Sport, Physical Activity, and Health Inequalities Among Youth Who Are Incarcerated: Perspectives of Youth Custody Workers in Ontario, Canada

Abstract

The current article seeks to understand, and critically analyze the implications of, how youth custody workers understand the relationship between sport, physical activity, and health among youth who are incarcerated. Data was collected through surveys (n = 15) and semi-structured interviews (n = 16) with youth custody workers in Ontario, Canada. We present and analyze three themes emerging from participants’ narratives: the potential for sport and physical activity to contribute, in a holistic way, to the physical, mental, and social health of youth who are incarcerated; the possibility for sport and physical activity to create space for building “therapeutic alliances” between staff and youth, which can improve the mental and social health of youth who are incarcerated; and perceptions of health deficits among youth who are incarcerated and their implications for social inequality. Through an analysis of these themes, we deepen the limited scholarly analysis of sport, physical activity, and health among young persons who are incarcerated and connect these discussions to broader considerations of social determinants of health (that is, structural and social factors that create health inequities) as a matter of social justice.

1. Introduction

A comprehensive United Nations report (Nowak, 2019) estimates there are 410,000 children (aged 17 and under) incarcerated globally in pretrial detention or custody facilities. Carceral institutions, such as prisons and young persons’ custody facilities, are widely recognized as unhealthy environments due to factors such as the psychosocial toll of incarceration, the deprivation of freedom and agency, and the heightened risk of acquiring disease, among others (de Viggiani, 2007; Kouyoumdjian et al., 2016; Sykes, 1958). In Canada, where the current study was conducted, the health of people who are incarcerated is found to be “poor compared with the general Canadian population, as indicated by data on social determinants of health, mortality in custody, mental health, substance use, communicable diseases, and sexual and reproductive health” (Kouyoumdjian et al., 2016, p. 215). As such, there is a pressing need to consider questions of health access and opportunity for young people1 who are incarcerated. Despite the broad recognition that sport and physical activity (SPA) can contribute to positive health outcomes (e.g., Amtmann, 2001; Melo, 2007; Penedo & Dahn, 2005; Warburton et al., 2006) and research highlighting the health inequities faced by youth from highly vulnerable circumstances and the potential impacts of SPA in their lives (e.g., Jacobs et al., 2019; McDonough & Jacobs, 2024), there remains minimal research that critically assesses the potential health outcomes of SPA for young people who are incarcerated—a significant gap in the scholarly understanding of SPA in spaces where young people are detained (see Murray et al., 2024; Norman et al., 2024).

The current article adds to this limited body of literature through an analysis of qualitative data collected with staff at youth custody facilities in Ontario, Canada. We sought to understand two research questions: (1) How do youth custody workers perceive the health outcomes of SPA in the lives of youth who are incarcerated? And (2) how do these views inform a scholarly understanding of the complex role of SPA among people deprived of liberty (PDL),2 broadly, and young people who are incarcerated, specifically? To address these questions, we present and analyze three themes that emerged from participants’ narratives: the potential for SPA to contribute to holistic health (physical, mental, and social) among youth who are incarcerated; SPA as a space for staff to build “therapeutic alliances” (APA, 2018) with youth, which benefit the latter’s health and well-being; and perceptions of health deficits among youth who are incarcerated and their implications for social inequality. We argue that the perspectives of youth custody workers point to some of the potential health benefits of SPA for youth who are incarcerated. Yet, through a critical assessment of participants’ claims in light of health and social inequalities, we also problematize the straightforward view of SPA as an inherent enabler of positive outcomes to youth who are incarcerated and demonstrate the risks for SPA interventions to further stigmatize criminalized young people (e.g., Norman & Smith, 2023). Through these discussions, we deepen the limited scholarly analysis of SPA and health among young people who are incarcerated and connect these discussions to broader considerations of health inequalities among PDL.

2. Review of Relevant Literature

2.1. Health, SPA, and Incarceration

Health is widely regarded as central not only to human dignity but also to enabling citizens to pursue the aspects of life they have reason to value (Ruger, 2004). Health is increasingly recognized, including by influential bodies such as the World Health Organization (WHO), as not merely the absence of disease but rather a holistic composition of “complete physical, mental and social well-being” (WHO, 2025, para. 1). Although such a conceptualization of health has been criticized for its broadness and utopic ideals, it remains influential in health-related fields of research (Leonardi, 2018). Moreover, health scholars and practitioners have demonstrated that health is shaped by unequal social structures such as poverty, racism, gender inequality, etc.—that is, by social determinants of health (SDOHs) (Marmot & Wilkinson, 2005; Raphael, 2025; WHO, 2021). Considering its importance to health policy and scholarship, we follow the holistic definition of health advanced by the WHO and, in analyzing our data, consider how SDOHs affect the experiences of SPA for youth who are incarcerated.

