Break Cycle of Repeated Incarcerations

Research Helps Released Inmates Follow a Healthy Path—And Break Cycle of Repeated Incarcerations

When talk turns to crime and punishment, it's the headline-grabbing issues — the death penalty, wrongful convictions, mandatory sentences and human-rights abuses in prisons — that spark the most lively public debate.

But for Nicholas Freudenberg, a Distinguished Professor of Urban Public Health at Hunter College, it's the inmate-related topics that go virtually unnoticed that have the biggest impact.

So for two decades, Freudenberg has been going behind the bars at Rikers Island Detention Center to try to find out what's keeping jail inmates from making a fresh start on the outside.

There was, for example, the 19-year-old who grew up in Brooklyn coping with a mother who drank and a father who had a tendency toward violence. He left school after 10th grade and had been arrested eight times for minor offenses that ranged from possession of marijuana and jumping a subway turnstile to disorderly conduct and resisting arrest.

After completing Freudenberg's REAL MEN, or Returning African-American Latino and Low-income Males to Enrich Neighborhoods program, this young man started to turn his life around. He began working on his high school equivalency degree and took a job at Dunkin' Donuts, where he has worked his way up to shift leader. What helped this young man break the cycle of crime? He credited REAL MEN, along with a host of other factors, including the support of family members.

And there was the 18-year-old felon from Manhattan with the "I hate the world attitude" who had spent nearly eight months at Rikers for two robbery convictions. He didn't have much incentive to live — his drug-addicted parents had recently died of AIDS and his younger brother succumbed to severe asthma shortly afterward — much less make something of his life. The only thing that eased the pain and anger was pot.

He says REAL MEN showed him another path: He's working on finishing his high school equivalency degree and hoping to begin a career in music so as to provide for his girlfriend and their baby.

Supported by the National Institute of Drug Abuse, REAL MEN aims to help young men who are released from jail stay healthy and free by offering them a 30-hour jail and post-release program on health issues.

Freudenberg noted that half the people leaving jail are re-incarcerated within 12 months. Many inmates have infectious diseases such as HIV, or suffer from asthma, or abuse drugs or have mental health problems. "There are more mentally ill people in jails than there are under psychiatric care," he said, adding that his research explores "what happens to jail inmates when they go home, how the re-entry experience may contribute to health inequities in low-income communities, and how our social policies may contribute to re-incarceration. It's one piece of the puzzle of improving health in poor communities."

The research, which between 1992 and 2002 was funded with more than $9 million from the Robert Wood Johnson Foundation, has led to changes in city and state policy. When one of his recent studies showed that women who had Medicaid were more likely to stay out of jail, the city began a program to offer sentenced inmates the opportunity to sign up for coverage that begins on their first day of freedom. And it was his data that helped lead to the passage of a state law in July that restores immediate Medicaid coverage to jail and prison inmates after their release.

"Dr. Freudenberg's research was an important factor in our starting this," said Kathleen Coughlin, Deputy Commissioner for Programs and Discharge Planning for the New York City Department of Correction. "Some people might ask, 'Why give incarcerated people extra services?' Dr. Freudenberg's research helped us to demonstrate that the answer is at least partly economic — it costs more not to provide the services that help people to stay out of jail than to pay for putting them in jail again."

The benefits accrue to the released inmate, and also to society at large, Freudenberg said. "We have the opportunity to connect these people to services while they are in jail as opposed to making our jails schools for criminals. Changing these policies will benefit community health because the inmates are connected to the people and services that can help them stay on a healthy path. If we're going to see any improvement, though, we're going to have to deal with all the other issues, including employment and education, as well as health care."

Since 2004, Freudenberg has been working more closely with the city as a member of the New York City Discharge Planning Collaboration, which was set up by the New York City Department of Correction and Homeless Services to bring together city officials, service providers, researchers and advocates to identify new approaches to improving outcomes for those discharged from jails and shelters. "We're trying to figure out how to best intervene to help break the cycle of re-entry into jail," Coughlin said. "We're hoping to come up with new ideas."

Freudenberg chose to base his research on inmates at Rikers Island's 10 separate facilities because it is the city's largest jail and also one of the nation's largest; he and his staff personally interview inmates and follow up with them after they are released. "Jails, as opposed to prisons, are where we place people who are awaiting sentencing or who are serving sentences of less than a year," he said. "Most public attention has been focused on the 600,000 people per year who are released from state and federal prisons instead of the more than 7 million who are discharged from jails. These people have a profound impact on the health of low-income urban communities."

