Call Us: ​ 225.324.6989

Monthly Health Highlights

Archived Articles


Louisiana tops a number of lists, some good and others not-so-good.  We boast several of the happiest U.S. cities and have the highest percentage of native-born residents of any state.  We also have world-class cuisine and popular culture, notably music. We do, however top several “bad” lists, including the nation’s highest murder rate, the highest STD/HIV rates and the highest incarceration rates per capita (over 1,400/100,000, double the U.S. average of 700 and 14 times higher than European rates of 100/100,000.)  

This disturbing incarceration statistic accompanies another sinister statistic, that 75% of the inmates are African American despite the fact that they are only 30% of the general Louisiana population.  How did it happen that we lock up more people than any other state and that most of them are Black?

The growth of the prison complex has occurred incrementally, yet represents a constant in Louisiana.  Since our rate is 1,400/100,000, it means that we have around 63,000 incarcerated adults, a huge number that is equivalent to the entire population of Alexandria and half of Rapides Parish.  You might say that the prison industry is flourishing. That would be true since a vast army of guards, administrators and ancillary staff find employment there. Yet this industry also comes at a cost, both financially and in human terms.

Mandatory sentencing laws, often dating back to the Clinton administration, as well as those relating to minors, have filled Louisiana prisons with non-violent offenders.  Besides not being able to vote while in prison, a felony conviction carries with it a lifelong stigma, as well as an inability to benefit from public housing, supplemental food programs, and other government programs after release.  Worse yet, most employment applications contain the check box for “Have you ever been convicted of a felony.” Since this can be anything from drug possession to murder, most employers consider a prior felony to be an exclusion criteria for job consideration.  The result becomes unemployment and recidivism leading to a high rate of re-incarceration, thus perpetuating the prison cycle.

Incarceration also creates high financial and psychological burdens for the families of prisoners.  Social stigma, loss of income, impact on children and spouses, disintegration of social networks and supports, all affect the larger community, mostly in very adverse ways.  Since incarceration limits income potential and possibilities of traditional education, lowering of those two critical social determinants (income and educational level) also negatively affects health.  

Incarceration and its consequences can reduce life expectancy, whether directly or indirectly.  In fact, Black males live around 5 years less than White males and over 7 years less than White females.  A huge contributing fact to reduced life expectancy is death among Black adolescents where homicides (rather than motor vehicle accidents as among Whites) represent the biggest cause of death.

Homicides not only reduce life expectancy through immediate deaths, but those who are incarcerated are also doomed to live shorter lives, either through execution (a small number) or because of reduced social determinants of wealth, education or social status and resulting poorer health outcomes.

Some initiatives should be attempted to reduce incarceration rates and their social costs: (1) Mandatory sentencing should come under scrutiny, especially for non-violent crimes. (2) The age of prosecution as adults needs to been raised (and has been recently), keeping younger non-violent offenders from getting into the revolving door of prison. (3) Banning “the box” (eliminating the check box for felony convictions, at least on initial job applications) should be implemented. (4) “Rocket dockets,” or expedited judicial proceedings, should be used to divert non-violent offenders from the prison system.

Keeping young people, especially African-Americans, out of the morgue and out of prison should be a priority.  Louisiana needs other growth industries besides prisons. We must get out of the top of many of the bad lists, specifically incarceration rates, but also murder, infant mortality, percent children in poverty and obesity rates as well.

For a state blessed with abundant natural resources, we must not squander our human resources by throwing them into prison.  A healthy society is a well-educated and prosperous one. We cannot incarcerate ourselves to prosperity, or even to public safety.  Let’s find solutions to enhance the lives of all our citizens by giving them opportunities besides crime and punishment.

David J. Holcombe, M.D., M.S.A.