In recognizing the importance of SDOHs, the WHO (2021) advocates for people to enjoy “the highest attainable standard of health” (para. 1) and calls for member states to address health inequities that prevent the attainment of this goal. This moral responsibility to address health-related issues is particularly critical in prisons, which, as noted in the Introduction, are commonly unhealthy environments (e.g., de Viggiani, 2007; Kouyoumdjian et al., 2016; Sykes, 1958)—so much so that, for de Viggiani (2007), they “epitomise the antithesis of a healthy setting” (p. 115). In such unhealthy carceral contexts, SPA is viewed by some actors as a cost-effective intervention capable of delivering significant physical, mental, and social benefits, thereby addressing some of the prison population needs and raising policy interest (Jacobs et al., 2022; Meek, 2014; Norman et al., 2024; Warburton et al., 2006). This perception is rooted in the recognition that engaging in SPA can be a key means of improving overall health, including providing physical benefits such as reducing disease and the effects of various chronic conditions (Amtmann, 2001; Melo, 2007; Penedo & Dahn, 2005; Warburton et al., 2006); helping to treat anxiety and depression symptoms and improving overall mental well-being (Bruhns, 2009; Digennaro, 2010; Murray et al., 2024; Morgan & Parker, 2024; Roe et al., 2019); and developing social relationships and skills, including for criminalized young people (McDonough & Knight, 2023a; Meek, 2014; Meek et al., 2022; Morgan et al., 2020; Morgan & Parker, 2023; Nurse, 2021). Taken collectively, the literature presents SPA as having the possibility to contribute holistically to mental, physical, and social health.

However, critical scholars of SPA (e.g., Piggin, 2019; Safai, 2022) provide an important cautionary note about the inevitability of such health outcomes, noting how SPA provision is inherently political, situated within unequal power relations, and, in some cases, a contributor to negative health outcomes. Nevertheless, it is clear that SPA can contribute to holistic health outcomes, making the consistently higher levels of sedentariness among PDL compared to the general population a cause for concern (Meek et al., 2022; Morgan & Parker, 2023). This issue is compounded by the acknowledged health deficits experienced in prisons and the inherent restriction of movement in prisons, making the provision of SPA to this population both a moral imperative and a practical necessity (Meek et al., 2022). In unpacking how youth custody staff understand the health impacts of SPA, we deepen the scholarly understanding of the potential and limitations for SPA to contribute to the holistic health of young people who are incarcerated.

2.2. The Psychosocial Impacts of Incarceration and Potential Contributions of SPA

Scholars have long recognized that, beyond the physical health challenges of incarceration, the deprivation of liberty also has profound impacts on the mental health of PDL. In his seminal work The Pains of Imprisonment, Sykes (1958) draws on ethnographic research to illuminate the psychological toll of incarceration. He identifies five primary deprivations that define the prison experience: the loss of liberty, autonomy, security, heterosexual relationships, and of goods and services. Sykes argues that these forms of punishment, though intended to substitute bodily punishment with more humane alternatives, “can be just as painful as the physical maltreatment they have replaced” (Sykes, 1958, p. 64).

Since their initial formulation, the pains of imprisonment have been widely applied, revised, and extended within research on prisons and criminalization. Haggerty and Bucerius (2020) analyzed how researchers have deployed and expanded Sykes’ (1958) framework, including through analyzing pains affecting specific incarcerated populations (e.g., women, older adults), incorporating pains that extend beyond the incarceration experience (e.g., parole conditions), and identifying modern pains (e.g., mass imprisonment). Edgemon and Clay-Warner (2018), for instance, argue that because prisons differ from each other, the specific conditions found in each institution play a major role in the experience of imprisonment, and that individual factors, such as underprivileged backgrounds and traumatic experiences prior to incarceration, affect PDL’s experiences of pains of imprisonment. Crewe (2011), in turn, suggests that the contemporary prison experience involves pains such as “uncertainty” and “indeterminacy” about the present and the future and undergoing psychological assessments that can determine a PDL’s future opportunities. The widespread popularity of the pains of imprisonment has led to critiques that the concept is inconsistently applied (e.g., giving similar weight to very different experiences of harm) and can lack theoretical imprecision (Haggerty & Bucerius, 2020). Nevertheless, Sykes’ (1958) concept, in its core focus on the inherent psychosocial harms created by incarceration, remains a valuable lens through which to understand how deprivations generate significant frustrations that compromise the mental and social health of PDL.

At the forefront of the pains of imprisonment is the deprivation of liberty, which prompts isolation from social relationships, engenders boredom, and reinforces stigma (Sykes, 1958). These issues are further worsened by the inherent loss of autonomy experienced in prison, where a set of rules and commands dictate and control the behaviour of PDL (Shammas, 2017; Sykes, 1958). This leads to degradation in the way PDL see themselves, profoundly affecting their self-esteem (Sykes, 1958). The consequences of such deprivation are further aggravated when there is a lack of activities for PDL, increasing boredom and, consequently, aggressive and depressive behaviour (Edgemon & Clay-Warner, 2018). Meanwhile, the constant threat imposed by the lack of security compounded with, in many prisons, the need to deter violence by appearing stoic and brave, aggravates anxiety and depression (Sykes, 1958). As such, through the lens of a holistic comprehension of health, the inherent pains of imprisonment can be understood to compromise the health and well-being of PDL.

Given the impact of the pains of imprisonment, it is notable that research has highlighted SPA as a promising strategy to mitigate the psychological suffering of incarceration and help PDL better cope with their sentence (Edgemon & Clay-Warner, 2018; De Marco & Meek, 2023; Müller, 2024; Norman et al., 2024)—with some scholars specifically engaging with Sykes’ (1958) conceptualization of pains of imprisonment to deepen the theoretical understandings of SPA in prison settings (Müller, 2024; Müller & Mutz, 2022; Norman & Andrews, 2019). Studies indicate SPA’s potential to represent an enjoyable moment for PDL, thereby enhancing social skills (Eime et al., 2013) and forging better relationships (Morgan & Parker, 2023, 2024). By playing together, PDL may find in SPA a unique platform to build trust with both their peers (Morgan & Parker, 2023) and prison staff (Meek, 2014), improving the process of relationship building among them (Eime et al., 2013; Meek, 2014; Morgan & Parker, 2023). This can build an environment in which PDL find comfort in the relationships forged through SPA, helping them to settle down and adjust to their lives in the prison (Dirkzwager & Nieuwbeerta, 2018).