Freudenberg became interested in the jail populations in 1988 when he was working to develop HIV-prevention programs in poor New York City communities. "Jails were collecting points for people with, or at risk of, HIV and other health problems, so it seemed like a good place for public health intervention," he said.

His most recent study focuses on jailed Latino and African-American adolescent males and how their concept of masculinity may put them and the people they care for at risk. "Some of the so-called macho behaviors they need to protect themselves in jail, like violence, are dysfunctional and don't work well for them or for society when they are released," Freudenberg said.

"There's not any single thing we can do," he said. "Inmates have a variety of intersecting problems — substance abuse, being victims and perpetrators of violence, chronic health problems, low levels of education — so it's a challenge to find an effective way to address this constellation of problems."

The support of Mayor Michael Bloomberg's administration, as well as interest from the state and federal government, has given Freudenberg hope that there will be more reforms.

"I'm optimistic," he said. "We've only begun a process of disenchantment with incarceration as a response to every problem. We send too many people to jail. More people are beginning to see that it's not possible — or desirable — to lock people up and throw away the key because almost everyone who is jailed does eventually come home."

Entrepreneurial Training Seen as Key to Productive Jobs for Former Prisoners

Small businesses that provide landscaping, office cleaning and other personal services have helped entrepreneurial-minded welfare recipients and immigrants find success. Now a new study suggests small business ownership may be the way to overcome the obstacles to work faced by another marginalized group: returning prison inmates.

According to Venturing Beyond the Gates: Facilitating Successful Reentry with Entrepreneurship, published this summer by John Jay College's Prisoner Reentry Institute, self-employment may hold the key to helping formerly incarcerated individuals secure jobs.

"As more and more people return from prison, many lacking educational and vocational skills necessary to compete in today's labor market," the report noted, "entrepreneurship may represent a means of capitalizing on an underutilized pool of human resources."

"Microenterprises," described as businesses with five or fewer employees and start-up costs of $35,000 or less, may be the way to go. According to the report, a combination of private and public sources funds an estimated 500 microenterprise development programs in the United States. These programs provide essential elements to novices including training and technical assistance; credit and access to credit; economic literacy and asset development; and follow-up services.

The publication noted that self-employment may not be a viable option for all former inmates, but there is value in the entrepreneurial training. "These individuals may never become entrepreneurs themselves, but will use their entrepreneurship training to improve their performance as employees and to proactively engage with their families and communities," the report said.

Case studies of formerly incarcerated persons who have launched their own successful businesses are interspersed throughout the publication. Adrienne Smalls saw a need while incarcerated for a service that would help families purchase and send "high quality, state-approved products to their loved-ones in New York State prisons." Smalls started in 1999 with $500 and a shopping cart to haul her inventory. Her company, Small Quality Packaging Corp., now nets nearly $50,000 a year and reaches over 4,000 inmates and their families.

Another former inmate, Theo Tiger, launched Ocean Touchless Cleaning Systems and Air Scents in 2007, using his first tax refund as start-up capital. The company received a minority business contract from Kansas City, MO, last April to provide multiple cleaning and sanitation services to firms in the city's metropolitan area.

In San Diego, CA, Robert Casas used knowledge he acquired on a prison work crew to develop Cut and Trim Landscaping, according to the monograph. Founded in 2000, the company provides yard work to residences and businesses in the area. Casas has three full-time workers and three freelancers. Cut and Trim Landscaping grosses between $120,000 and $150,000 a year.

The report serves a dual purpose as a primer for those unfamiliar with the issues surrounding reentry, and as a guide for others who may be acquainted with its inherent problems, but not the cutting-edge solutions being applied. A study the monograph cites found that in 2003, as many as 41 percent of inmates at federal, state and local correctional facilities lacked a high school education, as compared to just 18 percent of those 18 and older in the general population.

Mass incarceration, the phrase commonly used to describe the nation's current state of criminal justice, has had a significant impact on state budgets. The report cited a federal Bureau of Justice Statistics analysis of expenditures by state corrections departments which rose nearly 800 percent from 1980 to 2004 or from $6.9 billion to $62 billion.

"Imprisonment itself prevents hundreds of thousands of people from participating in the labor force and from contributing to the economy, resulting in reduced tax revenue and productivity," according to the report.