"You're an inmate just deal with it": experiences of formerly incarcerated individuals in New York City during the COVID-19 pandemic

The onset of the COVID-19 pandemic posed uniquely dire challenges in New York City's jails. Rates of infection and fatality well exceeded those of the general population as the virus spread through congregate residences, heightening the city's status as an early epicenter. Using an inductive, grounded theory approach, we conduct 12 in-depth interviews with persons incarcerated in these jails early in the pandemic to elicit their perspectives on the carceral system's ability to deliver healthcare services and a safe residence. Participants describe concerns of overcrowding, insufficient protective equipment, and difficulty accessing healthcare through a lens of interpersonal hierarchy, illustrating how their relationships with one another and with jail staff determined their access to public health measures. The data highlight how incarceration revokes individuals' autonomy and imposes a power dependent, hierarchical relational structure. That context complicates or precludes the development of mutual trust needed for effective public health interventions. We posit entrusting external entities with health communication during a disease outbreak as a mitigation strategy.