Going upstream: Applying a public health perspective to interventions for incarcerated youth

The United States incarcerates more people than any other country, and youth continue to comprise a high proportion of those individuals who come into contact with the criminal justice system. Increased awareness of the social determinants of health has necessitated identifying ways that public health can address institutional racism, poverty, and other structural factors that lead to youth incarceration and related negative health outcomes. Interventions with incarcerated youth focus on changing a variety of outcomes in attempts to improve health for this population and reduce further incarceration. This content analysis examined 67 research articles, published within the last 30 years in mainstream public health journals, about public health interventions with youth involved in the criminal justice system. The study identified where along the ecological model the interventions lie; underlying rationales, assumptions, and theories of change associated with the interventions; and challenges they highlight for creating structural change within the context of the criminal justice system. Results indicate that the majority of interventions with incarcerated youth predominantly target individual behavior change without addressing structural or institutional factors. Similarly, intervention evaluations primarily utilize individual outcome measures, such as recidivism and behavior change, to demonstrate program success. Implications for public health are discussed and recommendations for increasing institutional-level interventions for incarcerated youth and solidifying a public health approach rooted in social justice are provided.