Incarceration and Health, with Cindi McEachon of Peaceprints of WNY

Buffalo HealthCast co-host, Dr. Jessica Kruger, speaks with the CEO of Peaceprints of WNY, Cindi McEachon about incarceration and its effect on the health of those who were recently released from a justice setting, and what Peaceprints of WNY is doing to bridge the gap in disparities.

Teaching Notes

More information on Peaceprints of WNY

Credits:
Host/Writer/Researcher - Jessica Kruger, PhD, MCHES
Guest - Cindi McEachon, MBA
Audio Editor - Omar Brown
Production Assistant - Sarah Robinson

Intro 0:00
Hello, and welcome to Buffalo HealthCast - a podcast by students, faculty, and staff of the University at Buffalo's School of Public Health and Health Professions. We are your co hosts: Tia Palermo, Jessica Kruger, Skyler Lawson, and in this podcast, we cover topics related to health equity here in Buffalo, around the US, and globally. In this first semester of the podcast, we're taking a deeper look at racism and health. We'll be talking to experts around the US, as well as individuals here on campus and in the Buffalo community who are working to remove inequities to improve population health and wellbeing. You'll hear from practitioners, researchers, students, and faculty from other universities who have made positive changes to improve health equity and inclusion.

Jessica Kruger 0:47
Today's guest is Cindy McEachon, who is the CEO of Peaceprints, a local organization helping individuals who are justice involved and recently released from a justice setting. She holds a degree in Health and Human Services from the University of Buffalo. Welcome, Cindy.

Cindi McEachon 1:08
Great to be here.

Jessica Kruger 1:11
Could you tell me a little bit more about Peaceprints and what they do for folks in the Western New York area?

Cindi McEachon 1:17
Sure, Peaceprints is a reentry organization that has been around since 1985. We have all sorts of facets of programming, working with all sorts of individuals from all walks of life. The common thread is that there is justice involvement on some level. So we work with every jurisdiction level: local, state and federal. We have housing programs, we have intensive case management models, so more community-based, we work with young people, families, and we have our food pantry. So we do a lot with folks both inside the facilities as well as out in the community.

Jessica Kruger 1:56
That's excellent. It's so great to hear that folks are working with individuals in all sorts of settings. Now, can you tell me a little bit more about the background of scale of incarceration in the United States?

Cindi McEachon 2:11
Yeah, we are certainly number one in this space. We have over 2.3 million individuals that are incarcerated on some level. So whether that is local, state or federal, and another four and a half million that are out under community supervision actively, so we definitely incarcerate at the highest value. We are, putting it another perspective, only 5% of the world's population, but we incarcerate 25% of those incarcerated, here in the United States. So incarceration, mass incarceration, mass supervision is a way of life here.

Jessica Kruger 2:54
Wow, it's amazing to think about not only people who are physically within a facility, but under supervision in some way, shape, or form. That's a lot of individuals, and I'm guessing this affects the communities. Can you tell us a little bit more what you see?

Cindi McEachon 3:15
Yeah. So, you know, you figure 2.3 million people are currently behind bars, but 95% of those individuals are coming back into our community. So, they make up what is now that number of four and a half million that are currently under supervision, but that's not counting the individuals who have satisfied that supervision, who are no longer under or may have gone to jail, but are back out and did not have supervision. So we have this plethora of people that aren't even accounted for in this mix as well, but the key here is that 95% of the individuals who are incarcerated will come out likely under supervision back into their community. And that in and of itself, causes huge ripple effect because you've extracted somebody for an extended period of time, and then placed them back into the community where they have to assimilate. On top of that, there's a ton of research to show that there is an increased or an elevated rate of chronic disease, of substance abuse, of mental illness, of health related concerns when an individual is incarcerated. And a lot of that has to do or is fueled by environment. And then we're going to release individuals, right? 95% - that's our number - back out into the community when we've already increased some risk. So it's a very overwhelming system.

Jessica Kruger 3:27
I'm so glad you brought up the the challenges with chronic diseases among folks and as they're released back into communities. Can you tell me a little bit more about some of those health challenges in which people are facing after they've been released?

