Correctional-Community Healthcare Integration and Recidivism Outcomes for People Experiencing Homelessness: A Scoping Review

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Correctional-Community Healthcare Integration and Recidivism Outcomes for People Experiencing Homelessness: A Scoping Review

Correctional-Community Healthcare Integration and Recidivism Outcomes for People Experiencing Homelessness: A Scoping Review

Aviva Moses & Manya Malik
Schulich School of Medicine & Dentistry

FUNDER: Schulich-Windsor Campus Opportunities for Research Excellence Program (SWORP)

GRANT DURATION: 2026-2027

Related Programs:
Nucleus Cores:

People experiencing homelessness (PEH) are disproportionately represented in correctional systems and often face repeated cycles of incarceration and release without stable housing or continuity of care. This population experiences high rates of untreated mental illness, substance use disorders, and social exclusion, which contribute to frequent interactions with the justice system. The period immediately following release from custody is particularly high-risk, with elevated rates of overdose, acute medical complications, emergency department utilization, and reincarceration. Although correctional facilities provide in-custody healthcare, these services are often poorly integrated with community-based care after release. Transitional healthcare programs remain limited, and breakdowns in continuity of care may contribute to poor health outcomes and recidivism. This project will be a scoping review to systematically map and characterize the existing literature on community and correctional healthcare systems associated with reduced rates of recidivism among PEH. The review will follow PRISMA ScR guidelines and include randomized controlled trials, observational studies, program evaluations, qualitative studies, and relevant grey literature. Comprehensive searches will be conducted across major databases, and studies will be screened and extracted in duplicate. Findings will be synthesized descriptively and thematically to identify healthcare system characteristics (such as continuity of care across custody-community transitions, integrated mental health and addiction treatment, housing support linkages, and case management) that are associated with reduced recidivism. This review will inform possible correctional and community healthcare reform by guiding the development of integrated health and social interventions to improve outcomes for justice-involved PEH.
We anticipate that reduced rates of recidivism will be most consistently associated with integrated prison-to-community healthcare continuity, sustained addiction treatment post-release, multidisciplinary primary care tailored to homelessness, housing stability programs, and structured case management or peer support. In contrast, isolated or episodic healthcare delivery without structured transition planning may demonstrate weaker associations. By identifying healthcare system characteristics associated with reduced recidivism, this review will inform correctional and community healthcare reform, transitional program development, and cross-sector policy integration among health, housing, and justice systems. Even modest reductions in recidivism could translate into significant health system savings, improved housing stability, and more equitable outcomes for structurally marginalized populations.

CO-INVESTIGATORS

University of Windsor

  • Dr. Mehdi Aloosh
  • Dr. Jennifer Bondy


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