Criminal Justice Involvement
The criminal justice system includes law enforcement, the courts, and corrections.
People involved with the system are impacted by various social determinants of health throughout criminal activity, incarceration, and reentry.
Addressing social determinants of health, such as education, economic stability, and community context, is crucial for reducing crime and recidivism and improving health outcomes of formerly incarcerated individuals and their communities.
Here’s what you’ll learn:
How Social and Community Context Impacts Olivia
Meet Olivia—a young artist who has found community through volunteering, joining LGBTQ+ support groups, and sharing her experiences with homelessness on a youth advisory board. After law enforcement encounters and overcoming addiction, Olivia is working on building deeper connections with others and embracing her identity within her chosen family.
Get to Know OliviaHow Social and Community Context Impacts The Jackson Family
Meet Nichelle—a devoted wife and mother who balances caregiving for her mom with her own family responsibilities. Living near a Haitian community helps Nichelle feel connected to her culture. With her sister far away, she leans on her best friend and creative hobbies to find joy in daily life.
Get to Know The Jackson FamilyHow Social and Community Context Impacts The Garcia Family
Meet Elena—certified nurse assistant, National Guard veteran, and single mom. Living far from her support network, she is navigating grief, PTSD, and an invisible disability while raising her two children. Elena is trying to build community and find her way again.
Get to Know The Garcia FamilyHow Social and Community Context Impacts Chris
Meet Chris, a teacher who is blind and who has built a strong community through friends, family, and shared interests. Between hosting karaoke nights, playing Dungeons & Dragons, and spending time with his girlfriend’s family, Chris works to overcome stereotypes while nurturing his social connections.
Get to Know Chris
Terms to Know
The three components of the criminal justice system in the U.S. are law enforcement, the courts, and corrections.[1] Each agency works collaboratively and independently.
Incarceration is when someone is detained in a jail, prison, or psychiatric facility.[1] It can seriously affect a person’s mental and physical health, impact their ability to get a job, maintain relationships, and be part of the community. People might be incarcerated for committing crimes or breaking the rules of their probation or parole.
Jail is a form of incarceration for people awaiting trial, sentencing, or transfer to prison.[1] Local jails also detain people who violate parole or probation and people who are sentenced to less than one year.
The juvenile justice system works with youth under the age of 18 who are accused of committing a delinquent or criminal act.[1] Processes include arrest, hearings, and probation, but the goal is to avoid incarceration whenever possible, recognizing that young people have a greater potential for change and growth. Instead of prison, judges use different options to ensure public safety and address the youth’s treatment needs. However, some youth may still be placed in juvenile correctional facilities that often look like adult prisons.[2]
State and federally operated prisons confine people who are sentenced to incarceration for more than one year.[1]
[1] U.S. Department of Health & Human Services, National Institutes of Health
Recidivism refers to a person’s relapse into criminal behavior, typically after receiving intervention in the criminal justice system.[1] Recidivism is when someone gets rearrested, reconvicted, or sent back to jail after being released.
Reentry refers to the transition of formerly incarcerated individuals back into their communities after they’ve completed their jail or prison sentences.[1] Each person has unique needs, such as mental and behavioral health issues, which may not have been addressed before or during reentry.
Rehabilitation refers to programs that are designed to reduce crime and address the causes of criminal behavior. Rehabilitation aims to improve someone’s skills, behavior, mental health, social interactions, and access to education and jobs.[1]
Key
Facts
- Nearly 6.9 million people are on probation, in jail, in prison, or on parole in the U.S. at any one time.
- Black Americans are incarcerated in state prisons at nearly five times the rate of white Americans. Hispanic and Latino individuals are incarcerated in state prisons at a rate that is 1.3 times the incarceration rate of whites.
- While Black, Hispanic, and Latino people make up 30% of the U.S. population, they account for 51% of the jail population.
- In Indiana, Black Americans were 10% of the population in 2015. Yet, they accounted for 24% of people in jail and 34% of people in prisons.
Incarceration
Incarceration punishes criminal offenses, but it can negatively impact the health and well-being of incarcerated individuals and their families. Experience with incarceration affects physical and mental health, future employment, and housing stability and can have multi-generational impacts on children.
Incarcerated individuals often have high rates of chronic health conditions, mental health issues, and substance use disorders.[1] They face challenges to health care access and coverage, which can worsen their health and lead to higher rates of recidivism. This population also is more likely to have high blood pressure, asthma, cancer, arthritis, and infectious diseases.
