The Carceral State Beyond Bars: Pretrial Surveillance as a Social Determinant of Health

• In Event: 21009 - Policing & Surveillance

Abstract

The carceral state extends beyond prisons and jails, shaping health outcomes through various forms of surveillance and control. While criminal legal reforms have sought to reduce incarceration through cash bail reform and risk assessment tools, these changes have simultaneously expanded the use of pretrial surveillance mechanisms, particularly electronic monitoring (EM). EM is often framed as a humane alternative to incarceration, yet it introduces distinct health harms that remain largely unexamined in medical sociology. This study draws on semi-structured interviews with 38 individuals on pretrial EM in Cook County, Chicago, to examine its impact on health. We identify two key pathways through which EM produces adverse health outcomes: (1) the uncertainty and anxiety inherent in awaiting adjudication, and (2) restricted mobility, which obstructs access to healthcare and essential services. Participants reported significant psychological distress due to the indefinite nature of their pretrial status, with symptoms including hypertension, insomnia, and anxiety. Additionally, EM’s stringent movement restrictions made it difficult to attend medical appointments or access prescriptions, disproportionately affecting Black individuals and those with chronic conditions. By conceptualizing pretrial surveillance as a social determinant of health, this study challenges prevailing narratives that portray EM as a rehabilitative measure. Instead, our findings reveal that EM functions as an extension of the carceral state, reproducing health disparities and reinforcing racialized forms of social control. These findings contribute to medical sociology by expanding discussions on the health consequences of criminal legal involvement beyond incarceration. We call for a critical reassessment of surveillance-based legal reforms, advocating for community-based alternatives that prioritize health justice over punitive control. As EM and other forms of pretrial surveillance continue to proliferate, medical sociology must address these emergent forms of carceral harm as central concerns in health equity research.

Authors

• Erin Eife, George Mason University

• Brian Tuohy, Temple University