Plan elements

Co-location of juvenile and adult facilities

Change in number of adult and juvenile beds

Services

Diversion programs

Racial disparities

Visitation options

Economic disparities

Social support

Incarceration/ crime

Outcomes

How do all these plan elements affect health outcomes related to incarceration and recidivism?

1

Services

education

Δ Employment

Δ Self-esteem

Δ Income

Δ Chronic Disease

Δ Influence on next generation

Δ Incarceration

mental health care

Δ mental health

Δ Recidivism

substance abuse tx

Δ Substance use

restorative justice

Δ Offender accountability

Δ Victim perception of outcome

Δ Community involvement

Δ cmty sense of wellbeing/safety

Δ cmty support for crime-fighting

housing assistance

Δ premature mortality

Δ mental health

See Incarceration slide

Community-based services

Services in jail / transition

ctr

Re-entry Services

Δ homelessness

health assessment Δ healthcare access Δ healthcare utilization

2

Δ offender empathy

trauma-informed care/treatment

Δ parenting

Δ high school completion

Δ job training

Research Questions – Services Pathway

• How does service provision affect incarceration (rates of incarceration, recidivism)?– Type of service (which services are most

important)– Timing of service – Location of service (community, facility-based and

/ or re-entry)

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Primary Prevention

Δ Availability of mental health

resources

Δ Youth mentoring programs /

opportunities

Δ Chronic Disease

Δ Violence /

injury Δ Incarceration

Δ attitudes of inclusion (gender, race, orientation)

Δ Gender, race ,

orientation-based

violence

Δ Skill set for educational and

employment success

Δ Attitudes about education

Δ Knowledge of / utilization of educational resources

Δ Level of education

Δ morbidity / mortality

Δ mental health status

See Incarceration slide

Δ School involvement

Δ early childhood interventions (i.e. home visiting, services for foster

children)

Δ Social / emotional

support

Δ Funding that Prioritizes

Community-Based Services and

Infrastructure

Δ Youth drop-outs

Δ Income

Δ Chronic stress

Δ Healthcare Costs

Δ Substance abuse

Δ Policy

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Δ Healthy Community

Infrastructure

Research Questions – Prevention Pathway

• Can primary prevention reduce the need for incarceration?

• Are primary prevention services more cost-effective than incarceration to ensure a safe and healthy community?

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Diversion

Diversion:Alternative treatment

programs offered within criminal justice system

Δ Racial disparity in incarceration rate

Δ IncarcerationΔ Sobriety Court Diversions

Δ Drug Court Diversions

Δ Domestic Violence Court

Δ Mental Health Court

Δ access to services

Δ recidivism

Δ Recovery

Δ Family support

See Incarceration slide

See Services slide

6

Δ Community Support (CBO, faith-based)

Δ Prosecutor’s Diversion Process

Δ CMH Jail Diversion Program

Δ Community Correction Diversion Program

Δ Veteran's Court

Green: haveBlue: don’t have

Purple: pilot

Research Questions – Diversion Pathway

• Are diversion services more cost-effective than incarceration?

• To what extent can diversion reduce the need for incarceration and still ensure a safe and healthy community?

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Co-Location vs. Separate

Co-locate facilities

Δ Access to services

Δ Youth perception of self as a criminal

Δ Social stigma associated with youth incarceration

Δ Recidivism Δ Incarceration/Crime

Δ Employment

Δ Income

Δ Educational attainment

2 separate facilities

See Services slide

See Incarceration slide

Δ Cost of construction and operation

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Δ Program options for youth

Research Questions – Co-Location Juvenile / Adult Pathway

• How would co-location of adult and juvenile facilities impact youth?

• Would the benefits of co-locating the facilities outweigh the risks to youth (e.g. recidivism, mental health, stigma, educational attainment, income, etc.)?