Cindi McEachon 5:11
Yeah, I mean, when you're talking about chronic illness, we've had individuals that have had pretty intense surgeries. So we're talking heart conditions, we're talking about things like that, that health ailments that have helped, or happened while they were incarcerated, because they're also older in age, right,? We have an aging prison population right now. So we're not talking about as many young people, not that that really makes a difference, as it still impacts your health overall. But we have seen now the effects of mass incarceration for decades. And what we have is an aging incarcerated population, who's now going to come out into the community. So they're already older in age, you have naturally occurring diseases and illnesses that we see in the community often happen, a little bit later in life, happening earlier, because they're incarcerated. So you will have diabetes. You will have, unfortunately, we've seen a lot of folks with cancer coming out more recently. You have individuals that have had kidney failure, or the amount of medications individuals tend to pass through our doors, carrying with them, and then that's not counting where they stand in terms of the mental illness, right? If there is trauma that's been experienced, they're battling depression, or they do have a serious mental illness documented, and there's medications and/or treatment required in alignment with that. So we have folks that kind of run the gamut when it comes to what the need might be. What we find to be most overwhelming is that when an individual returns, they don't have a history, per se, of having a family doctor, or their health history documented, that is available to agencies in the community once they're released. That information stays in prison, and so it stays in the facilities and doesn't come out with them. That's very overwhelming; we find that they have a very limited supply of their medications made available to them. Sometimes individuals don't even have active Medicaid when they come out. And so if that's not already activated, pre-release, we're starting behind, right from the onset of release. And that's only if we're lucky enough to have an individual pass through our doors and we become aware. We certainly do not work with everybody that returns from incarceration that comes back to our community. And when we talk about these huge numbers of releases, we have, unfortunately, a lot of individuals who fall in the cracks who are not necessarily connected with services or don't have somebody to try and connect them with appropriate resources.

Jessica Kruger 7:59
Wow. So when we say incarceration as a public health problem, this is really hitting on so many levels. Not only while individuals are being incarcerated, not only communities, but also this can impact their health as people are released, not knowing their medical records coming out, possibly sicker than when they came in. And so this is something that we really need to talk about within the public health community more than we do now. What would you like to see if you had a magic wand and could change the system after someone was released? What do you think would be the ideal way to help people kind of go back into their communities?

Cindi McEachon 8:47
I would say with my magic wand, we would have increased accountability and communication. Those two things, I think, would shift one's access, and what it looks like to connect with resources from inside to outside. Unfortunately, what we find is that communication is stunted at release. Sometimes it's nonexistent, or incredibly limited at what's made available or what the person is bringing with them. You also have such unique stories person to person. So if an individual was incarcerated when they were 18 years old, and is now being released at age 55, their entire adult life has very little record outside of what happened in the facilities. That's a really difficult space to start, and to be able to connect somebody with resources. But then on the outside, that's really where I think accountability is huge, is that we do have a multitude of providers, of helping spaces. Another area where we struggle is that there is zero accountability on the side of providers. So when you talk about social determinants of health, you talk about access to services, you talk about this as a public health crisis; accountability plays a role, because service providers also realize that there's little happening prior, so there's little expected after. And with that mentality, sadly, being at the forefront of what fuels a lot of this, individuals and their families are set up to fail every step of the way, and then are blamed for it. But in fact, we've made it incredibly difficult for them to access what they need. It's very frustrating. So I would say communication and accountability on both sides, you know, certainly necessary. And I think that would improve things a lot.

Jessica Kruger 10:44
I can't imagine spending the majority of your adult life in a criminal justice setting, and then being released, and not knowing how to navigate the system, possibly even how to advocate for yourself. And going through that with a chronic condition could be incredibly challenging for individuals. So tell me a little bit more. When an individual's typically released, do they typically have Medicaid? Are they connected with a primary care doctor? What is that communication, or maybe that communication gap between release and during release?

Cindi McEachon 11:33
In a perfect world, yes, they have Medicaid already activated pre-release. We know our world is not perfect. Sadly, it's kind of a toss, right? We really don't know upon arrival, if somebody is one of the lucky few that did have their Medicaid activated prior to release, or if they fall into the group that did not. I will say, we see more and more that fall into the "did not get connected", unfortunately. I think there's multitude of reasons. For a while, the state was pushing, on a larger scale, connecting individuals prior to release. I was seeing change. As an agency, we were noticing that at release, more folks were coming out with their Medicaid activated. However, policy changes, COVID, all sorts of shifts to the way we were doing business, has changed a lot of the way things were operating. And so now individuals are getting out faster - individuals who didn't think they were getting out and had more time, all of a sudden, don't, and are eligible for release because of law changes and policy changes that have happened, and sweeping reform that has come in without prior planning to ensure that they don't fall through the cracks, because there's not an ability, on the system side, to catch up or prepare for that in advance. Sometimes it's happening in incredibly short notice, and so we have seen over the last 18 to 24 months, sweeping changes in New York State and its impact on pre-release planning, and what that looks like upon. So, already, not great, has become incredibly difficult. And when you break it down, I truly do believe, and I spent a lot of time going inside state facilities prior to COVID, you have some awesome people that do work in these facilities that are working towards the greater good. But facilities by design are in rural communities, are not typically connected to spaces where the majority of individuals are going back, and it is difficult on the side of the staffing, even, to have updated information, be able to access service and advocate for an individual prior to release, even in the old system. Because it just wasn't created to make it easy. I think COVID took that and dropped it on its head, on a whole different way, because all these agencies, whether we did great business or poor business, all of us were impacted by COVID. Many agencies shut their doors, changed the way they were doing things, shut down particular services or programs, and there's no way for information to transfer to the 50-plus facilities across New York State. And that's not even counting the jails - that's state facilities, right? And so this is a big deal. When you're talking about pre-release planning, when you're talking about access to information and connecting an individual for post release service, it's become even more difficult.

