Publication Date

8-2023

Date of Final Oral Examination (Defense)

April 2023

Type of Culminating Activity

Thesis

Degree Title

Master of Public Health in Leadership and Management

Department

Community and Environmental Health

Supervisory Committee Chair

Sarah Toevs, Ph.D.

Supervisory Committee Member

Desmond Banks, Ph.D.

Supervisory Committee Member

Taylor Neher, Dr.P.H.

Abstract

Background

Gaining a better understanding of the relationship between public health and individuals recently released from the carceral system in Idaho is vital. According to the Federal Bureau of Justice Statistics, in 2020 Idaho had the highest female incarceration rate of all US states at twice the national average (Bureau of Justice Statistics, 2020). The incarceration rate of women and girls has increased nearly 834% in the last 40 years and rates in Idaho follow this trend (Steinberg, 2018). Compared to 62% of women in prisons nationally, 80% of women in local jails report having children under the age of 18 (Glaze and Maruschak, 2016). Idaho has additional cause for concern, as the state has the highest incarceration rate of both non-violent offenders and drug offenders (Bureau of Justice Statistics, 2020).

The focus of this work is with individuals who are recently released. With 95% of incarcerated populations projected to be released and 5% currently serving life sentences (Hughes and Wilson, 2003), public health interventions focused on this population are extremely important. Idaho released 4,001 individuals from prison in 2020; this number does not include the re-entry rates for city or county jails (Carson and Cowhig, 2020). These statistics are one aspect of why public health efforts are essential to aid in the transition from incarceration to free living.

This project is in alignment with the core mission of those working in public health to improve health in communities served. Additionally, the Idaho Public Health Districts (PHD) have goals of evaluating the programs and interventions for underserved populations. Many of the PHDs in Idaho are working towards public health accreditation with the Public Health Accreditation Board. As a part of this process, the PHDs continue to make efforts towards more equitable health outcomes in our communities.

A necessary part of this process is to uplift outcomes for recently released populations–populations who are highly at risk for disparate outcomes involving epidemiology, mental health, substance abuse among others (Prina, 2022). Many individuals in this population are at risk upon release and face challenges including access to identification, housing, employment, healthcare, among other necessities. The purpose of this project is to establish connections between the public health districts and recently released populations.

Aim

The purpose of this study is to explore the connections between the public health districts and individuals recently released from carceral systems in Idaho. Prior to this study, little was known about the programs and support available to this population from the PHDs. Key-informant interviews were conducted with employees from the seven public health districts and used to describe the existing landscape, barriers, and opportunities. The goal of this project was to document existing connections and use this information as a foundational benchmark for future enhancements to aid in the health and wellbeing of individuals recently released from carceral systems in Idaho.

Methods

Using Grounded Theory, we documented existing connections and used this information as a foundation for enhancing the health and wellbeing of individuals recently released from carceral systems in Idaho. The seven public health district directors in Idaho identified one or more staff members to participate in one 45-60 minute web-based interview. All interviews were conducted via Zoom. The interview protocol was approved by the Boise State University Institutional Review Board under IRB #186-SB22-139. Questions were developed by the researcher and reviewed and piloted with members of the thesis committee. The interview questions were designed to gather information about public health resources, programs, outreach strategies, future opportunities, and efforts to serve individuals disproportionately impacted by carceral systems.

Results

Most respondents (6/7) stated that public health played a significant role in helping individuals transition from the carceral setting to the community. The same number of respondents stated that it is highly important for public health to be involved in these transitions, rating the importance at least an 8 out of 10. Additionally, the same number stated that public health provided many programs, however few specifically targeted this priority population. All reported that the current efforts in place were fairly to highly successful, however many stated that the PHDs had limited ways to measure the success of prospective programs. In regards to needed partnerships, (3/7) stated that there was a need to expand current partnerships. Some respondents (2/7) stated there was a need to expand partnerships for housing efforts. Many (5/7) respondents stated that outreach efforts for this priority population were non-existent in their PHD. None of the respondents stated that the current outreach efforts were adequate with more outreach efforts needed. In regards to networking efforts, almost all (6/7) respondents described their current Board of Health as not being opposed to efforts to reach recently released populations, especially the benefits of such programs.

Conclusion

These key-informant interviews are vital to helping us describe the existing landscape, barriers, and opportunities of re-entry programs in Idaho. The current connections between public health and individuals recently released from carceral systems in Idaho is present but weak. There is much room for improvement in efforts to assist this highly vulnerable population including expansion and streamlining of services, additional outreach efforts, establishing measures of success, and continued networking with Boards of Health and community partners.

DOI

https://doi.org/10.18122/td.2110.boisestate

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