The New Yorker - Starved in Jail

The following article appeared in The New Yorker and is published in the April 14th, 2025 print edition. "Starved in Jail" is written by Sarah Stillman, a staff writer for The New Yorker. Stillman previously wrote an investigative feature on the felony murder doctrine, "Sentenced to Life for Adccident Miles Away," which was featured in the December 2023 print edition of The New Yorker and won the 2024 Pultizer Prize in Explanatory Reporting.

Excerpts from "Starved in Jail" appear below.

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Carlin Casey first considered the idea of human starvation when he was seven years old. Back then, in 1992, his mother, Mary, read aloud to him and his little sister, Karina, from an unusual bedtime story, Anne Frank’s “Diary of a Young Girl.” The family led a life of relative abundance. At their pueblo-style home in California’s Coachella Valley, Mary blasted Madonna in the kitchen as she made her kids burgers or big plates of spaghetti, lighting candles and burning essential oils (“for the vibes,” Carlin told me). Curled up in bed, listening to his mother describe Anne Frank’s privations, Carlin wondered, what was it like to experience a hunger so cutting? “Now, when I look back on it,” Carlin said recently, “I think maybe that was my mom’s way of trying to warn me—trying to prepare me for how cruel the world can be.”

The memory returned to Carlin years later, in August of 2022, when his then partner, Eric, drove him to Banner-University Medical Center, in Tucson, Arizona. The pair walked into the emergency room. There, Carlin found his mother, looking skeletal in a hospital bed, wearing a diaper. When he’d last seen her, that spring, Mary was a healthy hundred and forty-five pounds, her cheeks bright. Now she was so emaciated that Carlin gasped. “She looks like a famine victim,” he told Eric. He stepped closer.

Mary could barely speak. She worried that Carlin wasn’t actually Carlin. She’d spent the whole night screaming in pain and fear. Her jailers, she believed, might come back for her. “You don’t understand,” she told her son, who she thought might be a robot, or a co-conspirator. “They’ll do whatever they want!”

Carlin told his mom that he would investigate. He’d figure out how she had wound up in such a dire condition, and he’d identify who, exactly, was responsible.

Carlin had no idea he was stepping into a scandal that involved health-care corporations with, in at least one case, an annual revenue of roughly a billion dollars—a scandal that implicated core institutions of American public life and affected a shocking number of victims across the country. At its worst, the wrongdoing involved state-sponsored homicides of the most vulnerable citizens, covered up by private companies and county officials.

Since the seventies, private companies have offered a solution by taking health care out of the counties’ hands. Often, a company like NaphCare signs a contract with a county to provide medical and mental-health care at a capped cost; any additional money expended on care comes out of the corporation’s earnings. The companies often try to control their costs by understaffing, Eric concluded from his research. According to a 2020 examination of jail-death data by Reuters, jails that provided health care through the top five companies in that market—including NaphCare—had death rates that were eighteen to fifty-eight per cent higher than those of jails whose medical services were publicly managed. Of the five companies studied, NaphCare had the highest death rate across a three-year period. Eric spent nights at his laptop, downloading legal filings against NaphCare that alleged horrific deaths from neglect or substandard care. “I kept wondering, why on earth did Pima County hire them?” Eric said.

During the past year, I found it hard to explain, to family and friends, a strange truth. I was reporting on places where starvation and dehydration deaths had unfolded across a span of weeks or months—but these were not overseas famine zones or traditional theatres of war. Instead, they were sites of domestic lawlessness: American county jails. After meeting Carlin, I identified and scrutinized more than fifty cases of individuals who, in recent years, had starved to death, died of dehydration, or lost their lives to related medical crises in county jails. In some cases, hundreds of hours of abusive neglect were captured on video, relevant portions of which I reviewed. One lawyer, before sharing a confidential jail-death video, warned me, “It will stain your brain.” It did.

The victims were astoundingly diverse. Some, like Mary, were older. Some were teen-agers. Some were military veterans. Many were parents. In nearly all the cases I reviewed, the individuals were locked up pretrial, often on questionable charges. Many were being held in jail because they could not afford bail, or because their mental state made it hard for them to call family to express their need for it. (These jail deaths would not have occurred, several lawyers pointed out to me, in the absence of the cash-bail system.) Others were awaiting psychiatric evaluation or a court-mandated hospital bed. Often, the starvation victims were held in solitary confinement or other forms of isolation, which is well proved to deepen psychosis. Some were given no toilet and no functioning faucet, or were expected to sleep on mats on concrete floors, in rooms where the lights never turned off.

What’s more, jail-death data are surprisingly hard to obtain. In most states, the details are not publicly accessible. When my colleagues at the Investigative Reporting Lab and I filed more than two dozen public-records requests with local sheriffs, many stonewalled us; most didn’t seem to keep clear data on starvation cases. We sought detailed records, for instance, on any fatalities in Los Angeles County jails since 2015 that showed a cause of death related to dehydration or starvation, offering up a long list of search terms. We heard back from the sheriff’s department: it was “unable to identify any records as responsive” to the request. But, when it later provided a list of all in-custody jail deaths in the county, we discovered cases such as that of Sergio Silva, who, at thirty-three, died of “dehydration due to history of mental confusion.” (His cause of death was listed as “natural.” So, too, we found, are the vast majority of starvation and dehydration deaths in jails.) We also requested a list of inmate deaths at the Pima County Jail since 2019 associated with a similarly long list of search terms, and we asked that, if such data were not available, we be given a list of all deaths by natural causes or else all jail deaths. The sheriff’s department replied, “We do not have any inmate deaths that meet this criteria.” We later discovered that at least twelve people, most of them under fifty, had died of “natural causes” during the time span we’d specified. Where had the evidence of these deaths gone?

“Right now, we have multiple starvation cases, and multiple dehydration cases, too,” Dan Smolen, a civil-rights attorney in Tulsa, Oklahoma, said. “I believe this is the civil-rights violation of our lifetime. Starvation deaths, though often unreported, do not go unwitnessed in jails.“These deaths are so prolonged, with tons of people observing them, and each death could easily be stopped at any point in the time line,” Smolen said. “So it’s crazy that that many people would allow this to happen.”

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You can read the full report, "Starving in Jail" in the April 14th 2025 print edition of The New Yorker, or at The New Yorker magazine website.

Sarah Stillman, a staff writer with The New Yorker, won the 2024 Pulitzer Prize for explanatory reporting. She also received the 2012 National Magazine Award for Public Interest and the 2022 George Polk Award for Magazine Reporting. She teaches writing at Yale, and is a MacArthur Fellow.