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Addressing the Unmet Health Needs of Formerly Incarcerated Individuals

Image of Pascale outdoors

September 23, 2022

Pascale Vallee is a recent graduate of the MPH in Global Health program at the Dornsife School of Public Health (DSPH). Before pursing an MPH, she had been advocating for disability rights and social justice locally and chose the program to build additional skills to serve Philadelphia and beyond. Her Integrative Learning Experience (ILE) project focused on prison health, and specifically on helping to ensure that individuals released from detention in Philadelphia were able to navigate complex barriers and be linked to the health services they needed.

In her ILE, Vallee supported local post-incarceration organizations and social workers at a local prison to improve linkages to care for released detainees. This included addressing chronic conditions, substance use treatment, mental health, and disabilities in collaboration with the Philadelphia Department of Prisons (PDP) staff and leadership teams like the Health Committee of the Philadelphia Reentry Coalition, the Office of Homeless Services, the Philadelphia Center for Independent Living, and other agencies and organizations in the city.

Organizations that support this population lack research to inform their services and care. “We desperately need more research because what is measured is addressed,” said Vallee.

To help fill this gap in data, she used PDP data that found 80 percent of incarcerated Philadelphians at the county jail came from medically underserved areas. She created a colorized map in accordance with how many incarcerated individuals were from these areas. Next, she used a map of Philadelphia's medically underserved areas to compare them and confirm the statistics offered by PDP.

“This introduced many questions about the causes of anti-social or criminal behavior, potential for improving social and political determinants of health in underserved zip codes, and the fragmented nature of services for vulnerable and stigmatized populations,” said Vallee. “While there are numerous services available to reentering individuals, there is no central portal or directory, which leads to frustration, reduced medical compliance, and fragmented support and care.”

Vallee also uncovered some gaps in communication from a qualitative assessment she led.

Once individuals are no longer under the care of the Health Committee of the Philadelphia Reentry Coalition, it is rare that feedback on the services they are referred to is communicated back to PDP staff. “The feedback loop never closes,” shared Vallee. “Incarcerated individuals may be referred to various services, but staff never hear how their former patients are doing upon release. These thin evaluation and assessment opportunities are to the detriment of all stakeholders, including the community.”

Vallee is hopeful that her research will have impact and improve health outcomes among this population. “The city's Office of Reentry Partnerships made a verbal commitment to use my research as a road map for change,” she said. “Hearing that was probably my proudest and most humbling moment while at DSPH.”

To make lasting changes, Vallee acknowledges the need to reimagine the current justice system in the U.S.

“When so much anti-social or criminal behavior is created by childhood trauma, limited economic and educational opportunities, unsafe neighborhoods, and a myriad of systemic causes, it seems obvious that the way that we currently and historically conceive of jails and prisons does not serve the community or the incarcerated population. We need to confront the human rights violations of our carceral institutions and their ineffectiveness at deterring crime, rehabilitating individuals to become productive community members, and facilitating peaceful, healthy communities.”

Throughout her career, Vallee is committed to advocating for vulnerable and stigmatized populations, and public health is a field that enables her to do so. She plans to stay in the Philadelphia area and continue to shine a light on injustices that inhibit health.

Learn more about the MPH in Global Health