Wayne State University receives grant to address health care and costs in state prisons

DETROIT – Wayne State University faculty member Rodlescia Sneed, Ph.D. has been awarded a five-year Career Development grant from the National Institute on Aging of the National Institutes of Health. Sneed joined the Institute of Gerontology at WSU in 2022 as an assistant professor jointly appointed with the Department of Psychology in the College of Liberal Arts and Sciences. The nearly $600,000 award, Maximizing the Scalability of the Chronic Disease Self-Management Program (CDSMP) Among Older Adults in State Correctional Settings, is aimed to deepen her training and refine her research for a future R01 grant submission to the National Institutes of Health.

Sneed’s focus is the health of incarcerated older adults, especially racial and ethnic minorities. Half of all people in prison have at least one chronic health condition, such as hypertension, diabetes, heart disease or arthritis. Without intervention, these conditions will worsen as the population ages. Sneed will study the effectiveness of an existing six-week program called the Chronic Disease Self-Management Program. Its use in community settings has been linked to improvements in health care communications, reduced emergency room visits and hospitalizations, and decreases in health care spending.

Sneed wants to scale up the program for widespread use in state prisons and to maximize its effectiveness with older adults. She will analyze the factors that influence the ability to scale up and use interviews, surveys and participant recommendations to create a user manual. A future R01 grant could test her tailored approach against Implementation-as-usual in state prisons to determine maximum effectiveness.

Sneed is particularly interested in how prisons adapt chronic disease management programming to reflect the special constraints of incarceration.

“Incarcerated individuals get their snacks from prison commissaries and have to exercise in the prison yard or in the confines of a cell,” she said. “What can the incarcerated person realistically do to improve their health in these situations?”

Sneed is committed to issues of social justice, but she acknowledges that attitudes about prisoners’ rights vary geographically and culturally.

“Some people are not interested in improving health outcomes for incarcerated people,” said Sneed. “They think: Why should prison be a health spa? I talk to those people about how the cost of poorly managed chronic disease comes out of taxpayer pockets.”

In 2013, the Federal Bureau of Prisons spent $881 million to care for older prisoners. It has risen exponentially since.

“Incarceration is already very expensive,” Sneed said. “Prisons weren’t designed to be nursing homes. When you add the cost of treating chronic disease to the cost of incarceration, it becomes a heavy taxpayer burden.”

Career Development grants are structured to also strengthen the recipient’s expertise in areas they see as crucial to future research success. Sneed will use the resources to gain experience in implementing interventions, especially with justice-involved populations and systems. She has seen many solid, evidence-based interventions used inconsistently or not at all.

“How can we make sure these proven approaches get implemented in a practical and sustained way?” she said. “And how can we help people continue to perform health-enhancing behaviors throughout their lives?”

This research is supported by the National Institute on Aging of the National Institutes of Health under award number K01AG076740. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

About the Institute of Gerontology at Wayne State University

The Institute of Gerontology does research on aging, trains students, and informs professionals, caregivers and older adults on aging issues (iog.wayne.edu). It is part of the Division of Research at Wayne State University.