Moreover, SPA can represent a means to counteract boredom by offering an alternative field for excitement and risk, aspects that are experienced with involvement in criminal activities (Meek, 2014). Through participation in a SPA-based intervention (SBI), PDL have the opportunity to develop new hobbies that challenge the stigma of “offender”, thereby contributing to the construction of a new and positive identity (Digennaro, 2010). Moreover, SPA can enable participants to receive internal and external recognition of their achievements, fostering the creation of a prosocial environment (Morgan & Parker, 2023). This process ultimately culminates in the development of what Morgan and Parker (2024) term “possible future selves”. By facilitating this shift, SPA has the potential to strengthen self-esteem (Morgan & Parker, 2023), thus contributing to the reduction in anxiety and depression among PDL (Murray et al., 2024).

This growing recognition of SPA’s capacity to enhance physical, mental, and social welfare in prison has led to its inclusion in internationally recognized guidelines for the humane treatment of PDL (Meek et al., 2022). For example, the United Nations’ Standard Minimum Rules for the Treatment of Prisoners (UN, 1990) and Rules for the Protection of Juveniles Deprived of Their Liberty (UN, 2015) identify access to SPA as a fundamental right. Both guidelines stipulate that PDL should be provided with daily access to SPA, preferably outdoors and for at least one hour (Meek et al., 2022; UN, 1990, 2015), underscoring the importance of SPA for improving the welfare and rehabilitation of incarcerated individuals. In the current study, we deepen the scholarly knowledge of the potential for SPA to mitigate the pains of imprisonment, including detrimental physical, social, and mental health outcomes, through an exploration of how youth custody staff attempt to use SPA to improve the holistic health and well-being of young PDL in their care.

2.3. SPA and Young People Who Are Incarcerated

While specific literature on the impact of SPA in young people’s custody remains sparse, characterized by a limited “geographic scope, substantive focus, and theoretical depth and breadth” (Norman et al., 2024, p. 327), recent years have seen a surge in studies on this important topic and, thus, a diversification of the literature (e.g., Hapeta et al., 2022; Jacobs et al., 2023; Meek et al., 2022; McDonough & Knight, 2023a, 2023b, 2024; Roe & Bäckström, 2022). The importance of this growing area of study arises in part from challenges faced during adolescence and young adulthood, which can be exacerbated through incarceration. Thus, the need for SPA and other recreational activities may be even more pronounced during this critical developmental stage for young people who are incarcerated (McDonough & Knight, 2023b; Norman et al., 2024). Furthermore, there is a compelling need to understand potentially health-enabling activities for young PDL, given that justice-involved young people are likely to have histories of victimization and trauma (e.g., Abram et al., 2004; Dierkhising et al., 2013; Malvaso et al., 2022). Thus, the potential health impacts of SPA may be uniquely important for young people who are incarcerated in comparison to adult PDL (Norman et al., 2024).

Several scholars identify key ways in which SPA can benefit the health and well-being of young people who are incarcerated. Nurse (2021), for instance, highlights the crucial role of friendship in the emotional well-being of young PDL, emphasizing the importance that it can also have for their emerging adulthood (Nurse, 2021). The author advocates for structures that encourage social interaction among young people, particularly through shared interests such as SPA (Nurse, 2021). Additionally, SPA can foster trust between facilitators and young PDL, providing a valuable platform for the development of mentoring and guidance (McDonough & Knight, 2023a; Morgan et al., 2020). Within this framework, SPA can offer a rare safe space for young PDL to express their fears and insecurities while also experiencing deeper social connections, key components of mental well-being (Morgan et al., 2020).

Furthermore, prisons tend to be oppressive environments that employ rigid social control mechanisms, heightening the sense of loss of autonomy experienced by PDL (Norman et al., 2024). Coping with such conditions is particularly challenging for young people, and carefully designed SPA can serve as a form of resistance by offering activities to young people who are incarcerated that contrast with their confinement, through movement, exploration of their bodies, healthy risk taking, and enjoyment (Bruhns, 2009; Roe et al., 2019). Therefore, the practice of SPA enables young PDL to experience relative autonomy, albeit within the confines of a carceral institution, potentially fostering empowerment and boosting self-esteem (Norman et al., 2024). These combined effects can play a fundamental role in the construction of “new-selves” (Morgan & Parker, 2023), a process that is especially significant for young people navigating their transition into adulthood. Meek (2014) further argues that SPA is one of the most effective ways for engaging young PDL in activities they have traditionally been excluded from or lack motivation to participate in, such as formal education, therapy, healthy eating, and quitting harmful behaviours. In other words, given SPA’s strong appeal, especially among young people, it can act as a “hook” for participation in other activities that can foster positive habits and personal development (Meek, 2014; Morgan et al., 2020; Norman et al., 2024).

