The Metropolitan Correctional Center (MCC) recently made national news as the site of convicted sex offender Jeffrey Epstein’s apparent suicide. Among the details describing the jail’s failings were not only accounts of staffing problems (e.g., guards falling asleep on the job), but also the horrible physical conditions—from pests to raw sewage contaminating the space.

While that latter imagery is striking, it’s not particularly unique. America’s jails are full of environmental hazards that stand to compromise the physical and mental health of the people who work and live within them. One of the most egregious problems: Filthy conditions in jail cells and common areas, particularly those involving human waste and other biological hazards, that have resulted in claims of unconstitutionality due to cruel and unusual punishment.

Built atop a landfill, Rikers, another jail in New York, is plagued by dangerous amounts of poisonous methane gas, damaged water pipes, and an unstable foundation. Recently, Manhattan Borough President Gale Brewer called on the city to recognize Rikers’ “insufferable environment and the culture of violence and abuse.”

Overflows of raw sewage in San Francisco’s main jail that made people sick led to a class action lawsuit against the City and County of San Francisco, the Sheriff, and other law enforcement personnel. Civil rights lawyer Yolanda Huang, who filed the action, told the San Francisco Bay View that “inmates who have come into physical contact with the sewage have developed skin rashes...intestinal problems, lung problems, breathing problems and headaches.”

In South Carolina, people who were incarcerated at the Lieber Correctional Institution in December 2018 were exposed to floods of human fecal matter after a backup. Residents were reportedly forced to eat meals in the cells that were flooding with raw sewage before jail staff instructed them to clean up the mess. In Pennsylvania, residents of the Fayetteville County Jail faced similar conditions between 2013 and 2017 as a result of “raw sewage running through cells, roaming rats, roaches, mice, and lack of running water.”

Residents were reportedly forced to eat meals in the cells that were flooding with raw sewage.

Exposure to raw sewage and related contaminants, can lead to illness due to the bacteria, funguses, parasites, and other biological hazards that can live in waste. The Center for Construction Research and Training reports that people who are exposed to biological hazards are at risk of developing diseases like e-coli, typhoid fever, salmonella, cholera, roundworm, Hepatitis A, and more.

In Oklahoma, jail staff in Nowata County made national headlines this spring when the county sheriff, Terry Sue Barnett, resigned due to poor jail conditions. Barnett told Tulsa World that there were multiple issues at the jail, including carbon monoxide leaks and issues with the sewer lines. “If you’re a prisoner, you still deserve human dignity. You still need the basics,” she told NPR, referring to the multiple health-code violations and environmental hazards at the jail she deemed dangerous.

The physical impacts are only part of the picture: .

There’s a growing body of research that explains how poor quality of housing, including limited insulation, air pollutants, and building contaminants like raw sewage, negatively impacts mental health—a reality that raises concerns for the14.5 percent of men and 31 percent of women in jails who have a serious mental illness.

Even for systems simply looking to clean up their sewage, there are financial barriers. The cost of imprisonment in the United States is an astounding $182 billion annually. According to the Prison Policy Initiative, almost half of the money spent on running the correctional system goes to paying staff. Money for repairs and maintenance of crumbling infrastructure is hard to acquire given public opinion about the prison system, according to David Tuttle, superintendent for the Worcester County Sheriff’s Office in Massachusetts.

“Corrections are kind of forgotten about at times,” he said. “When you’re a state representative or senator, would you rather stand in front of a new school, park, or hospital with a big check presentation or do you want to stand in front of a prison?”

There are federal regulations that are meant to protect the people who live and work inside correctional facilities. The Federal Bureau of Prisons are inspected by the Occupational Safety and Health Administration (OSHA), according to Denisha Braxton, an official with the Office of Public Affairs of the U.S. Department of Labor. “Employers are responsible for providing workers with a jobsite free of recognized hazards,” Braxton said.

OSHA inspectors, who handle cases involving health-code violations in correctional facilities, focus on the legal responsibilities building managers and related staff members have to ensure that jail and prison employees have a safe and healthful workplace for prison employees. But the various dangers and hazards that lurk behind bars affect people who are incarcerated in unsafe facilities in different ways given the fact that they live there.

While the situation is dire, there is some progress. Earlier this year, Macomb County, Michigan, Sheriff Anthony Wickersham revealed an estimated $400 million plan to replace the crumbling 1,518 bed jail. “We have been replacing and repairing numerous electrical and plumbing supplies throughout the facility for years...tiles are popping off walls in housing units and constant flooding is occurring in our basement,” Wickersham said.

In 2018, Los Angeles County supervisors approved a $2.2 billion proposal to replace the Men’s Central Jail due to years of multiple complaints. “It’s an aging, decrepit facility that’s falling apart structurally and also it’s not conducive to house inmates,” Commander Joseph E. Dempsey of the Custody Services Division told the Los Angeles Times.

“People work better when their offices aren’t falling apart. Prisons and jails work better, and the rehabilitation process works better, if we have the facilities to show these people we’re serious about helping them out,” said Tuttle in Worcester County.

Worcester County’s main jail, which opened in 1973, is currently undergoing multiple Division of Capital Asset Management and Maintenance-funded construction projects that include, but are not limited to, a $30 million dollar medical clinic, $300,000 in plumbing upgrades, and $70,000 in upgrades to housing units.