Community Relationship Quality and Reincarceration Following Rural Drug-Using Women’s Reentry From Jail

Published date01 June 2022
Date01 June 2022
Subject MatterArticles
CRIMINAL JUSTICE AND BEHAVIOR, 2022, Vol. 49, No. 6, June 2022, 853 –871.
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© 2022 International Association for Correctional and Forensic Psychology
University of Kentucky
University of Kentucky
University of Kentucky College of Medicine
Interpersonal relationships and social support are important factors in women’s successful reentry from incarceration, but
limited research has explored the role of women’s relationships to their communities during the reentry process. In the current
study, women were recruited from three rural Appalachian jails, screened for high-risk behaviors (including drug use and
unprotected sex), and interviewed at 12 months postrelease (N = 339). Interviews included the Relational Health Indices–
Community scale, a validated measure of women’s relationships in community contexts, with subscales for empowerment/
zest, engagement, and authenticity. Women who were reincarcerated during the 12-month postrelease period (43.4%) were
younger, less employed, more likely to have used illicit drugs, and reported lower-quality community relationships at
12-month follow-up. Multivariate logistic regression models indicated that the effect of community relationships may be
driven by the engagement and empowerment/zest constructs. Results suggest that community connectedness may relate to
more successful reentry outcomes for rural women.
Keywords: rural; community; relationships; women; recidivism
During the past 40 years, the population of incarcerated women in the United States has
grown at more than double the rate of men (Sawyer, 2018), with the number of women
in jails increasing 40-fold between 1970 and 2014 (Swavola et al., 2016). Rural jails have
contributed significantly to this trend, with the number of women in rural jails increasing by
43% between 2004 and 2014, compared with 29% in small/medium metro counties, and a
AUTHORS’ NOTE: Research reported in this manuscript was supported by the National Institute on Drug
Abuse of the National Institutes of Health under Award 1R01-DA033866. The content is solely the responsibil-
ity of the authors and does not necessarily represent the official views of the National Institutes of Health or
the University of Kentucky. The authors would also like to recognize the cooperation and partnership with the
Kentucky Department of Corrections and the local jails, including the Laurel County Detention Center,
Kentucky River Regional Jail, and the Leslie County Detention Center. Correspondence concerning this article
should be addressed to Martha Tillson, Center on Drug and Alcohol Research, University of Kentucky, 643
Maxwelton Court, Lexington, KY 40508; e-mail:
1073603CJBXXX10.1177/00938548211073603Criminal Justice and BehaviorTillson et al. / COMMUNITY RELATIONSHIPS & REINCARCERATION
6% decline in urban counties (Kang-Brown & Subramanian, 2017). As populations of
incarcerated rural women increase, continued attention must be given to the needs of this
unique demographic as they reenter their communities and how to support desistance from
criminal activity, particularly among women with a history of substance use, who may also
require recovery supports.
Gendered pathways frameworks (see Chesney-Lind & Pasko, 2012) suggest that cer-
tain concrete individual or interpersonal factors support women’s desistance after release
from incarceration (e.g., employment, sobriety, access to health services, or supportive
relationships with family, children, and peers; Arditti & Few, 2008; Berg & Huebner,
2011; Garcia, 2016; Huebner et al., 2010; Morse et al., 2014; O’Brien & Bates, 2005;
Staton et al., 2019). More broadly, however, the process of desistance for women is also
intertwined with stigma, self-concept, and identity management (Boppre & Reed, 2021;
Gålnander, 2020b). These phenomena are shaped not only by women’s relationships and
interactions with others but also by community context, which conveys normative mes-
sages of opportunity, acceptability, and belongingness (Clear et al., 2001; Gålnander,
2020a). For rural women specifically, who may return from incarceration to underre-
sourced areas and dense social networks, community and a woman’s relationship to it
may be a critical source of support or of alienation. However, women’s engagement or
empowerment relative to their communities remains an understudied area in criminologi-
cal research, despite its potential relevance to rural reentry.
Research has highlighted incarcerated women’s vulnerability to diverse physical and
mental health concerns (Freudenberg et al., 2008; Maruschak et al., 2015), including sub-
stance use and misuse. National data indicate that justice system–involved women may
have more severe substance use patterns compared with men, with 72% of women incarcer-
ated in jails meeting Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria
for a substance use disorder and 47% reporting drug use in the month before their arrest
(Bronson et al., 2017). Individuals who use substances often have pronounced mental and
physical health needs (Galea & Vlahov, 2002; Schulte & Hser, 2013), especially women,
who are at increased risk of adverse mental health (e.g., trauma, depression, and anxiety;
Covington, 2008) and physical health, including higher rates of hepatitis, anemia, hyperten-
sion, and diabetes (Covington, 2007), compared with their male counterparts. As chronic or
long-term conditions, these physical and mental health concerns have implications for
women’s care and well-being both during and after incarceration (Link et al., 2019).
Much research has focused on the reentry period following incarceration and factors that
may lower the likelihood of recidivism (e.g., Alward et al., 2020; Link et al., 2019; Mowen
& Boman, 2019). Employment, abstinence from substance use, and access to health ser-
vices have been consistently shown to be associated with lower recidivism among women
(Huebner et al., 2010; Morse et al., 2014; O’Brien & Bates, 2005; Staton et al., 2019). These
factors may represent behavioral changes, as women engage in socially sanctioned activi-
ties and roles: earning income through paid labor rather than criminal activity, or seeking

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