A new book by Nicholas Iacobelli, assistant professor in the Division of General Internal Medicine at the University of Washington, is set for release in June 2026. Titled“Wards of the State,” the work explores the complex relationship between healthcare and incarceration in the United States.
Iacobelli, who cares for hospitalized patients while conducting anthropological research, examines how medical care is delivered within a men’s maximum-security prison in Pennsylvania. Drawing on two years of ethnographic fieldwork, the book investigates how the prison’s medical unit functions as a “ward of the state,” simultaneously fulfilling a constitutional obligation to provide care while reinforcing the broader punitive aims of the correctional system.
The book situates its analysis in the wake of a 1976 Supreme Court decision affirming incarcerated individuals’ right to healthcare under the Eighth Amendment. Within this framework, Iacobelli reveals how incarcerated men are positioned as both recipients of care and as subjects of state control—rendered, in many ways, the biological and financial property of the system.
Wards of the State highlights how these tensions produce intricate dynamics of dependence, refusal, and skepticism, ultimately reshaping ideas of health and illness behind bars. At the same time, the book underscores how the right to care can create opportunities for incarcerated individuals to imagine different futures and advocate for personal and systemic change.
The publication contributes to ongoing conversations about healthcare equity, criminal justice reform, and the ethical responsibilities of state institutions.