Even before this past week, carceral institutions have been in the news as the prison and jail boom of the past forty years has intensified the damage of the Covid-19 pandemic. Mass incarceration has a devastating effect on public health. For the past two decades, as counties across the country have built new jails, the rural US experienced a wave of hospital and mental health facility closures. In rural Washington County, New York, where I am writing from, there are two state prisons. An abandoned hospital looms on the hill above town—closed in 2003, the same year the county built a new, larger jail.