Plea Bargains as Drivers of Incarceration-Related Health Outcomes

The discipline of public health has begun to recognize the structural inequities of the carceral system as drivers of poor individual and population health. The number of people incarcerated and the length of their incarceration determine the scope and gravity of their exposure to these individual and public health effects. Plea bargains all but guarantee a period of incarceration, often for many years, because prosecutors have significant bargaining power against defendants who often do not fully understand their rights or the likelihood of receiving the sentences that prosecutors would be seeking in trial. I propose and analyze several pathways through which to eliminate or severely restrict the practice of plea bargaining to minimize the health effects associated with incarceration. I conclude that state legislation would be most feasible and effective at eliminating plea bargains but, without concurrent interventions addressing mandatory minima and/or bail, would not fundamentally address the primary concerns of sentence length and overcrowding.