficient. It doesn’t meet whatever minimum standards even exist in the place you’re looking. But the way it’s deficient is pretty different from jails to prisons and immigration detention settings. Prisons have a very careful approach to trying to get people connected to the least amount of services possible.
Homer Venters:
This actually comes out of originally the effort to classify people for how much work a prison could get out of them. So you have longstanding classifications of how healthy people are or unhealthy. And the Estelle v. Gamble case really is a great example of how the prison system is designed to get work out of people. And the health system is there to not stand in the way.
Homer Venters:
And what that means is that when somebody comes into prison, they’re going to go to an intake facility or receiving facility, and they’re going to look very carefully at them to connect them usually with the lowest level of service they think they can provide. So that means if you come from a jail with a serious mental illness diagnosis or classification, they may look at you very carefully and they often will downgrade that and say, “Well, you don’t really need this level. You need a lower level.” But that, there are some things that are a prison does because they’re going to be responsible for people’s care for a longer period of time that you wouldn’t find in the jail. So thinking about what chronic health problems people are, what medicines must they get. Those things generally happen in most prison systems.
Homer Venters:
Now in a jail, people are coming in from the community, they’re coming in from this really chaotic time of arrest. Often people come into jail with a really toxic blend of acute intoxication with some substance, also withdrawal either from that or different substances and mental health crisis. And pretty much across the board what you see is a nearly universal response to that in jails, county jails, is to lock somebody in a cell.
Homer Venters:
What that does is it drives up the likelihood that they’ll die because people may be locked into a cell for what purported to be a mental health reason, but they may go through withdrawal from alcohol or benzodiazepines or opiates, which can be fatal. They may die from that while somebody’s watching them to make sure they don’t kill themselves. Similarly, they may come in and be put into a cell because somebody thinks they’re intoxicated and they may take their own lives. And so we still have this incredibly shameful statistic that suicide is the leading cause of death in US jails.
Homer Venters:
But if you look at how and why people die in jails in the United States, it’s because we’ve taken people with this really very serious and complex mix of behavioral health problems, and when I say behavioral health, I mean mental health and substances and really serious physical health problems, we’ve taken those folks and we’ve put them into these boxes where the accepted model is to defer a comprehensive health assessment for two weeks. For a decade or two, that has been kind of the accepted idea that you could have a quick interaction with a nurse.
Homer Venters:
And I’ve seen these happen in so many facilities where it might be, you’re standing in a hallway. You’re literally forced to stand up, talk in a public hallway or be in a very open space with correctional staff all around you, have a nurse ask you a few quick questions, and then that’s going to be, and maybe a quick set of vitals on. That’s what going to happen. When the thing you most desperately want is to lay down, go to sleep, eat, drink some water, and you might not be seen for a couple of weeks.
Homer Venters:
So that limited approach to finding out about health problems in jails is driven by the desire to not spend money, is to not have a doctor or a nurse practitioner see you and really comprehensively assess you.
Linda:
When you were speaking, I was just thinking about how personnel in these facilities sometimes take the path of least resistance, right? I’m here in this and I’m speaking to jail specifically because that’s my experience. I’m here. This person is coming in. Let’s not go that extra mile to actually see if there’s something physically wrong with them. In your experiences that dichotomy of the staff and how they’re dealing, are they seeing this person as a patient or are they seeing them as an inmate or a number?
Homer Venters:
I think that I am a firm believer in the need for systems to support staff and deliver care to patients so that we don’t have individual health providers being in this crucible where they’re going to have to go against what the security service wants or expects of them. But that’s the system we’ve created.
Homer Venters:
Sometimes I describe myself as a health administrator when I want to make the point that that’s the most boring sounding thing you could say. But health administration, this idea that we don’t just field a team of doctors, nurses, social workers, but we have people that are thinking about how they work, whether they can provide their care ethically, and do they provide care with the level of quality we expect.
Homer Venters:
Right now, most of those questions are answered by sheriffs and departments of correction. So the security people who put out a contract for an RFP for correctional health services, or the people who run the state department of corrections, they’re the ones who make these decisions about what’s the adequate scope of care, like what types of care should be provided, and what’s adequate quality of care. And we wouldn’t accept that in other communities, into a hospital, a nursing home certainly, at a dialysis center, but we do behind bars.
Homer Venters:
And so what it means is every day in solitary confinement in the United States, you have some amount of nurses usually who go on the solitary units and they do something called nurse rounds. But if you review video or if you watch those rounds, you’ll see that those nurses scurry on and off those units so quickly, they usually don’t go to every cell, even though there’s a policy that says, they certainly don’t check in with every person to say, like to try and figure out what’s going on, but on paper, there is some system that exists.
Homer Venters:
Now the difference is that because it’s not health people that oversee this healthcare, it’s both security people, and then it’s also the kind of risk management, risk mitigation lawyers from the county or from the state who are just trying to fend off the next lawsuits. They’re trying to figure out what’s the minimum we can do to defend ourselves to say we did something. Behind bars, you actually have to go through many more steps, again, as a lay person to show that this person got sick from this problem that existed at this time and that these people definitely knew about it, who were running it.