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Visitation Options

“Contact” vs. “non-contact” visits

Letters (ability of inmates to receive

letters)

Televised/Webcam visits

Δ Ability of all visitors to have more frequent communications with

inmates

Δ Visits with physically disabled

people

Δ Visits with people who must travel long distances

Δ Confidential communication with friends and

relatives

Δ Communication with those

forbidden from visiting inmates

Δ Confidential communication with healthcare

providers

Δ Opportunities for physical contact

Δ Inmates bonding with young children

Δ Secure attachments among

youth

Δ Inmate Stress

Δ Quality of relationships as

adult

Δ Mental health status

Δ Likelihood of adult and

adolescent criminal behavior

Δ Mental status among inmates

Δ Violence among inmates/jail crime

Δ Connection to support system

Δ RecidivismΔ Incarceration

rates/crime

Δ Access to healthcare services

Δ Health status

See Incarceration Slide

10Δ Inmate bonding with older children

Research Questions – Visitation Options Pathway

• How do limitations on types of communication for inmates affect re-entry success and future incarceration?

• Do benefits of limiting communication methods outweigh risks?

• Do different types of communication options have different effects on children?

• How does the physical design of visitation space impact visitors, especially children?

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Number of jail beds available

Decrease in juvenile detention beds/increase in

juvenile treatment beds/increase in day treatment capacity;

Create capacity to increase adult beds by 800 over the

next 20 years

Δ Racial disparity in incarceration rate

Δ Incarceration

Δ Pressure to fill beds

Δ Ease of incarceration

Δ Investment by service providers to provide services in jail vs. in

community

Δ Judicial choices

See Incarceration slide

Δ Police choices

Δ D.A. choices

Δ public defender choices

Δ Cost of constructionΔ Ability to locally

house “straddle cell” inmates, inmates

reentering from prison and parolees

Δ in ability to provide services to reentering inmates

See also Services and Visitation Options slides

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See Racial Disparities slide

Research Questions – Number of Jail Beds Pathway

• What effect does adding capacity have on incarceration rates and expenses?

• What is the “right” number of juvenile and adult beds?

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Racial Disparity in Incarceration

Δ Male to female ratio in population

Δ CPS contact in AA families

Δ Income in AA community

Δ Educational attainment among AA

Δ Stress among AA

Δ STI rates among AA

Δ Infant mortality

Δ Infertility among AA women

Δ AA children in foster care

Δ Violence against AA

children

Δ Chronic disease rates Δ Average life expectancy for AA

Health and Social Impact of Racial Disparities in Incarceration

Δ AA Sexual networks

Δ Mental health status

Δ ATOD use among AA

Δ AA teen pregnancy rate

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See Economic Disparities slide

Research Questions – Racial Disparity Pathway

• What effect does racial disparity in incarceration have on illness and life expectancy for African Americans?

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Impact of Economic Disparities

Economic Disparity

Δ Ability of former inmates to obtain employment

Δ Economic burden of the poor (jail fines, etc.)

Δ Family income (spouses, children)

Δ Ability to afford medical treatment

Δ Income among the poor

Δ Insurance coverage among formerly incarcerated and

their dependents

Δ Self-esteem

Δ Ability to access higher education

opportunities

Δ Ability to afford transportation

Δ Mental health status

Δ Healthcare in utilization, prevention,

and screeningΔ Health Status

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Research Questions – Economic Disparity Pathway

• What effect does economic disparity in incarceration have on illness and life expectancy for low income Muskegon residents?

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Incarceration/Crime

Incarceration/Crime

Δ Mental health risk factors affected by

incarceration

Δ Proximity to spouse

Δ Societal stigma

Δ Mental health status

Δ Marital status

Δ Employability

Δ Access to income and housing support

programs

Δ Income

Δ Stress levels

Δ chronic disease

Δ premature mortality

Δ infectious disease

Δ injuries

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Δ Social support

Δ Educational Attainment

See Economic Disparities slide

Research Questions – Incarceration / Crime Pathway

• What effect does incarceration have on illness and life expectancy?

• What is the societal cost of the health impact of incarceration?

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