Graduate Defense: Ashley Harris

Thesis Information

Title: Exploratory study of the connections between public health districts and individuals who have recently been released from carceral systems in Idaho

Program: Master of Public Health

Advisor: Dr. Sarah Toevs, Public and Population Health

Committee Members: Dr. Desmond Banks, Public and Population Health; and Taylor Neher, Master of Public Health

Abstract

Background
Gaining a better understanding of public health’s relationships with the carceral systems 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 10x in the last 40 years and Idaho is leading the way. 62% of women in prisons report having minor children and 80% of women in local jails report having minor children. Additionally, Idaho has the highest incarceration rate of non-violent offenders (Bureau of Justice Statistics, 2020). Idaho also has the highest rate of incarceration of drug offenders (Bureau of Justice Statistics, 2020).
With 95% of incarcerated populations being released in the future and just 5% currently serving life sentences (Hughes, 2003), public health interventions focused on this population are extremely important. Idaho released 4,001 members of its prison population in 2020, however this number does not include the re-entry rates for city or county jails (Carson, 2021). These statistics are why public health efforts are essential to aid in the transition from incarceration to free living.
This project is in alignment with the Public Health Districts’ goals of accreditation and evaluation of programs and interventions. Many of the Public Health Districts in Idaho are working towards public health accreditation with the Public Health Accreditation Board. As a part of this process, the PHDs have made efforts towards more equitable health outcomes in our communities. A necessary part of this process is efforts to uplift outcomes for recently released populations- populations who are highly at risk for disparate outcomes involving epidemiology, mental health, substance abuse, and long term care (Prina, 2022). According to the 2015-2019 strategic plan for all the Idaho Public Health Districts, one of the top goals is to, “evaluate and improve the quality of programs and interventions,” (Spencer et al., 2015). The purpose of this project is to evaluate and improve the quality of programs and interventions for 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. Currently little is known about the programs and supports available to this population from the public health districts. Key-informant interviews will be conducted with employees from the seven public health districts and used to describe the existing landscape, barriers and opportunities. The goal of this project is to document existing connections and use this information as a foundation for enhancing the health and wellbeing of individuals recently released from carceral systems in Idaho.

Methods
The 7 public health district directors in Idaho identified one or more staff members to participate in one 45-60 min zoom interview. All interviews were conducted via zoom. The interview protocol has been approved by the Boise State University Institutional Review Board under IRB #186-SB22-139. The interview questions are regarding public health resources and programs, outreach strategies, future opportunities, and efforts to serve individuals disproportionately impacted by carceral systems.

Results
Most respondents stated that public health played a large role in helping individuals transition from the carceral setting to the community (85.71%). Additionally, most participants (85.71%) 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. Most respondents stated that public health provided many programs or services for individuals transitioning back into the community (85.71%). One participant stated that there were no resources targeting this specific population. All reported that the current efforts in place were fairly successful to highly successful (100%). Participants had highly varied views on the current outreach programs at the public health districts. This perceived effort to reach recently released individuals ranged from none to many. The success of these efforts ranged from unable to gauge to very successful. None of the participants stated that the current outreach efforts were adequate with the majority (57.14%) stating that current efforts were not adequate.

Conclusion
These key-informant interviews are vital to help us describe the existing landscape, barriers and opportunities of re-entry programs in Idaho. Using Grounded Theory, we documented existing connections and use this information as a foundation for enhancing the health and wellbeing of individuals recently released from carceral systems in Idaho. The current connections between public health and individuals recently released from carceral systems in Idaho is strong but there is much room for improved resources and outreach programs to better assist this highly vulnerable population.