Homer Venters:
And that again comes back to the systemic racism at the base of why we have these different standards for people behind bars, even though these are the same health problems when it comes to chronic care. And some of the problems, health problems are endemic, physical and sexual abuse, infection. Those are things that we know, everybody knows grow out of incarceration, are kind of natural to incarceration.
Dave:
Yeah, that’s the threshold that I always struggle with. And for someone who’s listening, who hasn’t heard the term deliberate indifference anymore, the way I always like to characterize it is in these lawsuits behind bars, you don’t just have to prove that the facility or the sheriff or the jail guard was negligent. You have to prove essentially that they were evil. That’s oversimplifying it a bit, but that’s generally the threshold that we’re talking about in these cases.
Dave:
And when you have the spreadsheet and the risk manager and the healthcare system and the sheriff and the lawyers and the bureaucrats involved to just come up with a bare minimum level of care and control that they need is an incredibly difficult bar to clear. But also, the disparity between what people think is the value of their own healthcare, right? Oh, they shouldn’t get better care than me, or maybe the poor healthcare should be part of the punishment.
Homer Venters:
I do think that it’s important to recognize the opportunities to build a more equitable or a more humane system when they come up. And so I wouldn’t say that I’ve given up on the ability to do this with COVID. But I think it’s different than what I thought. I thought the CDC would just be like, “Oh yeah, we see this. We see that more people get sick from COVID and die from COVID behind bars. So we’ll take it upon ourselves to do this.” Well, they have, right? Or they’ve done some work. They’ve put out guidelines, which have been very helpful.
Homer Venters:
But for instance, they’ve been mostly silent on release as a public health tool. Even though we have good evidence that both from the inside and the outside, that is a better way to approach it, lots of upsides to COVID management.
Homer Venters:
But we do have policy makers. We do have, so for instance, the Senate has just announced a joint … I don’t know if you call an investigation inquiry into care being provided by the federal bureau of prisons that’s going to look closely at COVID care. So I think that there are some places, and there’s some states. In my state of New York, my old boss, Dr. Mary Bassett, who really championed a lot of the efforts at documenting the health risk of incarceration. She’s now the Commissioner of Health for the whole state. So I think that there are some places where you have some capacity.
Homer Venters:
But I think that we do have not just with COVID, but with things like opiate overdose deaths. In the last decade, we have a lot more awareness around opiate overdose deaths, maybe because more white people are dying from opioid overdoses.
Dave:
I think certainly-
Linda:
Exactly. We could agree on that. Definitely.
Homer Venters:
But I think that we have, or hepatitis C treatment, those are areas where community health structures have kind of like said, “Oh, this is a problem. That’s a problem.” I think that where I always go back to though, is that we have to syndicate or agree on this principle that we need independent oversight of these places by health professionals. It comes back to, for me going to local and state commissioners of health and saying like, “Why aren’t you involved? What’s the reason? What’s your … ” And particularly when those institutions and those people use the word disparities, or they dare to say systemic racism, which most of them won’t, but when they bring up these notions, for me then it’s like, well, there are places that are clearly disparate in care. Why aren’t you involved?
Linda:
Just in your opinion, in your experiences, what would work? I mean, because there have been attempts at this again, right? I mean, you have these facilities that end up investigating themselves. You’ve got the risk management lawyers telling everybody at least their bare minimum, what to say they did even if they may or may not have done it. And then you’ve got this … The police are always telling the truth. The corrections officers are always telling the truth. The administrations are the only ones that you can trust. So that when someone tells you that they’ve been harmed or you get that interview of the event that happened, then it’s not believed.
Linda:
So in your experience, I mean, what do you think is one of the best practices that can be initiated to hold these people accountable and really have transparency when it comes to healthcare in these jails and prisons?
Homer Venters:
Yeah, I think that that’s really, I mean, for me, the most important area to think about and try to work on. We have these two sides of the coin. We have transparency and we have accountability. I think you can see cities and maybe states, but certainly cities and counties where they’ve tried to set up some sort of transparency. So the New York City for instance has a board of correction, right? And they technically oversee and have ordinances or guidelines that have the weight of a local law over the healthcare in all the city jails. So I would report to them, the city reports to them all the time about what’s happening, both the health service, which is an independent security service.
Homer Venters:
But what you see is that they don’t really have much power. So a really profound time recently, a series of board meetings where the board members who are the oversight are asking the department of corrections, when do you think you might be able to follow the rules? When do you think? We really would want you-
Dave:
Not to bother you, but, yeah. Right?
Homer Venters:
Yeah. I think that to be … I have great respect for a lot of people on the board, but that’s the position we’re in. In most places we don’t have transparency or accountability, but in some places we have built in some transparency.
Homer Venters:
I think that we must have the same power because this is fundamentally a power issue that stands behind whether or not a hospital gets to operate, has to stand behind whether or not correctional health is adequate. These power structures, somebody gets to decide, for instance, if it’s safe or unsafe to send another ambulance to a hospital. And there’s a whole complex set of decisions about a hospital going on diversion.
