Prison population reductions and COVID-19: A latent profile analysis synthesizing recent evidence from the Texas state prison system

Vest, N. A.; Johnson, O. D.; Nowotny, K. M.; Brinkley-Rubinstein, L.

Importance: People in prison are particularly vulnerable to infectious disease due to close living conditions and the lack of protective equipment. Public health professionals and prison administrators seek information to guide best practices regarding prison population to capacity rates for the COVID-19 outbreak. Objective: Using latent profile analysis, we sought to characterize Texas prisons on levels of COVID-19 cases and deaths among incarcerated residents, and COVID-19 cases among prison staff. Design: This observational study was a secondary data analysis of publicly available data from the Texas Department of Criminal Justice (TBDJ). Data were downloaded and analyzed on July 24, 2020. This project was completed in collaboration with the COVID Prison Project. Setting: One-hundred and three prisons in the state of Texas. Participants: The unit of analysis is the individual prison units that comprise the TDCJ. Exposures: None Main Outcomes and Measures: Latent profiles on levels of incarcerated resident COVID-19 cases, staff COVID-19 cases, and incarcerated resident COVID-19 deaths. Results: We identified relevant profiles from the data: a low outbreak profile, a high outbreak profile, and a high death profile. Additionally, current prison population and level of employee staffing predicted membership in the high outbreak and high death profiles when compared to the low outbreak profile. Conclusions and Relevance: Housing persons at 85% of prison capacity may minimize the risk of infection and death related to COVID-19. Implementing this 85% standard as an absolute minimum should be prioritized at prisons across the US.