Nonetheless, it is also important to demystify SPA as an inherent good or a panacea that can resolve health inequities on its own (Coalter, 2007; Meek, 2014; Morgan & Parker, 2024). Indeed, scholars have critiqued the “mythopoeic view” of SPA (Coalter, 2007) and the “great sport myth” (Coakley, 2015), essentially arguing that SPA is popularly framed as an inherently positive contributor to personal and community development when, in fact, this is not always the case. Particularly in carceral environments, where inequalities are frequently heightened, understanding the limitations of SPA is paramount to avoid its misuse (Meek, 2014; Norman, 2017). The highly competitive nature of traditional sports, combined with its strict rules and disciplinary structure, may exacerbate frustration and anxiety among young people, potentially leading to aggressive and violent behaviours (Norman et al., 2024). Moreover, failing to recognize the participants’ prior (in)experiences, as well as the social, cultural, racial, economic, and gender contexts that permeate their lives, might contribute to viewing criminalized young people through a “deficit discourse” that ignores these structural factors (Norman & Smith, 2023). This means that, by failing to acknowledge that motivation and skills are socially influenced, SPA facilitators may stigmatize participants as lazy or incapable, enhancing anxiety and low self-esteem (Digennaro, 2010; Hartmann & Kwauk, 2011)—potentially fostering social exclusion and exacerbating inequalities, instead of tackling them.

3. Context and Methods

3.1. Context: Youth Custody in Ontario, Canada

The data for our article was collected for a broader research project, led by the first author, investigating how youth custody workers in the Canadian province of Ontario engage youth who are incarcerated in SPA and perceive the meanings and outcomes of this participation. Under Canadian law, the responsibility for the confinement of children under the age of 18 lies with the country’s provincial/territorial governments. Ontario is the largest of these 13 provinces/territories, with a population of approximately 15 million, and a study of its youth correctional system offers valuable insights into the role of SPA in the lives of young people who are incarcerated.

The operation of youth custody facilities in Ontario is somewhat complex for two reasons. Firstly, facilities are categorized either as “open” or “closed”. The Government of Ontario (2023, Section 3) describes open facilities as “smaller residences located in the community where youth can have access to staff supervised programming in the community” and closed facilities as “larger sites, which have higher security measures…and youth access to the community is generally facilitated only where approved”. In other words, closed custody facilities more closely resemble secure prisons, whereas open custody facilities allow greater freedom of movement for residents, albeit with a host of punitive restrictions (e.g., curfews, ongoing surveillance, etc.). Secondly, a small number of closed custody facilities are operated by the provincial government (called “direct operated” facilities); the remainder (called “transfer payment” facilities) are run by not-for-profit organizations who receive funds from the provincial government to operate these custody centres.

Publicly available details are scant about the delivery of SPA programming in Ontario youth custody facilities. For example, the only relevant item in the government’s Child, Youth and Family Services Act, 2017 (which dictates policies for youth who are incarcerated) states that children in care, including custody, have the right “to participate in recreational, athletic and creative activities that are appropriate for their aptitudes and interests, in a community setting whenever possible” (Government of Ontario, 2017, 13.2.f). Given the lack of specific and publicly available information, the broader study from which this article emerged sought to investigate two primary objectives: the form and organization of activities offered to youth who are incarcerated in Ontario; and the perspectives of custody staff about the meanings and outcomes of SPA for youth who are incarcerated. These research questions were intentionally broad so as to allow participants to explain their perspectives and experiences about SPA for youth who are incarcerated. The current article emerges from this broader study, focusing on data that relates to topics of health and SPA.

3.2. Recruitment and Data Collection

The study originally intended to collect data from staff working at both direct operated and transfer payment youth custody facilities. However, the Ministry of Children, Community, and Social Services rejected the research team’s request to collect data with staff at direct operated facilities. The rationale provided for the rejection was that the Ministry already “collects considerable information about these programs” (personal correspondence), although such research does not appear to be available to the public. This experience reflects, perhaps, a broader challenge in some jurisdictions for researchers trying to access correctional institutions (Norman, 2018).

Given the lack of access to staff working at transfer payment facilities, the data for the study was drawn entirely from individuals working for transfer payment organizations. Initially, the study was only going to analyze closed custody facilities. However, after being denied the opportunity to collect data from staff at direct operated custody facilities, the first author decided to widen the scope of the study to include open custody facilities in order to increase the sample of participants and depth of qualitative data. We recognize that there are important differences between these two types of confinement. Nonetheless, although open custody facilities are not entirely analogous to prisons, we consider them alongside closed custody facilities as “carceral spaces” characterized by experiences of harm arising from detrimental punitive measures and spatial restrictions (Moran et al., 2018).

Data was collected in two phases. First, the first author created an online survey, which was sent to publicly available email addresses at each of the 14 secure youth custody centres in Ontario’s transfer payment sector.3 The surveys, which were anonymous, asked respondents for descriptive information about the characteristics of the facility at which they worked and the SPA available to youth who are incarcerated. They also contained open-ended questions about participants’ perceptions of the benefits, challenges, and meanings of SPA for these youth. We received 15 completed survey responses, meaning that at least one facility had multiple staff complete the survey. At the end of the survey, participants were offered the opportunity to provide their email address to be contacted about a follow-up interview (the email address was delinked from their answers, in order to preserve anonymity). In the current article, survey respondents are identified by “SR” and a number (e.g., “SR1”). All survey respondents worked at secure facilities.

All participants who provided their email address were contacted for follow-up interviews. Further, to expand the sample of participants, recruitment emails were sent to transfer payment organizations who operate youth custody facilities and to the listserv of a professional society for Ontario youth justice workers. At this time, we made the decision to include open as well as closed facilities in our study.

