Date of Defense:
April 26, 2019
Introduction: Mass incarceration began with the War on Drugs in 1971 and the overall rates of incarceration skyrocketed between 1980 – 1997.1, 2 In addition, there has been a massive increase in number of females incarcerated, with a > 800% increase from 1980 to 2016.3 Data from 2011 – 2012 on gender health differences in incarcerated individuals, has shown that females have higher rates of chronic conditions, infectious diseases, multiple chronic conditions, and concurrent chronic condition and infectious disease.4 In addition, females who are incarcerated face other health issues compared to their male counterparts.3 These issues include “history of abuse, trauma, and mental health problems” prior to incarceration, and incarceration tends to worsen these issues.3
This is a public health concern because mass incarceration causes health inequities to continue, impacting communities intergenerationally. Females are the fastest growing population within the prison system 5 so those served in this field experience are directly impacted by this issue. Studies have shown major benefits to incarcerated populations as well as economical and societal benefits due to courses taught in prisons.6 Internally, these benefits include an increase in positive relationships between staff and incarcerated individuals, increased self-esteem, a decreased rate of violence, and destroying racial and ethnic barriers.6 Economic and societal benefits include savings on cost of incarceration and lower crime rates.6
Experience: My goal for this field experience was to increase knowledge on women’s health among incarcerated females. I began reviewing current research and an existing health literacy curriculum in another justice-involved setting. I drafted a program proposal for a 12-week health literacy program, collaborating with the Minnesota Department of Corrections and MCF-Shakopee. When those were completed, I developed part of the curriculum and created a survey to gain feedback for each lesson. Last, I facilitated 4 weekly sessions on women’s health, sexually transmitted infections, family planning, and mental health at MCF-Shakopee and reviewed and incorporated survey feedback into subsequent sessions.
Through all of this work, I addressed each learning objective, including 1) Increase understanding of social and behavioral determinants of health for justice-involved populations; 2) Identify key health issues impacting justice-involved women; 3) Develop a health literacy curriculum for justice-involved women; 4) Apply knowledge of sexual health and key principles of Maternal & Child Health to justice-involved women; 5) Monitor program implementation and incorporate feedback in subsequent sessions.
I created a survey consisting of 5 questions that students answered weekly about that week’s class. The questions addressed likes, dislikes, suggestions, satisfaction, and recommending to others. We started with 15 students, but one student was transferred, leaving the sample at 14.
Organization: MCF-Shakopee is a state-owned prison facility that hosts all of Minnesota’s female prison population, currently 606, including all custody levels.7 The facility feels like a college campus, with courtyards, big buildings, classrooms and a library, and they offer a range of college and trade courses that can also be beneficial after release.8
The MCF mission is to “reduce recidivism by promoting offender change through proven strategies during safe and secure incarceration and effective community supervision.” 9 This experience fit with their overall mission by providing an educational course that is rooted in evidence-based content. It provided information that they can use in their current living situation as well as after release to help them make more educated decisions about their health and health behaviors which impact many aspects of their lives.
Results: Patterns found in the qualitative portions of the survey showed an overall satisfaction with the course, with the main comments being requests for more information and time or responding “nothing” on the question about what could be improved. The total average enjoyment score was 4.6/5.0 and all students said they would recommend the course to others.
|Weeks||Avg Enjoyment out of 5||% recommend to others|
|1 – 9||4.6||100|
Lessons Learned: This field experience taught me: 1) When working with the justice system, it is important to expect the unexpected. Our 12-week course became 9 weeks due to unforeseen circumstances, making it difficult to provide the breadth of education planned. 2) Facilitating a class takes a lot of planning. There is a lot of research involved in creating a high-quality evidence-based course, and the content approval process is slow. 3) Engagement is more important than amount of information. Students learned more when they had a safe space to actively engage. 4) Justice-involved females have a lot to offer. Through shared experiences and knowledge, they taught us so much.
A personal challenge I faced was the fear of not enough… Not enough information, time, or engagement. In the end, I understood that it was a beginner course and we did our best with what we had. Through this experience, I gained a new perspective and understanding of incarcerated women and the justice system and developed personal and professional growth.
Recommendations: Although MCF-Shakopee offers a variety of courses, I recommend that they continue offering health education. The students were very engaged during class and craved more information. Further, I suggest offering a sequence of health courses that build on each other, because students wanted to dive deeper into topics, but time would not allow. Finally, I would recommend collaborating with other colleges and MCF facilities to provide this experience to other college students and others involved in justice systems around the state, but tailor the curriculum to meet the needs of everyone involved. For instance, it wouldn’t make sense to teach a course on women’s health to males.
Conclusion: This field experience addressed the need for health education among females of incarceration. It also gave me a valuable experience and insight into course development, facilitation and evaluation.
1 Drug Policy Alliance. (2019). A Brief History of the Drug War. Retrieved from http://www.drugpolicy.org/issues/brief-history-drug-war
2 Dumont, D.M., Brockmann, B., Dickman, S., Alexander, N., & Rich, J.D. (2012). Public Health and the Epidemic of Incarceration. Annual Review of Public Health. 33(325-339).
3 Equal Justice Initiative. (2018). Incarceration of Women is Growing Twice as Fast as that of Men. Retrieved from https://eji.org/news/female-incarceration-growing-twice-as-fast-as-male-incarceration
4 U.S. Department of Justice. (2016). Special Report: Medical Problems of State and Federal Prisoners and Jail Inmates, 2011 – 2012. Retrieved from https://ay17.moodle.umn.edu/pluginfile.php/2731246/mod_resource/content/0/Maruschak%20%20Berzofsky%2C%202015.pdf
5 Prison Policy Initiative. (2018). The Gender Divide: Tracking Women’s State Prison Growth. Retrieved from https://www.prisonpolicy.org/reports/women_overtime.html
6 Northwestern Prison Education Program. (2019). Benefits of Prison Education. Retrieved from https://sites.northwestern.edu/npep/benefits-of-prison-education/
7 Facility Inmate Profile. (2019). Minnesota Department of Corrections Minnesota Corrections Facility – Shakopee. Retrieved from https://coms.doc.state.mn.us/tourreport/04FacilityInmateProfile.pdf
8 Wikipedia. (2018). Minnesota Correctional Facility – Shakopee. Retrieved from https://en.wikipedia.org/wiki/Minnesota_Correctional_Facility_%E2%80%93_Shakopee
9 Minnesota Department of Corrections. (n.d.). Vision, Mission, Values and Goals. Retrieved from https://mn.gov/doc/about/agency-background-history/