Solitary confinement does little to rehabilitate inmates, is extremely expensive (where the average per-cell cost is $75,000), and exacerbates health problems — yet the American prison system is over-reliant on solitary confinement. In fact, a 2018 report found that, 61,000 individuals were being held in solitary confinement across the US. While the living conditions in such units are known to be associated with adverse health outcomes, we still don't understand the lifetime cardiovascular burden (i.e. the direct and indirect costs) associated with solitary confinement.

To explore the health consequences of solitary confinement, Brie Willams and her colleagues compared the lifetime cardiovascular health burden from solitary confinement, relative to those of inmates who were not held in isolation.

The researchers first looked into public data from a 2015 lawsuit. This data contained descriptions of hypertension diagnoses among two groups of men: individuals in the first group who were held in a prison’s solitary confinement “supermax” units (the “Supermax Unit Group”), while individuals in the second group were housed in regular, less-isolating maximum security units (the “Less Isolated Group”). Both groups’ levels of loneliness were measured with the UCLA Loneliness Scale.

The researchers then used the Cardiovascular Disease Policy Model to estimate and compare the lifetime burden of cardiovascular problems for both groups, while accounting for potential factors, such as socioeconomic factors, which may affect comparisons. Medical costs associated with the cardiovascular disease burden were also estimated using California’s health costs, and these estimates were then deflated to the U.S. national average costs.

The study found that the hypertension rates were 31% higher in the SuperMax Unit Group than those in less-isolated units. In addition, about a third of the SuperMax Unit Group were more likely to experience heart attacks, strokes, and higher scores of loneliness.

In fact, the authors point out that if their findings were applied to simply 25,000 individuals held in “supermax” solitary confinement units, this alone would result in $155 million in additional future healthcare costs — and would likely still be an underestimate as there is a widespread use of solitary confinement beyond “supermax” units.

These findings call for a reform in American prisons. Evidence already shows that solitary confinement is counter-productive — this is one more study which points to the health consequences of solitary confinement.