Building a Requiem for Rikers Island: Examining the Carceral Harms Experienced by People within New York City’s Penal Colony

Abstract

Mass incarceration represents a critical public health issue in the United States, producing profound and enduring harms for individuals, families, and communities. While a growing body of research has documented the health consequences of incarceration, less attention has been paid to how carceral systems function as environments that shape the health and well-being of all those exposed to them, including people who are incarcerated, corrections officers, and health staff. This dissertation addresses this gap by examining how carceral systems produce harm across populations confined and working, respectively, within jails and prisons, and by identifying pathways through which harm is sustained, experienced, and resisted. This dissertation integrates quantitative and qualitative data to examine the health impacts of carceral systems across three related studies. Chapter 1 uses national mortality data from 2020–2021 to assess premature mortality among U.S. corrections officers, comparing their risk to the general population and to other public safety workers. Chapters 2 and 3 draw on in-depth qualitative interviews with people formerly incarcerated, former corrections officers, and former health staff who lived or worked on Rikers Island to examine how carceral environments shape health and well-being, and how people navigate and resist these conditions. In Chapter 1, I estimate age-adjusted rate ratios of premature mortality among corrections officers relative to the general population and other public safety workers, including police officers and EMTs/paramedics. Findings indicate that corrections officers experience elevated risks of premature death, with variation by race, gender, and occupation. These results demonstrate that carceral institutions function not only as sites of harm for people who are incarcerated but also as hazardous occupational environments for those who work within them. In Chapter 2, I examine how people formerly incarcerated, former corrections officers, and former health staff experience and interpret harm on Rikers Island. Through thematic analysis of interview data, I identify shared and distinct forms of harm across groups. This analysis results in the development of the Rikers Island Spiral, a conceptual framework grounded in participant narratives and analytic interpretation that illustrates how structural conditions, institutional practices, and everyday interactions accumulate to produce compounding physical, psychosocial, and sexual harms. The findings highlight how carceral environments produce harms across groups and shape the distribution and experience of those harms. In Chapter 3, I examine how people survive, build community, and engage in acts of resistance within carceral institutions, and how they imagine futures beyond them. Participants describe a range of strategies, including collective care, solidarity, and everyday acts of resistance, that enable survival within harmful environments. They also articulate visions of reparative justice and abolitionist futures that center care, dignity, and human connection. These findings shift the analytic focus from resilience to resistance as both a means of survival and a source of knowledge for transformative change. Together, these findings further advance an understanding of carceral systems as institutions that produce harm among people confined and working within them. By centering the interconnected experiences of those who live and work within carceral systems, this dissertation contributes new empirical and conceptual insights to public health scholarship by offering evidence that may inform efforts toward decarceration, reparative justice, and the development of systems grounded in care, dignity, and human rights. Lastly, at its core, this body of work aims to begin building requiems to honor and remember the people most harmed by carceral systems and capture their thoughts on how to rebuild and reimagine worlds free of carceral violence.