Market Care and Custody: A Health Policy Analysis of Incarceration and Long-Term Care Systems in the U.S.

The United States has one of the world’s largest criminal justice systems, with nearly 5.5 million people under correctional supervision and almost 2 million incarcerated. This scale of confinement, coupled with the rise of privatization across correctional and related services, reflects a broader neoliberal trend in public governance. This paper explores the consequences of privatization and marketization of the U.S. criminal justice system—particularly the proliferation of private prisons and immigrant detention centers—and draws parallels to the consequences of privatization of health and social care, especially long-term care (LTC). Both systems reveal shared logics of marketization that prioritize profit maximization, efficiency, and cost-cutting at the expense of care, justice, and equity. Relying on interdisciplinary perspectives from public health and criminology, this paper situates private corrections within the health policy framework of the Commercial Determinants of Health (CDoH), arguing that privatized carceral institutions not only harm incarcerated individuals but also endanger workers, families, and surrounding communities through systemic under-resourcing, precarious labor conditions, and structural violence. By comparing the private, for-profit prison industry with private for-profit LTC systems, we illustrate how these structures have commodified both care and correctional systems. These findings suggest that privatization within carceral and care sectors perpetuates health inequities and reinforces cycles of racial, gendered, and economic disadvantage. Accordingly, this paper calls for strengthening publicly held models and a reassertion of public accountability and interdisciplinary collaboration to restore social justice, health, and human dignity as central organizing principles of both systems for residents, workers, their families, and communities.