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This journal published an article on prison overoccupation and its impact on individual and collective health in 20121, and we have been asked to reflect on this issue eight years later. In 2012, there were 10.2 million inmates/day worldwide2. This figure now stands at 11 million, although the growth in the number of inmates has been very similar to the increase of the world population (3.7% vs. 3.0%, respectively in the last 3 years)3 and so it can reasonably be assumed that the prison population has remained stable over this period. The fact that prison over-occupation is unacceptable and negatively impacts health is undeniable. One the one hand it is a breach of international prison standards4-7 and is also: a) a hazard to inmates’ psychological and physical health; b) a public health risk; c) an underlying cause of danger for prisoners and prison professionals; and d) a breach of human rights, in which cruel and degrading treatment may be involved. The number of references in the literature on how this phenomenon affects the psychological and physical domains at individual, collective and environmental levels is immense. The term “overcrowding” has been and continues to be widely used to refer to large numbers of inmates in penitentiary spaces that do not have the space to house them. However, this term is openended and lacks any clear consensus as to what it is exactly and how it can be measured8. There is an increasing tendency therefore to use the term overoccupation, which is more specific and measurable. In any case, there continues to be a certain degree of conceptual confusion, and it is not uncommon to find that the incarceration rate is used to indicate excess occupancy, which is really the rate of persons incarcerated per 100,000 inhabitants, without making any reference to the space or its characteristics. The level of prison occupation and the incarceration rate, or the crime rate, which is another concept that is often used, are not similar concepts, although they are sometimes indiscriminately and erroneously used. Spain for example has a crime rate (rate of crimes and misdemeanours per 1,000 inhabitants) of 45.69, which is considered to be a low one, and as a country it does not occupy a high place in the European classifications for the main types of crime (homicide, rape or robbery), and so it is regarded as one of the safest countries in Europe. However, the rate of incarceration or imprisonment, which in 2019 was 111 in Catalonia and 128.5 in the rest of Spain10, is one of the highest in Europe and almost double that of other countries in northern Europe, where the lowest rates are to be found. To measure prison occupation, the Council of Europe recommends using the “density”; or rather, the ratio between the number of inmates and the number of available places, expressed as the number of inmates per 100 places available. When this yardstick is used, there are about one hundred countries with prisons whose capacity is exceeded by more than 10%. There are more than 20 countries with over-occupation that exceeds 200%, a few countries whose over-occupation exceeds 400% or 500% and there is even one in the Republic of the Congo, which exceeds 600%3. Spain has an occupancy rate of 80%. It is important to point out that over-occupation is not only a patrimony of poor countries. According to the SPACE report of 202011, 15 European countries acknowledged that they had over-occupied prisons and 10 (8 of 10 member states of the European Union) defined the levels of over-occupation as “severe”. The increasingly common use of “density” as a unit of measurement of occupation enables rates Editorial

Prison overcrowding and over-occupation: what we are talking about and the situation in Spanish prisons