by Barbara T. Baylor, United Church of Christ

All people deserve the opportunity to reach their full potential — and part of this is being able to make choices that lead to good health and quality of life. But the United States has a widening gap between those who have a fair chance to make these choices and those who do not.

As the World Health Organization points out, large differences within countries in health outcomes are not only unnecessary and avoidable, but also unfair and unjust. Poverty, low socioeconomic status, racial discrimination, gender bias, disabilities, and mental health conditions all contribute to today’s significant health disparities in the United States.

An individual’s resources — such as money and power — most often shape the economic and social conditions he or she lives under. Another influence on people’s environments, though, is that of the policies and choices that decision-makers support. Policies that affect food security are one example.

In many states, people who have been convicted of a drug-related felony and have served their sentences are banned or restricted from participating in SNAP (formerly food stamps) and TANF (Temporary Assistance for Needy Families). These bans also apply to the formerly incarcerated person’s entire household, including children.

People with lower incomes are incarcerated at disproportionately higher rates, and many enter the prison system with chronic illnesses. Health problems are exacerbated by the prison environment, which can include overcrowded and unsanitary conditions, poor nutrition, lack of ventilation, and the impact of violence, trauma, and solitary confinement.

Ironically, people in correctional facilities are the only group in the United States with a constitutional right to health care. But when they return to their communities, they often do not have access to quality health care. It is not difficult to see that declaring people ineligible for assistance to get the food they need is also bad for their health. To a person with a chronic illness, going without food can lead to hospitalization (which, incidentally, costs much more than food assistance). A ban on food assistance for ex-offenders and their families works at direct cross-purposes to the goal of improving family and community safety and security.

The United States has a far higher rate of incarceration than most other high-income countries. Mass incarceration is now a public health crisis that has increased hunger and poverty. Health and human service providers and people of faith must view the problem through a social justice lens. This lens can help us see that often, people’s only “choices” range from bad to worse. In addition to enabling us to see situations as they are, a social justice lens can and should help find ways to expand the choices that are actually available to people!

Barbara T. Baylor is currently the Policy Advocate for Domestic Issues at the Washington, DC, Policy Office of the United Church of Christ. She holds a Master’s Degree in Public Health.