Incarceration Prevention and Community Reintegration

Incarceration prevention and community reintegration approaches address social determinants of health (SDOH) through service delivery and prevention efforts. This model provides services and support to previously incarcerated individuals, helping them with community reintegration and preventing criminal justice system involvement.

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. Incarceration can have lasting impacts on individuals, including loss of jobs and educational opportunities, higher rates of poverty and reduced economic stability, housing instability, and worse health outcomes. Incarceration can also have lasting impacts on 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, and a lack of trust or negative feelings toward law enforcement officials.

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. Over 40% 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 increased rates of unemployment and poverty. As a result, many incarceration prevention and community reintegration programs include elements for workforce development and educational attainment. For more information about how these approaches can help address SDOH, see Workforce Development and Human Capital and Improving Education.

Strategies to Prevent Incarceration and Support Community Reentry

There are numerous approaches that can provide accountability for minor offenses while avoiding 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 community 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.

The APIC model includes the following steps:

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

The Women in Need Diversion (WIND) program is a collaborative partnership between 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 participating women the chance to continue living with their children. Participants are deemed, by the court judge, eligible to be tried in a specialized court for women aged 18 and older. The program works with substance use treatment centers to provide treatment services and to connect participants to public housing.
Middle Tennessee Rural Reentry (MTRR) is a nonprofit organization focused on reducing recidivism and helping rehabilitate and improve the lives and well-being of currently incarcerated individuals. MTRR provides a 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. To help incarcerated individuals transition back into their communities and families, MTRR provides reintegration support for the incarcerated individuals and their children. This support includes assistance finding a job, workforce skills training, housing, transportation, and providing connection with benefits and other social services.
Greene County Correctional Program established the Career Correctional Pathways (CCP) model in 2015 to help incarcerated residents rehabilitate and gain new skills for successful community reentry. Cross-sector partners who began the program identified the need to help incarcerated individuals gain a basic education and job skills to successfully enter the workforce and 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 help incarcerated individuals to receive their High School Equivalency Diploma. The program eventually partnered with the mayor and other local leaders to 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 providing grants to help 3 new communities replicate and adapt the CCP model in the region.

Implementation Considerations

Adapting programs to fit the context and culture of each rural community is key when using a model or strategy to prevent incarceration and address reintegration after incarceration. Since the 1990s, most new prisons have been built in rural areas, and the impact of incarceration prevention and reentry programs can be far-reaching in a community. In particular, there are fewer resources available to support the rural justice system, including technology and legal services. In many rural areas, there are fewer attorneys compared to the population, and limited broadband in these areas can make it even more challenging to access legal services and other resources. Jails operating in tribal areas also experience unique challenges, including limited funding and a lack of reentry programs.

It can 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 hiring decisions. Rural residents who were previously incarcerated may be less likely to access needed support services due to fear that other community members will learn of their experience in the criminal justice system.