Article 9: Measuring Violence and Harm Reduction in Correctional Institutions: Toward a Public Health Surveillance Model

https://doi.org/10.65264/KLCW5873

Violence, self-harm, and injury among incarcerated people and correctional staff are persistent challenges. To measure these concerns, correctional systems often rely on incident reports, disciplinary records, and use-of-force documentation, which provide an incomplete picture of the harm occurring. This article describes a best-practices approach for measuring and reducing violence in correctional institutions by applying a public health surveillance model. Evidence shows that official records capture a fraction of violent events due to underreporting, definitional inconsistency, and administrative incentives. Clinically grounded injury surveillance that is anchored in urgent or emergency health encounters, serious injury determinations, and related outcomes offers a more objective measure of experienced harm and fills in the gap of missing data from administrative measures of observed and adjudicated violence. Empirical studies, national injury surveillance data, and oversight audits all show gaps between correctional incident reports and clinical findings. Taken together, this evidence supports an integrated public health surveillance model that measures four domains: observed violence, adjudicated violence, harm to incarcerated individuals, and harm to staff. Integrating these domains can reveal hidden violence, identify systemic safety failures, support prevention-oriented interventions, and strengthen accountability for institutional conditions that generate harm.

Keywords: Correctional Health Care; Prison Violence; Injury Surveillance; Public Health Surveillance; Institutional Safety Climate; Underreporting