The number of individuals released from state and federal prison has increased substantially in recent years. According to The Bureau of Justice Statistics, in the United States, about 5 million formerly incarcerated adults (returning citizens) are under community supervision (e.g. probation or parole) at any given time. And these returning citizens face numerous barriers—inadequate housing, poverty, unemployment, and lack of access to nutritious food and physical activity.
“Formerly incarcerated individuals—or returning citizens—face significant barriers in accessing health care and engaging in activities that promote health and wellness,” said Rodlescia Sneed, assistant professor in the Division of Public Health in the Michigan State University College of Human Medicine. “Healthy eating and physical activity depend on numerous social determinants of health, including food access, adequate housing, community/social support, education, and income,” she added. “Returning citizens typically experience gaps in these areas.”
Sneed is partnering with the MADE Institute, a community-based reentry program based in Flint, Michigan, to address these issues. Their project, Harnessing Education and Lifestyle Change to Support Transitional Health (HEALTH) for Returning Citizens: A Pilot Study, will be funded by a two-year, $50,000 grant from the Blue Cross Blue Shield of Michigan Foundation.
“Given the high disease burden and unique educational needs of returning citizens, this project fills an important gap in the support services currently offered to this population,” Sneed said. “This project will allow us to design and test physical activity and nutrition intervention specific to the needs of returning citizens that can eventually be evaluated for effectiveness in a large, randomized trial.”
Returning citizens often experience high rates of chronic disease and disability. Half of all persons in state or federal prisons report having a chronic condition such as asthma, heart disease, or diabetes. This translates into a high burden of chronic disease upon community reentry. Yet, chronic disease prevention and self-management are not typically addressed in community reentry programs.
Furthermore, poor eating behaviors and a lack of physical exercise are linked to numerous chronic health conditions, including obesity, type 2 diabetes, chronic pain, heart disease, hypertension, stroke, certain cancers, and depression.
“While medications are known to improve management of these conditions, lifestyle changes can also lead to improvements,” said Sneed, noting that existing reentry programs don’t typically address the benefits of physical activity and healthy eating habits.
The MSU researchers will address these gaps that currently exist in reentry programs.
Through their pilot study, the research team will train formerly incarcerated adults to serve as group fitness instructors who can provide physical activity training to their peers.
“Training formerly incarcerated adults to serve as fitness trainers will provide these individuals with a skill that can then be leveraged for future employment and income opportunities,” Sneed said. “This is so important because this population often has difficulty finding work due to their criminal backgrounds.”
The team will also develop a 16-week nutrition education curriculum.
“Limited access to healthy foods is a major barrier for returning citizens,” Sneed said. “There are no full-service grocery chains in the city of Flint, and many in this population rely on local food pantries and food assistance benefits for nutrition. We will address these constraints by teaching returning citizens how to maximize food pantries and food assistance benefits for healthy eating. The program will also rely on visual recipes for non-readers, given the low literacy rates among formerly incarcerated individuals.”
“Finally, this project increases equitable access to healthy eating by acknowledging the role that housing security can play in healthy eating. Our nutrition curriculum will be intentionally designed to support healthy eating for individuals who lack access to kitchens, refrigerators, and cooking equipment,” Sneed added.
“Through our partnership with the MADE Institute, we will design and test a physical activity and nutrition model that, if effective, could be broadly implemented within community reentry programs around the country.”
February 7, 2022