Emily Kack ’22 works to address personalized needs with incarcerated populations
by David Cohen
Emily Kack, Master of Public Health (MPH) ’22, recently partnered with Wellpath health care system for her practicum work. Wellpath provides care to vulnerable populations including those in various levels of correctional facilities.
Kack sought to understand the public health needs of incarcerated patients, hoping to create an intake plan designed to investigate their medical needs based on both medical diagnoses and social determinants of health. The information would direct the patient’s subsequent care during incarceration and once they leave a correctional facility. This evaluation of health needs comprises one part of reform needed to provide the resources necessary to re-enter society and avoid returning to the prison system.
Kack remains motivated to broaden her own understandings of health inequalities and learn about the obstacles that have impacted prison reform.
“I’m working with Wellpath’s Chief Clinical Officer, Dr. Thomas Pangburn, to incorporate social determinants of health into correctional care,” Kack said. “My undergraduate degrees were in sociology and criminal justice, so my interest in exploring the inequalities behind prison health systems has been developing for a long time. We wanted to make sure there is continuity between the care that incarcerated patients receive before and after they are discharged, since they are often released without proper resources.
Kack said the Wellpath program will start in Michigan with hope of expansion to the rest of Wellpath’s locations across 34 states as it continues to develop. While doing background research for the program, she examined the impact of social determinants of health in the top disease states served by Wellpath. Currently, she evaluates the impact of incarceration as a whole on health as it influences social determinants.
Kack set project goals to ensure individualized improvements for inmates and to assure proper resources once released. She also believes her work will address community concerns, including dismantling the system that encourages recidivism and drives inmates in and out of prison.
“The U.S criminal justice system, in my opinion, is inherently flawed,” she said. “Within three years of release, about two-thirds of individuals will be re-arrested. There is a reinforcement loop where people go into the prison system, come out, have no resources, and then return to prison. Wellpath is working to break this cycle of recidivism in the incarcerated population by connecting patients to resources in their communities that will address their social and health needs.
“In addition to a lack of resources, individuals who have previously been incarcerated face barriers once released, including lack of access to loans and personal benefits and (in felony cases in certain states) the inability to vote which takes away their voices from the community and their ability to impact change in the prison system. Ideally, by providing resources, we can help persons who have been incarcerated with housing, education, jobs, and other basic needs so they don’t return into the prison system.”
Kack noted she obtained multiple skills through MPH program classes and learning experiences that led to her current success with the practicum.
“Epidemiology and biostatistics taught me to analyze the rates of communicable and non-communicable diseases that are prevalent in the incarcerated population. I also completed class work in health behavior that helped me to understand the ways people change their health behaviors,” she said. “We’re trying to implement a program which partially relies on behavior change to improve health outcomes. An example would be dietary changes in a patient with diabetes or smoking cessation programming for a patient with hypertension or lung disease. Having a greater understanding of behavior and change frameworks will create more effective interventions that are more likely to be utilized.”
Because Wellpath’s program is one of the first of its kind in correctional healthcare, Kack said it will take some time to demonstrate an improvement in health outcomes and a reduction in recidivism. However, she remains hopeful that Wellpath and other leaders in correctional healthcare will continue to find interventions that improve patient health and help previously incarcerated persons in their integration into the larger community.