Jessica Kruger 14:41
Yeah, I know many of us really want reform in the criminal justice system and really want to change the way things are being done, but you're right. We're not thinking about some of those other ripple effects that this has, especially on the individuals who are being released and not having that planning and that opportunity to get things in line, or even communicate to organizations in which they may be going to, or working with.

Cindi McEachon 15:10
Right, when the primary method of communication is a typed or handwritten letter, and I mean, typed from like a typewriter, or handwritten letter. It's a needle in a haystack - you throw it out there and just hope, whomever you sent that letter to, to offer or ask, is still around. And not only are they still around, that they open your letter, and then from opening it, that they actually respond to you. These are all things, that, in our world today, in our society, we don't really do that. We want instant, even as providers, so we want to be able to email, we want to be able to pick up the phone, worst case scenario and call. But sadly, you got to take the time to handwrite or type a letter response back. And that's how information is passed. And that's pretty difficult, right? When you're prepping for a release.

Jessica Kruger 16:11
Wow, it's like time traveling to a different world. So these are a lot of really heavy topics that I don't think a lot of folks think about on a daily basis. So when you think about what your organization does, and the impact that you have on individuals, could you tell us a little bit about some success stories that you've had and what your organization is working towards in the future?

Cindi McEachon 16:40
Absolutely. You know, I've been doing this for about 11 years now, and sometimes, just getting connected with services will be success, right? Or it could be, you have a complicated story, and it's taken three staff and a phone call for me, and constant letter writing, and bothering people to get you a birth certificate. And sometimes it's that, right, and we have to celebrate even the tiniest of wins. But on a large scale, when we find folks satisfy the terms of their supervision, take it to that next level - they've got a job, they've rekindled relationships with their loved ones, they're driving, they own their own vehicle, some of them have their own places, whether that's an actual house that they've purchased, to opening their own businesses, right? It depends on the person because it's so highly individualized. But when you hear, each step of the way, these little successes that compound into something larger, because they beat the odds. I think that for us is what fuels us to keep going. I mean, we're all human. There's not one of us that doesn't wake up some days and just not want to do something, feel unmotivated, or make, maybe, not the greatest decision. We all do it. That's the beauty of it. That's actually life, that is not being a good or bad person, that is not being incarcerated or not. That's truly life - we all experience this, and the individuals we work with are living just like we are. And so we look for all of these little wins. And in some cases, these larger ones, of where does this take us? Where does this go? We had one individual pass through most recently. He actually was highlighted in our annual appeal this year, but Eddie is his name, and Eddie has gone through our Bissonnette House transitional program. So fresh out of the facility, graduated, moved into our Hope House program. He's off parole, he's working, he owns two vehicles at this point. He is thriving. And he's so excited. He's even advocating for people to make donations to us, right? I mean, this is just mind blowing, right? When you think of these wins, and for us, it's these stories, right? Another young lady that, I don't know, from when I met her five years ago, to now she's working two jobs. She's in her own apartment. I mean, she's doing great. And she's off supervision, right? These are the things that, and we remain in contact, we have conversation. She has her ups and downs, life still happens. But these are the stories, and I firmly believe it's access to that opportunity. And unfortunately, this particular industry in the space often denies access, truly denies access to individuals, and then blames them for not persevering or trying to push past what we denied. And when you just offer that little bit, that opens up access, and people just move with it. And it's pretty amazing to see.

Jessica Kruger 20:16
Thank you for sharing those stories. I mean, I'm sure you have hundreds and hundreds more of the successes that you find with all the individuals that you work with and your staff work with. It's been really interesting to learn more and more about incarceration in the US, and see some of the disparities with things that you have talked about, whether, who's been incarcerated, but also the access. Could you speak to that a little bit?

