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Rural Health Information Hub

Incarceration Prevention and Community Reintegration

Incarceration prevention and community reintegration approaches aim to address social determinants of health (SDOH) by preventing criminal justice system involvement and providing services and support to those who have been previously incarcerated to help them with community reintegration. Incarceration, when a person serves time in a federal/state prison or local jail, has been identified as an important SDOH. Certain populations are more likely to serve time in jails or prisons, and often these same populations experience higher rates of poverty, chronic disease, and overall worse health outcomes. Incarceration can have lasting impacts on entire communities, affecting health and well-being for generations. Communities with higher rates of incarceration experience disruptions to community life, reduced economic development, and the potential for increased crime rates as the community may begin to have negative feelings toward law enforcement officials.

For individuals, some of the lasting impacts for people who are incarcerated can include:

  • Loss of jobs and educational opportunities
  • Reduced economic stability
  • Poorer health outcomes
  • Housing instability
  • Disruption to family life

In recent years, the rapid growth of rural jails has highlighted the importance of implementing strategies to prevent incarceration. There are disparities in rates of incarceration for different populations. Racial disparities in the rates of incarcerated Black men are the most pronounced. Black Americans make up 13% of the overall U.S. population but are 33% of the incarcerated population. In 2015, 9.1% of young Black men in the U.S. were incarcerated, compared to 1.6% of young White men. In addition, 10% of Black children had at least one parent who was incarcerated. While it is estimated that women make up only 7% of the current incarcerated population, the majority of incarcerated women are the primary caretakers of their children. When these women enter jails and prisons this can have lasting repercussions on the lives of their children.

People who are incarcerated are more likely to have lower educational attainment and are much more likely to grow up in poverty. After being released from incarceration, many people struggle to find a job. Only half of released incarcerated individuals report having earned any income after their release. People who do find jobs report earning less than a full-time minimum wage salary. More than half of people previously incarcerated have obtained a high school diploma or general educational development (GED) diploma as their highest educational attainment, while approximately one quarter have not completed high school. Lower levels of educational attainment are related to higher levels of unemployment and increased rates of poverty. As a result, important elements of many programs focused on incarceration prevention and community reintegration as strategies to address SDOH also focus on workforce development strategies and approaches to improve educational attainment. For more information about how these approaches can help address SDOH, see Workforce Development and Human Capital and Improving Education.

Some proponents of prison reform suggest preventing incarceration by focusing on making policy-level changes. In addition, there are many recommended approaches that can serve as alternatives to incarceration. For example, drug courts are a type of court that provides an alternative to a prison or jail sentence for people with substance use disorders. Drug courts have been shown to reduce recidivism the return to jail or prison after release. For more information about how drug courts and other substance use disorder strategies can prevent incarceration, and to find examples of rural programs, see Drug Courts in the Rural Prevention and Treatment of Substance Use Disorders Toolkit.

Once a person has been incarcerated, a focus on reintegration back into the community is essential to improve health outcomes and well-being after release. Successful reentry into the community after incarceration is an important process for addressing SDOH, reducing crime rates, and lowering the chances of recidivism. Some models for reentry, such as the Assess, Plan, Identify, and Coordinate (APIC) model, have been developed to focus specifically on helping incarcerated populations with mental illnesses and substance use disorders transition back into the community. Many of the principles that make up this model may be applicable when designing rural reentry programs for other incarcerated populations. These steps include:

  • Assess incarcerated individual's social and medical needs during entry and again before reentry.
  • Plan to connect incarcerated individuals with proper resources and services.
  • Identify appropriate community resources and services to connect incarcerated individuals to before their release.
  • Coordinate and manage the release transition process, incorporating case management when possible.

