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Health Professionals Join the Fight Against Jail Construction in Los Angeles

by David M. Reutter


Los Angeles has historically been a trail blazer in the expansion of policing and incarceration. Its 2020 abandonment of jail expansion plans revealed a new group of advocates against expansion of incarceration: medical and public health practitioners.

With over 19,000 people held in its county lock-ups, Los Angeles has the largest jail system in the world. Like the rest of the United States, it began building that infrastructure in the 1980s. The result is that the U.S. has the highest per capita incarceration rate in the world.

“The growth of carceral institutions had no clear connection to reported crime rates,” wrote Mark-Anthony Clayton-Johnson, Shamsher Samra, and Jeremy Levenson in an article that appeared in the American Journal of Public Health. “It did, however, coincide, not coincidentally, with the flight of industry overseas, as well as shrinking social welfare.”
The authors of the article used the “2012 to 2019 campaign against jail construction in Los Angeles, California, as a case study to propose that the health community is a natural and needed ally in the movement for abolition.”

In 2015, the Los Angeles Board of Supervisors listened to the urging of advocacy groups and decided to pause plans to expand its jail system. That move was a reversal from decades past where jail expansion proceeded without any real consideration of factors beyond the rhetoric of the “tough on crime” agenda that prevailed at the time. The Supervisors hired an external consultant group to guide their decision. The group listed correctional health as an area of expertise. Just two months later, the group recommended the same size jail as originally planned. It, however, recommended changes to the design to “meet the future population’s health needs which they expected to grow in medical and psychiatric complexity.”

Their recommendations created disbelief from advocates against jail expansion: how could health be a reason to build a jail? That reasoning provided the catalyst to abandon the expansion plan.

The unprecedented reversal came as a result of a grassroots political movement. Community groups across Los Angeles united as the JusticeLA Coalition. They were formed in tandem with the Movement for Black Lives. JusticeLA pushed campaign slogans such as “Care, Not Cages” and “Can’t Get Well in a Cell.” They argued that “Los Angeles should not build a jail because jails can never meet the health needs of incarcerated people and their wider communities.” JusticeLA argued that a growing jail population represented a health crisis.

In response to the silence of health professionals in the campaign, Clayon-Johnson, one of JusticeLA’s leaders founded Frontline Wellness Network. “The network pointed to the tradition of health professional engagement in movements for racial and economic justice,” Clayton-Johnson, Samra, and Levenson wrote. Health professionals responded by writing letters, signing petitions, submitting public comments, organized and attended demonstrations, and met with Supervisors. “They elaborated the many services needed by their patients, instead of incarceration…. Their voices contributed to the transformation in Los Angeles, where 8,000 fewer people were incarcerated in July 2020 compared with 2012.”

In July 2020, the Board of Supervisors passed a motion to close Los Angeles’s largest jail without adding new beds elsewhere. In doing so, they frequently cited health as a reason to reduce jail capacity. This paradigm shift to care rather than punishment signaled a commitment to “care first, jail last.”

Clayton-Johnson, Samra, and Levenson urged health professionals to “add their voices to local policy and budget debates on the criminal justice system and help build social institutions highlighted in multiple publications.”

At a Board of Supervisors meeting in June of this year, the plan was re-assessed, coming up on the one-year mark of the initial vote.

The board reviewed a March 2021 a report by the MCJ Closure Workgroup, which provided a plan estimated to take 18-24 months. The plan redistributes some prisoners across other jails, while releasing about 4,500 people into residential programs or community treatment.

Sheriff Alex Villanueva, who has had an adversarial relationship with the Board’s position, continued to oppose the plan, saying that “releasing 4,500 inmates onto the streets is not a legal option for the county ... and trying to cram 12,500 inmates into 8,500 beds is ... unconstitutional.”

Board Supervisor Janice Hahn also stated that she believed 3,000 prisoners currently in county jails are there due to a pandemic-related moratorium on transfers to state prisons.

The sheriff added that “Government code section 22605 clearly states that the sheriff runs the county jail, and I have full intention to carry out my mandate.”

Supporters for the MCJ Closure Workgroup plan reminded the Board that the jail population would be reduced dramatically by releasing people who are pre-trial detainees for non-violent crimes.


Source: American Journal of Public Health, with an update from

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