Arizona Luminaria has been publishing investigative stories about deaths in the Pima County jail since November of 2022. At first, the reports of deaths were a trickle, inconsistently reported by the sheriff’s department. The trickle has become a stream.
In the months following the publication of our first investigation, the deaths continued. Something was seriously wrong. The medical examiner counts 15 jail-related deaths so far this year.
Arizona Luminaria is taking the 20,000-foot view. We are asking: why is this happening and what might the community do to solve it?
Our articles on the issue are long and complex. That’s for a good reason — it takes careful research and thoughtful context and language to be ethical and equitable in our reporting. We are committed to that kind of journalism.
For a speedier breakdown on the scope of the problem, we are compiling concise takeaways on Pima County jail deaths.
1. People are dying at a rate higher than other jails
Numbers of reported deaths at the jail have varied. Reasons for that included inconsistent reporting by the sheriff’s department; an effort by Pima County Medical Examiner Gregory Hess to scrutinize deaths and count people who died shortly after being released; and families who have said there are more deaths than officials are publicly disclosing.
From 2022 through August 2023, 38 men and women have died inside the jail or shortly after being freed, according to medical examiner records.
In 2022 alone, at least 12 people died in the jail, according to a Dec. 27 county memo. That’s a per capita mortality rate more than four times the national average as of 2019, and higher than New York City’s notorious Rikers Island jail, which had 19 deaths in 2022. The population of Rikers Island is slightly below 6,000. The population of Pima County jail is nearly 1,900.
Following Arizona Luminaria’s investigation earlier this year, the medical examiner reviewed 2022 county records and identified another 11 jail-related deaths, for a total of 23 people who died that year.
Pima County Sheriff Chris Nanos has disputed that the rate of deaths is outsized. However, multiple professional statisticians specializing in jails and prisons have confirmed Arizona Luminaria’s calculations.
2. Why the community should care
Incarcerated people are constitutionally protected against cruel and unusual punishment. Nobody deserves to suffer or die in jail. Many people in Pima County jail are not guilty. Most are pre-trial detainees, meaning they haven’t been convicted of any crimes. Some people sentenced to less than a year are in jail instead of prison.
People often spend a few days or weeks inside. However, some remain detained for a year or more awaiting trial. Sheriff Nanos has said that people with mental health issues can stay in jail awaiting competency rulings longer than they would’ve been incarcerated for mandatory sentences. People who can afford bail are released until their trials. Those who can’t afford to pay, stay in jail.
“Death seems like a particularly egregious punishment when there hasn’t been a ruling in someone’s case,” says Andrea Armstrong, a professor at Loyola University and national expert on jail and prison conditions.
3. Why this is happening
It’s complicated. We have written 11 stories on the topic over the past year. Here are a few big-picture issues that have come up over and over:
- Jail health care is run by for-profit company, NaphCare, which has not fully staffed medical positions in the jail for a single month since it began operating in 2021, according to audits by Pima County.
Medical care has been dangerously delayed as pleas for help are ignored and mismanaged, according to employees, inmates and public records.
- Mental health care in Tucson is a patchwork of underfunded and overstrained services. As a result, people with severe mental illness and without the means for care can end up in the jail if the police are called.
According to a January 2023 memo to the board of supervisors, out of 1,837 detainees 35%, or 645 people, had a substance-use disorder or needed substance-use intervention. Of that group, 43% were also receiving medication for a mental health condition.
Recognizing the importance of getting mental health providers and health care workers in the jail, Nanos also recently said: “I question the motive. Are we doing this because we want to put services in there for people who are there or are we doing it because we have nowhere in the community to put these people except in our jail?”
- Drugs like fentanyl are deadly and everywhere — including the jail. At least eight of the in-custody deaths over the past two years were related to drug overdose or complications with withdrawal.
- People who can’t afford rising housing prices and rent can be forced into precarious living situations or onto the street where addiction and lack of access to mental health care can lead to more frequent interactions with law enforcement.
4. Who is accountable for the jail and those inside
- Pima County Sheriff Chris Nanos, a Democrat elected in 2021 for the second time. He also was appointed sheriff from 2015-2016.
- The Pima County Board of Supervisors
- Pima County Attorney Laura Conover, a Democrat elected in 2020.
- NaphCare, the for-profit company based in Alabama that is contracted by the county to provide health care inside the jail.
- Both county and city law enforcement agencies that arrest and send people to jail, even for non-violent offenses.
5. What has changed
Following Arizona Luminaria’s November investigation into jail deaths, Nanos in a December 2022 letter to the board of supervisors, said the facility faced a “full-blown crisis,” was perilously jammed and that support staffing was “critically low.” He successfully urged county supervisors to give jail staff a raise.
He also argued for building a new jail, which could cost taxpayers as much as $380 million. A commission was appointed to determine whether that’s the right path. Some community members have repeatedly expressed their fierce opposition to a new jail.
In May, the Tucson City Council discussed an array of questions they want addressed by Pima County officials, including whether jail is the right place for people in a medical crisis to detox from addictions to drugs.
Mayor Regina Romero invited county officials to a future public meeting to discuss jail processes, including staffing medical care and prevention of suicide and overdose deaths.
6. What can I do to get involved?
- Write your supervisors and city council members
- Show up to public meetings. Posted agendas will show you if a topic you are interested in — like the jail — will be discussed. Here are the Tucson City Council agendas and here are the Pima County Board of Supervisors agendas.
- Get involved with community groups:
7. Can I read more about this?
Absolutely. Links to all our journalism work on this topic are here:
- ‘Unconstitutional hole’: How Pima County jail deaths — one recently ruled a homicide — are part of a grim pattern
- How we reported the Pima County jail story
- Pima County approves raise for guards at deadly jail
- People continue to die in Pima County’s jail. Could bail reform make it less deadly?
- Pima County considers building a new jail as the 1980s-era facility crumbles and bookings increase
- Sheriff Nanos cancels attendance at Pima County jail panel following advice from county attorney’s office
- Jail grievances: “I need my heart medication before I have another heart attack that would be 100% preventable…”
- Medical care in Pima County jail is dangerously delayed as pleas for help are ignored and mismanaged, say inmates and employees
- 5 takeaways from AZ Luminaria’s Pima County jail crisis community event
- Tucson City Council calling for answers on Pima County jail deaths from county leaders
- Recent Pima County jail-related deaths are more than twice as high as reported according to medical examiner
- Pima County has docked NaphCare $3.1 million for jail medical care deficiencies
- Pima County jail public meeting lasts only 4 minutes amid shouting and live music

Contact reporter John Washington
John Washington is an investigative journalist based in Tucson with a focus on immigration and borders, as well as criminal justice and literature. His first book, “The Dispossessed: A Story of Asylum at the US-Mexico Border and Beyond,” was published in 2020 by Verso Books. Email John at jwashington@azluminaria.org or find him on Twitter @jbwashing