Data collection for interviews was disrupted by the COVID-19 pandemic. The first author conducted one preliminary interview before the onset of the pandemic and completed one additional interview in October 2020. It was not until September 2022 that he reinitiated recruitment and conducted the remainder of the interviews, which were concluded by June 2022. In total, the first author interviewed 16 individuals: 13 in one-on-one interviews (in-person or via telephone) and 3 in a conference telephone call. Of these 16 participants, 7 worked at closed facilities and 9 at open facilities. Fourteen participants identified as men and two as women, and all participants identified their race as white/Caucasian. The median age of participants was 42, and the median years of experience working with justice-involved youth was 14 years.

Interviews were semi-structured, meaning that they loosely followed an interview guide yet provided space for (1) participants to guide the discussion toward topics they wished to discuss and (2) the researcher to probe responses and seek elaboration or clarification (Brinkmann, 2020). Interviews were transcribed verbatim and analyzed by a three-person research team (including both authors of this article4). Our analysis was a multistage process inspired by how Strauss and Corbin (1990) describe open and axial coding, with the first of these steps involving a wide identification of codes in the data and the second comprising the organization of these codes into broad thematic categories. In practice, this meant we began with the three researchers independently coding three transcripts for emergent themes, after which we compared and refined our preliminary list of codes. Next, the second author coded the remaining transcripts and survey responses, refining and adding new codes as needed and checking with the other two research team members throughout the process. Ultimately, we each reviewed the final coded data, merging some together, and organized these “child” codes into broader thematic “parent codes”, or thematic categories.5 The current article features the data related to the parent code SPA as a contributor to holistic health.

3.3. Research Ethics

All research was approved by the [redacted for anonymity] University Research Ethics Board (#0618) prior to recruitment. To protect participants’ confidentiality, surveys were anonymous, and any participants who provided their email addresses to be contacted for a follow-up interview had these delinked from their survey responses. Following the transcription of interviews, participants were identified with a pseudonym, and identifying information (name, place of work, etc.) was redacted. While complete anonymity is not always possible in interview research, as respondents may be identifiable by the stories that they tell, researchers have a responsibility to protect the identities of participants (Kaiser, 2012). As such, we endeavoured to report data that is highly unlikely to make the respondent identifiable.

4. Findings

We organized our findings around three broad themes that emerged from our data analysis: the potential health contribution of SPA to youth’s holistic health, the possibility for SPA to facilitate relationships that resemble a “therapeutic alliance” between custody staff and youth, and the views of custody staff on youths’ health deficits.

4.1. The Potential Benefits of SPA to Youth’s Holistic Heallth

Participants, all of whom were youth custody workers with oversight of SPA programming, were clear that they consider SPA to provide youth who are incarcerated with a diverse range of benefits. Many of these claims centred around how SPA contributed to young persons’ health, broadly defined in line with the WHO’s (2025) understanding of health encompassing “complete physical, mental and social well-being and not merely the absence of disease or infirmity” (para. 1). We unpack how participants understood SPA’s contribution to each of these domains of health.

Many participants, such as Jamie, trumpeted the physical health benefits of SPA participation: “I want our youth to be active…. Learning team sports, being active, physical fitness. It helps you sleep better at night, the whole bit, right?” Sarah similarly linked physical activity with making broader changes to physical health, stating she noted changes to youth’s “healthy living because as they started to work out, you saw that their diet began to change…and they were more cognitive of what they were putting into their bodies. [I saw] the overall long-term effect it has on their health”. In these words, custody workers make clear their belief that youth who are incarcerated can make important improvements toward their physical health by participating in SPA, sometimes in ways that contribute to broader lifestyle changes. Thomas elaborated on this latter point and spoke to the possibility, outlined in the literature (Meek, 2014; Morgan et al., 2020; Norman et al., 2024), of SPA being a “hook” for engaging youth who are incarcerated in wider behavioural change, suggesting that these activities can be used to teach behaviours to youth such as nutrition or smoking cessation:

There’s the nutrition…aspect of it, we do a little bit [of teaching on that topic]…. [Young people] might tell me that they smoke 100 cigarettes outside of the facility…. [I will say] “well you haven’t had a cigarette that long, that shows that you’re able to quit!”

While participants clearly saw physical health benefits arising from SPA participation, as evidenced by their stated belief about long-term behavioural changes among participating youth, other participants focused more on the mental health benefits. For example, Luc stated “if they’re involved with activities that got them exercise it was also good for the mind as well, right?” And John reflected that

A lot of the kids that we got in custody already had either severe mental health [issues] and been diagnosed, or we’re getting ready to be diagnosed…. Changing the way that we do recreation in those settings would go a long way to help them manage their own mental health better … [and] we started identifying that.

Many others, such as Luc, highlighted what they believed to be mental health outcomes for participating youth: “if they’re involved with activities that got them exercise it was also good for the mind as well”. Larry similarly stated “if you can tire them out, they’re better behaved overall, they have better mental health…. It reduces anxiety and depression, that’s pretty clear”.

Finally, numerous participants spoke about relationship building—a theme whose implications we unpack in more depth in the next section—thus alluding to the potential social health benefits of SPA. For staff, SPA was seen as an ideal way to connect with young people in their care. Anthony described SPA as “probably one of the number one ways to build rapport with the youth, build that positive, prosocial type [of] relationship”. And Calvin explained that staff proactively engage in SPA with youth to build relationships:

Our staff don’t just sit back at a desk and make sure the unit is running smoothly…. They’re interacting, they’re engaging, they’re building relationships, they’re having conversations with [youth]. That way, we can be proactive in supporting them, managing behaviors. So, when they go to the gym or the workout room, a lot of our staff…will participate in whatever they’re doing. So, if they’re playing volleyball, it’ll be they’ll play with them. If they’re playing basketball, staff will jump in and play with them…. It’s a way to, to build that relationship with them, and in different ways, rather than [if] you’re the youth worker back in the unit managing the place. It’s a way to have those relationships built and kind of made stronger a lot of times, too…. It fosters a different relationship with them than seeing them as the guy that’s consequencing them or timing them out.