Education and Employment
People who are incarcerated are more likely to have lower education levels and are more likely to grow up in poverty.[2] After release, many struggle to find jobs, and those who do often earn less than minimum wage. Only half report any income after release.
More than half have a high school diploma or GED as their highest level of educational attainment. Lower education levels are linked to higher unemployment and poverty. Programs to prevent incarceration, improve reentry, and avoid recidivism focus on improving education and job skills.
The lasting impacts for formerly incarcerated individuals include loss of jobs and educational opportunities, reduced economic stability, poorer health outcomes, housing instability, and general disruption to family life.
Housing and Economic Impact
When comparing similar criminal histories and charges, Black, Hispanic, and Latino individuals are more likely than white individuals to be arrested and held in jail before trial.[3] They also tend to have higher bail and receive more severe punishments.
Racial disparities in incarceration rates are influenced by housing, economic, and criminal justice systems that disproportionately affect Black communities.[4]
Segregated housing results in higher incarceration rates in low-income Black neighborhoods. Historical practices such as Jim Crow laws and redlining forced many Black people into underserved areas with limited opportunities for social and economic mobility. These areas are often overpoliced, leading to higher arrest rates for minor offenses.
Additionally, racial biases in bail decisions, legal representation, plea bargains, and sentencing contribute to higher conviction rates and harsher sentences for Black individuals.
[1] U.S. Department of Health & Human Services Office of Minority Health
[2] Rural Health Information Hub
[4] A comprehensive framework for operationalizing structural racism in health research: The association between mass incarceration of Black people in the U.S. and adverse birth outcomes.
Key
Facts
- 49% of men and 67% of women who have been incarcerated have a chronic physical health condition requiring treatment.
- 2 out of 3 people are rearrested, and more than 50% are incarcerated again within three years of their release.
- 27% of formerly incarcerated people are unemployed
- Lifetime earnings are nearly $500,000 less for formerly incarcerated people
- People who have been to prison are seven times more likely to experience homelessness
Reentry and Recidivism
People reentering their communities after incarceration face significant barriers to health care access. They often experience homelessness, unemployment, and a lack of social and family support.[1] These barriers are made worse since felony and other convictions often disqualify individuals from public assistance and other resources, such as housing vouchers and options.
Health Impacts
These individuals face high risks of negative health outcomes and death due to preexisting behavioral and physical health conditions and the adverse effects of incarceration. They have higher rates of overdose, suicide, disabilities, stroke, heart attack, and death.
Access to health care is a major challenge for reentry. Historically, incarcerated individuals have been excluded from Medicare and Medicaid, with federal law requiring suspension or termination of Medicaid benefits during incarceration. Even with insurance, accessing care is difficult due to the stigma associated with incarceration, mental illness, substance use disorders, post-traumatic stress disorder, and internalized racism.
These barriers are made worse by the challenges of returning to under-resourced communities and strained or estranged family relationships. The intensity and complexity of these issues vary for those leaving prisons versus jails.
Addressing the various social determinants of health that impact incarceration and reentry is crucial for lowering the risk of recidivism and reducing crime rates.[2]
Barriers to Reentry
- Housing insecurity
- Lack of quality employment opportunities
- Food insecurity
- Finding appropriate community social and community supports and services
- Untreated trauma, SUD, mental illness, and chronic health conditions
- Lack of health coverage or access to trauma-informed care
- Community and institutional stigma
- Lack of education access opportunities before, during, and after incarceration
- Lack of rehabilitation services prior to release
- Prevalence of neighborhood crime
- Effects of historic social and structural racism
A major factor in recidivism is the lack of resources and support for reintegration.[1] Formerly incarcerated people often have additional psychological, financial, and vocational needs.
Unemployment is the highest in the first two years after release. Pre- and post-release job services are crucial for reducing recidivism.[2] The unemployment rate for formerly incarcerated people is over 27%.[3]
Reduced income after incarceration makes it even harder to get out of poverty.[4] Lifetime earnings are reduced by about $500,000 for people who have been incarcerated. Since Black, Hispanic, and Latino individuals are disproportionately represented in the criminal justice system, these economic losses hit their communities hardest and widen the racial wealth gap.
