Harvard Study Finds Accreditation Reduces Jail Deaths by 93%

Accreditation of jail healthcare services may improve patient health and reduce jail deaths by 93 percent, according to a new Harvard study.

The study examined conditions at 44 jails across the United States over four years, and hoped to find interventions that would increase the quality of healthcare offered to inmates. The research was led by Harvard Kennedy School Professor Marcella M. Alsan ՚99 and Harvard Law School Professor Crystal S. Yang ՚08 and published in the National Bureau of Economic Research.

Accredited jails, which are evaluated by the National Commission on Correctional Health Care, are held to certain standards, such as properly training personnel and ensuring that patients are seen in a timely manner.

“This piece is thinking about how we address pretty dire conditions, often, in our nation’s jails,” Yang said in an interview last Wednesday.

The study also found “suggestive evidence” that accreditation can reduce recidivism rates by over 50 percent compared to the control group.

Accreditation can cost anywhere from $5,000 to $10,000 per facility, but can generate up to $41.6 million in benefits, according to the Health Inequality Lab at the Kennedy School.

“For county decision makers or sheriffs who are interested in trying to reduce mortality and improve health of incarcerated individuals, accreditation can be a really cost effective intervention that they might consider undergoing,” Yang added.

One challenge was finding jails that we were willing to help with the study, Yang said.

“I think this is the first randomized control trial we’re aware of across U.S. jails, and after having gone through four years of working on this project, we probably understand why it was the first,” Yang said. “There were so many pieces that had to come together.”

Lucy Tu ՚24, who also worked on the project, said that it was difficult to ensure that sheriffs, accreditors, and patients were “satisfied and staying active” in the study.

Tu also said that she is excited about future research on the topic.

“My hope is that people don’t react to this study as the sort of final point, but rather see it as a really important first step in both continuing to research how we can improve health care within the criminal justice system,” Tu said.

A large team of student researchers were involved in the study, including both undergraduate and graduate students.

“I think we really do want to give a shout out to a pretty incredible research team of students that we’ve worked with over the past years,” Yang said.

James R. Jolin ՚24, a former Crimson News Editor who worked as a research assistant on the project, praised Yang and Alsan for involving students in the process.

“Their level of one-on-one undergraduate student mentorship and support has truly animated my interest in a career in public health policy and law,” Jolin wrote.

Alsan and Yang are planning to publish an additional study that estimates the impact of a law-enforcement led education program launched in Flint, Michigan’s county jail.

“Evidence suggests that that program gives people hope and better prospects — better chance at reintegrating and thinking about their lives beyond incarceration,” Yang said.

The study, which has been approved for publication and will come out later this year, found that for each additional month of exposure to the educational program, inmates’ weekly misconduct within jail and three-month recidivism decreased by 25 percent and 24 percent, respectively.

“We’re really working on expanding that project, but also thinking about other types of interventions that might make the experience of incarceration more humane and lead to better long run outcomes, not just for those individuals, but also for communities more broadly,” Yang added.

—Staff writer Caroline G. Hennigan can be reached at caroline.hennigan@thecrimson.com. Follow her on X @cghennigan.
—Staff writer Bradford D. Kimball can be reached at bradford.kimball@thecrimson.com.