While Calvin explained relationship building through SPA as beneficial to staff goals, such as managing behaviour, it is clear that he, and many other staff, also view relationships with youth as central to their work. Speaking to this sentiment, participants regularly described various forms of relationship building through a diverse range of physical activities beyond the team sports and workouts mentioned by Calvin. For example, Anthony stated “you could [build relationships] during ping pong,” Paul explained “golf was one of what I first used … [as a] way of engaging a kid,” and Jamie described youth taking “hikes and walks along creek sides and little rivers … [as] a great source of fresh air, and you can still talk with staff”. As we unpack in the next section, such relationships are seen by participants to make important contributions to youth health and well-being, particularly in the creation of a therapeutic relationship that can benefit young people’s well-being.

Notably, participants expressed an awareness of the overlap of mental, physical, and social health, while expressing the view that SPA could contribute to all three. SR6, for example, wrote:

I think the youth in secure custody use sports and physical activity as [an] outlet for their emotions and [it] can act as a release for their frustrations and stress…. It keeps there [sic] mind busy and they can get away from their negative thoughts and feelings. I feel that participating in [an] organized sport helps them feel like they are part of a team, building their relationships with both peers and the staff. It also teaches them about living a healthy lifestyle and the importance of staying active.

Here, this youth custody worker expresses the view—common throughout participant narratives—that participation in SPA can improve not only the physical health of youth who are incarcerated but also their mental health (e.g., “as a release for their frustrations and stress”) and social health (“building their relationships with both peers and the staff”). In the following section, we unpack the implications of SPA for fostering such healthy, and potentially therapeutic, experiences for youth who are incarcerated.

4.2. SPA: Helping to Build a Therapeutic Alliance?

The term “therapeutic alliance” refers broadly to “a cooperative working relationship between client and therapist, considered by many to be an essential aspect of successful therapy” (APA, 2018, para. 1). Therapeutic alliances have been recognized as being crucial to successfully engaging children in mental health fields such as counselling and psychotherapy (e.g., Campbell & Simmonds, 2011; DiGiuseppe et al., 1996), including work with justice-involved youth (e.g., Brown et al., 2014). While participants did not explicitly use the term, the ways in which they described building relationships with youth who are incarcerated implicitly framed SPA as a vehicle for developing therapeutic alliances with youth in their care. Although the youth custody workers interviewed were not necessarily trained therapists, central to their view of SPA was a belief that, when paired with ongoing relationship building between staff and youth who are incarcerated, these activities had a therapeutic purpose. John spoke to this possibility, explaining that

Most people usually just think recreation is fitness, and it involves pumping up basketballs and playing a game and doing that kind of stuff. Where we had changed the idea and started to move to a more therapeutic recreation idea, and that sort of mantra, kind of long before that happened.

Many other participants employed the language of therapy: “sports and physical activity have therapeutic and rehabilitative aspects in general” (SR6), “we have the idea that all activities can have therapeutic value when presented the right way” (SR4), and “[physical activities] build that therapeutic relationship, because [youth] were stepping outside their comfort zone and we were able to laugh together and enjoy some quality time” (Sarah).

Participants were clear that SPA did not have an inherent therapeutic value but rather required dedicated and creative staff willing to engage youth through these activities—suggesting a critical awareness of SPA that contrasts the “mythopoeic view” of sports that characterizes many SPA-based interventions (Coalter, 2007). Paul expressed the view that “if you just did [SPA] for the experience, I wouldn’t see a therapeutic value to it”. Instead, he explained,

when they spend those hours away [from the routine of incarceration], or they get engaged…you can talk to them. You’re not going to cure them with one talk, but at least you can introduce a question in their mind, and you can [get] them to maybe think, even for a brief period of time, about the consequences of their behavior or what they want out of life, what they want out of the world, some kind of hope that most of these kids generally don’t have. So that’s the value of getting into that from the therapeutic point of view…, as a way to get the kids’ defenses down so that you can introduce a thought process that help them go in the right direction.

Here, Paul expressed the belief that deeply engaging youth through recreation, made possible through an extended period of relationship building, could open them up to discussions that could create genuine, lasting change in their lives—while recognizing the limits to these possibilities (e.g., “for a brief period of time”). Other participants similarly explained that participating alongside young people in physical activity created space and time for deep, potentially therapeutic, conversation. Joseph stated, “with rec therapy, you hope to get that intensive experience where you can do motivational interviewing, and you can have assessment pieces, and you can really draw some of that stuff out”. And SR9 wrote:

Many activities can be done with our youth as a relationship building/therapeutic tool and/or as a backdrop for some of the deeper more trauma based work we do with youth. Engaging in physical/recreational activity with youth while having targeted conversation is often less anxiety provoking than simply talking about behavioural issues that are often symptomatic of deeper-rooted traumas.