Cindi McEachon 20:52
Yeah, you know, over the years, I think what was one of the most eye opening for me - and I identify as a white female, I grew up in a suburban town, and I come back, I move into the city, and I start working with individuals and people of color that are justice involved. And what I started seeing was the inconsistencies of individuals passing through my services, this is all walks of what I've done. So all the spaces where I've worked in, participated, or volunteered time, and depending on what they look like, what I draw from them in terms of their conviction, or the amount of incarceration they've done, vary greatly, simply by the color of their skin. And this is, before we were, sadly, even recognizing it. It just happened to be something I was noticing - that I could talk to a young man who's in his 20s, who's white, and this was his first time incarcerated, and he only was in for, you know, a year and is now out on parole. Then I look at a young man, same age, who's Black, who, in my opinion, has a lesser conviction, but was incarcerated for a longer period of time, and also got a longer sentence attached to him, which was fascinating to me. I could not wrap my head around how or why it was happening. And I was newer into the industry, you know, at that time, but it was just fascinating to me how no one talked about it. No one recognized that as a concern, or an issue, and truthfully, that the majority of the individuals I served were people of color. That was the majority of the individuals. Why was that? Why is that? I am thankful that we are moving in a direction of acknowledging it now. I think we have a long way to go. But we're at least recognizing that there's some error there. But it's very real, and so it started to come down to communicating with individuals and just pointedly saying, it's not fair. It's not right. But we need to use the fact that I am a white woman, and I'm a CEO, to break barriers. It's not fair and it's not right that I have to use that. But I want you to know, I recognize the privilege that I have with it. And I need you to share with me what's happening, and together, we will go through this until the world shifts enough that we don't have to do this and that your voice is heard. But our choices are: get angry, and have no change, nothing happens, or go through this together. And that has been my motto and the way we've gone through things, and I think that's rippled out through the agency, and become ingrained in the culture of the organization. Would love to see full scale change, and I can give you countless stories of where we've had to use our privilege, where I personally have had to in situations, and it shouldn't be that way.

Jessica Kruger 23:59
Yeah, I think you bring up a great point in the fact that we really need advocacy on this issue from all levels. And, sadly, at this point in time, we do have to use our privilege to speak for others who are not heard as much as others are in this world. And hopefully, I'm right there with you, I can't wait to see change continue. And I think by spreading awareness about what's happening as people are being released, and even the disparities in which are occurring in and out of the criminal justice system, I hope to see that and I am so glad that there are so many passionate people like you working on this project and many projects like it around the US. So, I thank you so much for your time, and before we go, I would love to know what's next for you and the organization.

Cindi McEachon 25:00
Well, we are looking to keep moving and grooving, challenging the status quo, and hopeful that we will bring about some new housing opportunities, hopefully sooner rather than later. But that's a difficult thing to maneuver through, in terms of the politics of it, but we're really excited just to grow as an organization. So, we'd like to extend our housing accessibility, and really start paying attention to, I think I'd mentioned earlier on, the aging, incarcerated population. Well, if you are older while you're in, you are even older when you get out, and finding suitable housing for individuals that are older in age, and appropriate housing, if you will, that is clean, safe, and affordable for somebody. We are looking to fill a gap that we're seeing or recognizing, trending higher here locally, which I'm assuming is happening nationally. And then our in-prison program, we have a collaboration with the local jail with an innovative program called Project Blue. And our goal is for our program that has served just over 300 individuals over the last couple years, could expand to become a jail-wide program and so, hopeful that that's on the horizon, and we'll continue to move. That program is currently being followed by a team of researchers from Georgia State assigned to us from the federal government, so the Department of Justice and the Bureau of Justice Assistance gave us a grant to actually collect data points on this program and determine if it could be a national best practice model that we could see implemented in other spaces. So kinda cool - happening here in Erie County.

Jessica Kruger 26:45
That's fantastic. I can't wait to see where you go and the organization goes and helping others. We'll link in our show notes to Project Blue and some other information about the organization. I'm Dr. Jessica Kruger and I was joined by Cindy McEachon today, the CEO of Peaceprints. Thanks so much for tuning in.

Outro 27:07
This has been another episode of Buffalo HealthCast. Tune in next time to hear more about health equity in Buffalo, the US, and around the globe.

Buffalo HealthCast

Incarceration and Health, with Cindi McEachon of Peaceprints of WNY

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