Homer Venters:
Nobody’s saying that we’re not going to put people in hospitals. Nobody’s saying that a patient with a heart attack shouldn’t get hospital care absent a few very extreme circumstances during the worst moments of COVID. But generally we have a system set up to say, these are the standards of care in hospitals and clinics. You have to follow them. And if you don’t, there are consequences that go at your ability to keep doing this job.
Homer Venters:
We have to have that level of power and those teeth in the assessments and accountability for our correctional health services work. And so that requires the state department of health who want nothing to do with this world. They want nothing to do with it. So you can see in a couple states how this can start. So New York State probably, I don’t know, 15 years ago, New York passed a set of laws, putting the state DOH with some oversight over care for HIV and hepatitis C for everybody who’s incarcerated in New York State. So there is an office in the state department of health for New York that has to look at whether or not that area of care is adequate. And around the country, you can see some other similar efforts.
Homer Venters:
Those are the efforts that I think we need to grow on, and COVID is a pretty easy set of breadcrumbs to follow is that we may have more waves. We have other pandemics. One of the other things we don’t talk about that’s really becoming relevant behind bars is as climate change occurs, we have more and more jails and prisons that are air conditioned, where people who we know are heat sensitive. So they have something about them that make them more likely to have heat stress and heat stroke, and die. Those are things that DOHs know about and could be looking at. But we need that level of power behind the accountability. Otherwise, I think we all could name a whole series of prisons and jails that have been under receivership or federal monitors.
Homer Venters:
And I work as a federal monitor in a couple of places. And I believe that that’s an important process right now, but I don’t believe it’s sufficient to get us to the point that we want to get to.
Dave:
Boy, if you don’t understand the cascade effect after we’ve gotten the climate change affecting this problem, I don’t know what’s going to get through to people to understand the impacts that it’s having on all of our communities.
Linda:
So I’m going to be optimistic that there’s change, but it’s got to start in the hearts and minds of each individual in this country.
Homer Venters:
I think that one of the things I’ve seen in the last few years is that I feel like when I started in this world, we often would end up in this kind of dispute about this being abolitionist mean that you can’t care about conditions. And I think Dave, you alluded to this earlier. I certainly have been a big supporter. There’s a couple groups that I am a strong, strong supporter of, and really look to in terms of how I learn about conditions of FAM Foundation, WRAP, and also just Leadership USA. Those are groups that are led by and focused on the experiences of people who are incarcerated and their families.
Homer Venters:
What I’ve seen in the last few probably five years is that those groups have more connection to policy makers and health leaders than certainly when I started. And that’s incredibly important and that gives me optimism. Because what it means is those groups that have marshaled the real actual experiences of people and justice system and have used that power and smarts and capacity to get the ear of senators and Congress people in some state legislatures, not all. I think a great example is this incredibly, this limbo that people were in who were released from federal prison, these 4,000 or 5,000 people that were released during COVID, and then it was unclear if they were going to have to go back or not. Even though they had been out living with their communities, working, things like that. And those groups really were effective. And finally getting the DOJ and national policy makers, at least from my outside perspective, to come to a conclusion on behalf of those folks.
Homer Venters:
So I think those kind of, the power and the voice of those groups gives me a lot of hope for what we can accomplish. Because as you said, Linda, these truths have been there forever.
Linda:
It validates what, what my people and what people who are incarcerated are saying about their experience. Right? They can tell people about it. But it’s validated by the work that you do because that’s the actual evidence of it all. So again, thank you so much for your time and I just appreciate it so much.
Homer Venters:
Well, thanks. It’s really a pleasure and honor to be with you both. I’m left with, in the COVID work, kind of going back to where we started, one of the most common things that you run across that you know very well from talking to people is that people don’t want to report sometimes their symptoms of COVID because they’re going to go into the shoe. They’re going to go into the box or the … And I’ve had people tell me that their experience being sick with COVID and medical isolation in a solitary unit is worse than actually being in solitary for multiple of reasons.
Homer Venters:
I will say though, that coming back to this room for optimism, I have come across facilities that have decided to do it differently where when people have COVID they go into a housing area, but the doors don’t have to lock, which there’s no infection control reason they have to lock because people already have COVID, right?
Dave:
Yeah.
Homer Venters:
That people can move around, that people can have their property. People can talk to their families. I have come across places. And these seem like minor things from the outside when we talk about undoing mass incarceration, which is true. I think that trying to undo mass incarceration is our goal. But it is just so crucially important, at least from where I sit in this myopic perspective, to think about how to instill humanity and agency, especially when anything to do with health has been invoked.
Homer Venters:
So a medical isolation setting should not be punitive. It often is, but there are ways we can change that to make it less punitive or to make it not feel so horrible. So I think that that certainly goes to the justice system at large, but behind bars, I think there are many ways that we can deliver better healthcare. But again, the people that will make this standard and not anecdotal are the people with power, and that’s our state DOHs and our CDC. So anyways, I just thank you so much for the great observations and discussion.
Dave:
Dr. Homer Venters is a physician, an epidemiologist, a nationally recognized leader in health and human rights. He is a Clinical Associate Professor at the NYU College of Global Public Health and the author of the book, Life and Death in Rikers Island.
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