SR9’s observations speak to the possibility for SPA to create temporary spaces for the building of relationships between dedicated custody staff and youth who are incarcerated that, informally, resemble therapeutic alliances. William echoed these sentiments, noting that SPA is ideal for building relationships without necessarily needing youth to speak about challenges, even trauma, in their lives: “A lot of [youth who are incarcerated] are not able to verbalize some of their trauma [or] addiction stuff, so a lot of the time even just playing a game of basketball … [or] soccer, it leads to a lot of positive interactions, a lot of rapport-building with staff and clients, but also very therapeutic”. These quotes not only align with Morgan and Parker’s (2023) observation regarding the centrality of the relationship between participant and facilitator to the efficiency of an SPA program but also point to a vital aspect of working with youth who are incarcerated: that young people involved in the justice system are, to a greater degree than those in the general population, likely to have experiences of victimization and trauma (e.g., Abram et al., 2004; Dierkhising et al., 2013; Malvaso et al., 2022).

4.3. A Health Deficit? Perspectives on Youth Who Are Incarcerated and the Social Determinants of Health

Whether speaking to the physical, mental, or social health, participants often presented the young people in their care as lacking health resources due to their life circumstances. Brad, for example, suggested many youth he worked with had “a lack of role models in their life” and added that “they don’t play sports because they fit in by smoking drugs and stuff in the community”. And Anthony stated, “we do have kids who come in and they’ve been whether they’re doing fentanyl, or doing meth, they’re kind of in rough shape, right?” In this context, some participants suggested that participating in SPA while incarcerated might help youth undo or relearn some of the unhealthy behaviours that predated their incarceration:

A lot of our youth come through with mental health struggles and a lot of our youth [are] coming with addiction struggles…. They generally don’t lead a super healthy lifestyle prior to coming in to us, either the way they eat [or] the way they exercise or don’t exercise. So just trying to introduce them to that and then let them see how it feels. When our guys come in, they’re eating three square meals a day, they’re having snack, they’re getting proper sleep, they’re getting physical education or recreation. They’re no longer having drugs or alcohol in their system.

(Calvin)

It is important to note that such statements risk presenting youth who are incarcerated within a deficit discourse—that is, the use of language and symbols that position marginalized communities as lacking characteristics and resources—while simultaneously framing these as a personal or community failure rather than acknowledging structural factors (Fogarty et al., 2018). Indeed, SPA-based interventions are one of many policy realms in which deficit discourses of young people have been operationalized (Darnell et al., 2018; Norman & Smith, 2023; Roe et al., 2019; Spaaij, 2011). That said, despite the importance of not stigmatizing or pathologizing justice-involved youth, most participants appeared to be coming from a place of empathy and a desire to work with youth who had faced numerous social barriers to health and well-being. In doing so, participants expressed an implicit awareness of how SDOHs—defined as “non-medical factors that influence health outcomes … [i.e.,] the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life” (WHO, 2025, para. 1)—affected the health of youth in custody. For example, Mathieu explained how certain behaviours he observed in recreational practices needed to be understood within the social history of the participants:

When you look past the surface of what you’re seeing—so you might be seeing anger, frustration or disinterest, or whatever, it might be a range of things—often it’s their learned behaviors from years of practice and, in often cases, trauma.

Like Mathieu, other participants recognized that youth in custody frequently had experiences of trauma and victimization, relating to the claim of Edgemon and Clay-Warner (2018) that socio-demographic conditions and prior experiences to incarceration have a significant impact on PDL’s lives. Larry, for example, explained that “a lot of our guys suffer from trauma and some traumatic events, and…physical activity really helps with dealing with that”—suggesting that SPA can provide mental health benefits for some youth who are incarcerated, particularly those with experiences of trauma.

While some participants’ statements drew from deficit discourses, participants overall expressed an awareness of how SDOHs had limited the opportunities for young people to engage in meaningful and healthy activities, including SPA. Some participants noted that young people from poor backgrounds likely did not have opportunities to learn and benefit from participation in physical activity. Calvin explained that while he is “a huge advocate of physical education [and] physical exercise…, unfortunately, a lot of our youth don’t have those options in their community because of poverty…or maybe they weren’t in school”. Brad similarly identified that many youth who are incarcerated were “coming from homes that did not have the capacity financially or emotionally to support the young person in any sort of physical activity”. As a result, he added, they had “very low” sport skills and lacked “confidence” in SPA environments, leading to challenges with participation. As these statements indicate, participants believed youth from poor backgrounds can face multiple and intersecting barriers to SPA participation, such as lack of experience, education, or low self-esteem.

Other SDOHs, which created barriers to engaging youth in SPA, were noted by participants. For example, Sarah noted the effects of diverse forms of disability: “there would be barriers in terms of able-bodied versus non-abled [and] intellectually wise, there was barriers [engaging youth in SPA]”. Further, in some instances, Calvin explained that youth who are incarcerated may be recovering from physical injuries due to “gunshot wounds, stab wounds”, which would mean “they just can’t participate in sports for the first little bit [of their sentence]”. Racialized youth were also recognized by some participants as facing unique barriers to SPA, and participants described efforts to accommodate diverse identities and engage outside organizations to assist with providing culturally specific recreational programs. For example, Jamie, who worked with a large number of Indigenous young people, noted that the intersection of remote geography and limited resources in northern Ontario Indigenous communities affected young people’s ability to participate in SPA, explaining that youth from “a remote reserve” often had limited exposure to organized SPA. However, Jamie, and other participants, did identify a variety of culturally specific forms of activity that were organized at the facility:

We do have Indigenous programming every Tuesday night. We offer smudging every shift. We have … a June 21 feast set up for National Indigenous Peoples’ Day. Our old secure facility, we had a sweat lodge there…. So, we do provide a lot of cultural programming because we want our youth to feel like they’re at home, kind of thing. And if their surroundings are more normal and what they’re used to, they’re more apt to build that relationship so that we can help them. Because nothing really works without the relationship piece.