Examples of Rural Programs that Focus on Incarceration Prevention and Community Reintegration

  • GrowingChange is preventing youth from entering the criminal justice system by connecting them with opportunities to develop job skills and knowledge about a career in agriculture. The GrowingChange model aims to convert decommissioned prisons into active farms. The program is currently renovating one decommissioned prison into a farm in North Carolina and then will roll out the open sourced, replicable model for implementation in other rural communities. Partnering with local campuses, universities, land grant universities, and the Massachusetts Institute of Technology, the program is providing opportunities for students to learn about sustainable agriculture and is creating job opportunities in agriculture. All of these initiatives aim to improve the health and well-being of the rural communities where these youth live and to ultimately reduce crime rates. An early pilot study of the GrowingChange model found that it was successful at preventing youth from entering the adult prison system.
  • The Women in Need Diversion (WIND) program is a collaborative partnership between many community service providers, including Community Health of East Tennessee, the Campbell County Department of Children's Services, the Sheriff's Office, the probation department, and local police and housing authorities. The program provides an alternative to incarceration and allows women the chance to keep living with their children while participating. Participants are deemed eligible to be tried in a specialized court for women age 18 and older by the court judge. The program works with substance use treatment centers to provide treatment services to participants and to connect participants to public housing opportunities.
  • Middle Tennessee Rural Reentry (MTRR) is a nonprofit organization that focuses on reducing recidivism and helping to rehabilitate and improve the lives and well-being of currently incarcerated individuals. MTRR provides a wide range of services to incarcerated adults, all with the goal of reintegration back into the community. Some of the services offered include screenings and assessments, substance use and mental health counseling and therapy, high school equivalency classes, and health education classes. In order to help incarcerated individuals transition back into their communities and families, MTRR also provides reintegration support for the incarcerated individuals as well as their children. This includes assistance finding a job, workforce skills training, housing, transportation, and connecting incarcerated individuals with benefits and other social services.
  • Greene County Correctional Program established the Career Correctional Pathways (CCP) model in 2015 as a way to help incarcerated residents rehabilitate and gain new skills to successfully reenter the community. Cross-sector partners who began the program identified the need to help incarcerated individuals gain a basic education and job skills to be able to enter the workforce and successfully integrate back into community life. Leaders in the criminal justice system in Greene County and the Tennessee Department of Labor and Workforce Development worked together to provide a way for incarcerated individuals to receive their High School Equivalency Diploma. The program eventually partnered with the mayor and other local leaders to also employ participants to help them earn money to save for their eventual release. The program also linked participants with counseling and transportation services, and helped them pay off all debt through earned program wages. Since the program has been successful, the Tennessee Institute of Public Health at East Tennessee State University is helping 3 new communities replicate and adapt the CCP model in the region by providing grants.

Implementation Considerations

Adapting programs to fit the context and culture of each rural community is key when using any of these models or strategies to prevent incarceration and address reintegration after incarceration. Since the 1990s, the majority of new prisons have been built in rural areas, and the impact of incarceration prevention and reentry programs can be far-reaching in a community.

When implementing programs to address SDOH in rural jails and prisons, it is also important to recognize how rural jails differ from urban jails. The resources available to jails and to previously incarcerated individuals upon release may be more limited in rural areas. Transportation to outside services, such as substance use treatment appointments, is more limited in rural areas, which can make addressing SDOH challenging. Rural jails and prisons are often smaller in size, which can lead to overcrowding and other negative consequences for incarcerated individuals. In some areas it may be difficult to recruit qualified staff. Jails operating in tribal areas also experience unique challenges, including funding and a lack of reentry programs.

It can also be challenging to implement incarceration prevention and reentry programs in rural communities where people are closely knit. When local employers and businesses know everyone in the community, they may also know about a person's previous criminal record, which can impact their decision to hire the individual. Rural residents may fear that other community members will find out about their past experience in the criminal justice system and may be less likely to access needed support services.

Program Clearinghouse Examples

Resources to Learn More

Out of Sight: The Growth of Jails in Rural America
Describes reasons behind the growth of jails in rural America and presents rural challenges to preventing incarceration.
Author(s): Kang-Brown, J. & Subramanian, R.
Organization(s): Vera Institute of Justice, John D. and Catherine T. MacArthur Foundation Safety and Justice Challenge
Date: 6/2017

Safety and Justice Challenge Innovation Fund
Lists awardees participating in the Innovation Fund working to find new approaches to reduce the number of people incarcerated in jails across the country.
Organization(s): Urban Institute, John D. and Catherine T. MacArthur Foundation