[1] Community Policing Dispatch
Successful Reentry
- Evaluate social and medical needs when individuals enter incarceration and before reentry to the community
- Connect incarcerated individuals to necessary resources and services
- Identify social supports and find suitable community resources and services for individuals before their reentry
- Coordinate and manage the reentry process, using case management when possible
Key
Facts
- 7% of U.S. children have experienced the incarceration of a parent
- At least 60,000 children experience homelessness due to parental incarceration
- Parental incarceration increases infant mortality by 40%
- 34% of families with an incarcerated family member went into debt to pay for phone calls and visits
- The average debt for court fines and fees is $14,000
Family and Community Impact
Incarceration negatively affects individuals and also impacts the health of their families and communities.[1] Families face stress, stigma, and economic strain from losing a member who may have provided financial and non-financial support like childcare and household management. This can lead to economic instability and additional costs.
High incarceration rates harm communities by removing working-age adults, increasing exposure to infectious diseases, and diverting public resources from health and social support to the criminal justice system.
Key
Takeaways
- Incarceration causes negative impacts to the health and well-being of the individual and their families.
- Improving education and boosting job skills can help lower crime rates, reduce recidivism, and improve the lives of incarcerated people after reentry.
- People of color are disproportionately represented in jails and prisons.
Other Social & Community Topics
Community and Social Supports
Isolation and loneliness harm well-being, while strong social ties help individuals and communities thrive.
Social Identity
Social identities like race, disability, and age shape experiences in daily life. Marginalized groups often face discrimination that contributes to poorer health outcomes.
Trauma
Understanding adverse childhood experiences and intimate partner violence helps us prevent trauma and support healing.
Employment: Incarcerated people risk losing their jobs during pretrial procedures. About 37% lost their jobs after being held for eight or more days, one-third after four to seven days, 7% at one to three days, and 3% after less than one day.[1]
Income: Formerly incarcerated people earn nearly $500,000 less over their lifetimes. This loss disproportionately affects people already living in poverty and Black, Hispanic, and Latino people who are already overrepresented in the criminal justice system, worsening the racial wealth gap in these communities.[2]
Food access: Incarcerated people often lack access to fresh produce. About 54% rarely, if ever, have access to fresh fruit, and 62% said they rarely have access to fresh vegetables.[3] They are six times more likely to become ill from a foodborne illness.
[1] Administrative Office of the U.S. Courts
[2] Brennan Center for Justice
[3] Impact Justice
Access: Family income can suffer when a member is incarcerated. Teenaged children may leave school to work, impacting their education, future success, and community health.[1]
Attainment: People who don’t finish high school are 63 times more likely to be incarcerated than people with four-year college degrees.[2]
Literacy: 70% of incarcerated adults cannot read at a 4th-grade level.[3]
[1] Institute for Justice Research and Development
[2] Center for Labor Market Studies
[3] National Center for Education Statistics
SUD: Formerly incarcerated people are 40 times more likely to die from an opioid overdose compared to the general population.[1]
Behavioral health: In state and federal prisons, less than half of the people with a history of mental illness are getting treatment. About 70% of youth in the juvenile justice system have a mental health condition.[2]
[1] U.S Department of Health and Human Services
[2] National Alliance on Mental Illness
Segregated neighborhoods: When incarcerated people complete their sentences, they are released into the community. Their residency in a neighborhood can lower property value or cause people to move if they prefer not to live near formerly incarcerated people.[1] Further, communities are impacted by the absence of the incarcerated individual, because their families might struggle to maintain properties or contribute to neighborhood upkeep.
Isolated prison facilities: Many prisons are isolated, located far away from where most residents live. This distance contributes to health disparities, staffing shortages, and makes it harder for friends and family to visit.[2]
[1] Institute for Justice Research and Development
[2] Association of Health Care Journalists
ACEs and trauma: Women who have been incarcerated are more likely to have gone through childhood trauma and sexual abuse.[1]
Aging and disability: Many correctional facilities are not equipped to address the health needs of an aging prison population, despite the number of adults aged 50 or older increasing in the criminal justice system.[2]
Juvenile justice involvement: Children of incarcerated parents are five times more likely to end up in prison themselves. This cycle means that parental incarceration can lead to higher future crime rates, creating additional costs for society.[3]
Social supports: Incarceration separates people from their support systems, disrupts families, and causes lifelong impacts to well-being.[4]
Race and gender: 44% of Black women in the U.S. have an incarcerated family member, compared to 12% of white women.[5]
[1] U.S Department of Health and Human Services
[2] U.S. Department of Health & Human Services
[3] Association of Health Care Journalists
[4] Association of Health Care Journalists
[5] A comprehensive framework for operationalizing structural racism in health research: The association between mass incarceration of Black people in the U.S. and adverse birth outcomes.