As a law professor in Louisiana, the state that leads the country and world in the percentage of residents it incarcerates, Andrea Armstrong of Loyola University New Orleans College of Law had a question: How many people are dying in Louisiana’s jails and prisons?
Armstrong, a national expert on prison and jail conditions, couldn’t answer the question, a report released Wednesday says, until a research team she formed first found a way around “a glaring lack of transparency in prisons, jails and detention centers” across the state.
After sending public record requests to 132 facilities across Louisiana, Armstrong and her team of 47 law students released the 49-page document “Louisiana Deaths Behind Bars,” which reports the team’s finding that between 2015 and 2019, 786 Louisiana men, women and juveniles are known to have died while incarcerated.
That’s the number of known deaths. The number of actual deaths is still unknown. Of the 132 facilities that were sent public records requests, 38 of them (29%) didn’t respond, Armstrong’s team reports, “in violation of (the) Louisiana Public Records Act.” According to its report, the research team “has also not received any death data from federal agencies operating detention centers in Louisiana, which is particularly troubling as the number of people detained for immigration violations has soared since 2017.”
Of the 786 deaths that the researchers were able to count, the overwhelming majority (about 85 percent) were of medical causes. Suicide was the next most common cause of death at 6 percent, followed by unintentional drug overdoses at 4 percent, accidents at 1.7 percent and violent deaths at 1.5 percent.
Of those who died of medical causes, heart disease and cancer were the most common diagnoses. According to data from the Centers for Disease Control and Prevention, in 2019, heart disease and cancer were also the top two leading causes of death in the state and the country.
“Louisiana Deaths Behind Bars” is the first comprehensive study of such deaths, Armstrong said. The report not only includes the number of incarcerated people who died and their causes of death but it also provides demographic details including sex, age, race and ethnicity.
Armstrong teaches constitutional law and criminal procedure, and “Louisiana Deaths Behind Bars” notes: “Our state and federal government are constitutionally obligated to provide safe and humane conditions for incarcerated people, including constitutionally adequate health care. These obligations arise from the Fifth, Eighth, and Fourteenth Amendments to the U.S. Constitution and Article I (Sections) 2 and 20 of the Louisiana State Constitution.”
The report and its related data can be found at IncarcerationTransparency.org. Armstrong said she expects to continue updating the website with new reports and data until the state and parish jails start doing it themselves and “it’s no longer needed.”
State prisons vs. parish jails
Fully half of Louisiana’s post-conviction incarcerated population is serving time in parish jails, and the report separates the people who died in state-run facilities from those who died in parish-run facilities. It also separates the people who died after they’d been convicted from those who died before their day in court. The report even looks at where inside a penal facility an incarcerated person died.
For example, according to the report, “Medical deaths are more likely to occur in nonmedical spaces in parish jails (59.17%) than in state facilities (87.12%). This may be indicative of the fact that jails are generally less likely to have robust medical facilities behind bars, such as 24 hour infirmaries for patient treatment and observation.”
Although 558 of the 786 deaths counted occurred in state-run facilities, the report suggests that being incarcerated in a parish-run facility is a lot less safe. State-run facilities are where people with longer sentences are incarcerated and, therefore, should be expected to have more people who die there. But parish-run facilities, which typically house people for shorter stretches of time, had a far higher number of suicides, a far higher number of deaths from overdoses and a higher number of deaths from accidents and an equal number of violent deaths as state-run facilities.
The parish-run numbers may be even worse, though, because, as noted above, officials from several facilities did not provide the requested public records. “In contrast,” the report says, “the state (Department of Public Safety and Corrections), which administers eight state prisons holding approximately 16,000 people, fully responded to our requests and also sent responses for people legally under their custody but serving their sentence in local jails.”
The researchers found that 61 percent of the suicides among the state’s incarcerated population occurred in jails and 29 percent occurred in prisons. Of those jail suicides, 43% occurred when the person was being held in solitary confinement. In the state’s prisons, 7% of the suicides occurred during solitary confinement.
Armstrong said in an interview Tuesday that people held in solitary confinement are supposed to be watched more closely than anybody else.
“How are people completing this process of suicide if they're supposed to be checked every 15 minutes for visual observation?” she said.
The Louisiana Sheriffs’ Association did not return messages left Tuesday seeking comment about the data that suggests that parish jails are less safe than state-run prisons. Neither did officials from the East Baton Rouge Sheriff’s Office, the Jefferson Parish Sheriff’s Office or the Orleans Parish Sheriff’s Office.
According to the report, in the five-year stretch between 2015 and 2019, East Baton Rouge Parish Prison had the most in-custody deaths with 26, followed by Jefferson Parish with 21 and Orleans Parish with 15. (The East Baton Rouge Worker Release program had an additional three deaths).
Four juveniles are among the 786 people who are known to have died while incarcerated in Louisiana between 2015 and 2019. Three of them died of suicide: one while in a cell and two while in solitary confinement. The cause of the fourth death is not listed.
On May 24, the Louisiana House approved House Resolution 50 from Rep. Royce Duplessis (D-New Orleans) which “requests the legislative auditor to conduct an audit on the use of all forms of solitary confinement in juvenile facilities, and to submit a report to the Juvenile Justice Reform Act Implementation Commission.”
Poor medical care for the incarcerated
Armstrong said the aim of her study was to collect data, not make findings or draw conclusions, such as what sheriffs and wardens need to do differently or how Louisiana compares to other states. She did say, however, that she finds it noteworthy that, as the report says, “Approximately half of known medical deaths were related to a preexisting medical condition, indicating that half of medical related deaths were due to conditions first diagnosed by prison or jail medical staff.”
Armstrong is an author of a report submitted to the Louisiana Legislature in May called “Adequacy of Healthcare Provided in Louisiana State Prisons.” She said Tuesday that the healthcare report found that people incarcerated in Louisiana don't receive adequate preventive health care such as annual checkups or get to see physicians who are specialists; therefore, a case of cancer or heart disease may be more advanced when it’s detected in a person serving time.
Prisons will have a more robust treatment space where they can actually admit and observe incarcerated patients,” Armstrong said. “Whereas jails are less likely to have a space for continued observation and treatment. It raises the question of whether (incarcerated people) are being diagnosed early enough in the disease to ensure that treatment options … are available,” she said.
Norris Henderson, founder of Voice of the Experienced, which advocates for incarcerated and formerly incarcerated people, agreed that jails aren’t as equipped as prisons are to provide medical care.
He said copays to see a doctor are so expensive that many incarcerated people don’t seek care unless it’s too late. And often, a security guard determines whether a patient should see a doctor or not, he said.
“Most of the people making these decisions are nonmedical personnel,” Henderson said. “They're nonmedical people and making these life-or-death decisions on behalf of people.”