We do not suggest that the awareness among youth custody workers, or even SPA programming intended to address SDOHs, is sufficient to address structural and detrimental health inequities experienced by youth who are incarcerated. Nonetheless, we point out that many of the participants in our sample did take a nuanced view of the possibilities and limitations to using SPA to address the health needs of the youth with whom they worked.

5. Discussion

Our findings demonstrate how youth custody workers in Ontario, Canada, understand the health benefits of SPA for youth who are incarcerated. While limited in geographic scope, and representing a relatively small sample of custody workers, our study nonetheless adds to the underdeveloped literature on SPA and young persons’ incarceration (see Norman et al., 2024) and raises critical questions about social justice and health for young people involved in the justice system. Specifically, the findings provide nuance to the ways that SPA is deployed in carceral settings to achieve positive health outcomes, with implications for working toward social justice goals by addressing SDOH. Participants expressed a strong belief that SPA interventions, carefully organized and sensitively delivered, could not only improve youths’ physical health, but also their mental and social health. This resonates with the WHO’s (2025) holistic definition of health and implies that, for some young PDL, SPA may help minimize the detrimental pains of imprisonment (Sykes, 1958) inherent to forced confinement. Especially given the impact of the deprivation of liberty (Sykes, 1958), as well as the compounding pains of imprisonment for young people with experiences of trauma (Edgemon & Clay-Warner, 2018), the belief among youth custody staff that SPA can offer health outcomes and meaningful, potentially even therapeutic, experiences is notable. Further, given that spaces of incarceration are understood to be unhealthy to PDL’s mental, physical, and social health (de Viggiani, 2007; Kouyoumdjian et al., 2016; Sykes, 1958), there are compelling reasons—arguably a matter of social justice—to better understand activities that may contribute to holistic health. Of particular importance to participants was the value of SPA for youths’ social health, most notably through relationship building between youth and staff. SPA was, implicitly, understood by participants to facilitate the construction of a supportive “therapeutic alliance” (APA, 2018) that enabled staff to engage youth in therapeutic practices within and beyond SPA.

It is important to recognize that the language used by some participants replicated deficit discourses, which can risk pathologizing criminalized people. SBIs frequently employ such language, problematically suggesting that structured SPA may contribute to addressing the deficits experienced by young, socially marginalized persons (Darnell et al., 2018; Norman & Smith, 2023; Roe et al., 2019; Spaaij, 2011). In contrast, strength-based perspectives emphasize the resources and skills of individuals and communities who have been socially marginalized and seek to leverage these to generate social change (Paraschak & Thompson, 2014). While our participants did not draw from strength-based perspectives to describe the young people in their care, they did frequently provide nuance to some of the deficit discourses they employed, particularly explaining that (and expressing great empathy toward) many youth who are incarcerated have experiences of trauma and other challenging life circumstances. As such, some of them implicitly invoked SDOHs to explain detrimental health or low engagement in SPA.

There are of course severe limitations to SPA’s potential contribution to redressing SDOHs, and alone, it will not solve unequal social structures (e.g., poverty, racism, sexism, etc.) that contribute both to inequality and injustice and act as barriers to engaging in meaningful forms of SPA (e.g., Collins & Kay, 2014; Donnelly et al., 2011; Vandermeerschen et al., 2017). Further, the role of SPA in contributing to social justice and meaningful social change is, at best, mixed—as evidenced, for example, by the wider body of research that critically analyzes how SPA is deployed and experienced in prison settings (e.g., Martinez-Merino et al., 2019; Martos-Garcia et al., 2009; Meek, 2014; Norman, 2017; Roe, 2021). In Canada, for example, Indigenous physical cultural programming in carceral institutions is laden with tensions between perpetuating ongoing harms of settler colonialism and providing cultural activities that may, in small ways, contribute to decolonization and meaningful individual experiences (Norman et al., 2023)—thus raising questions about if and how culturally specific forms of recreation, identified as significant by some participants, will affect the holistic health of Indigenous youth who are incarcerated. In light of such concerns, it is promising that scholars of SPA in the lives of young PDL are increasingly considering the experiences and meanings of physical activity for racialized young people (e.g., Hapeta et al., 2022; Jacobs et al., 2023). Thinking more broadly about health and social justice, and given that incarceration can create or exacerbate existing health inequities, there are compelling reasons to better understand whether SPA may contribute to holistic health for marginalized PDL in spaces of incarceration.

6. Conclusions

In presenting and unpacking the views of youth custody staff in Ontario, Canada, we contribute to the small, but growing, body of research on SPA and health among young people who are incarcerated. Our findings demonstrate that SPA is viewed by staff as a healthy activity for youth who are incarcerated, yet they complicate this view by showing how assumptions about poor health can contribute to deficit discourses that stigmatize youth and highlighting the role of SDOHs in creating health injustices that cannot be remedied by SPA alone. Of course, we recognize the limitations of relying on custody staff without including the voices of youth who are incarcerated, as well as the limited generalizability of our sample. We hope to deepen and broaden the scope of our research in future studies, with a particular emphasis on including the perspectives of young people who have experiences of incarceration. It is clear that SPA among PDL, broadly, and young people who are incarcerated, specifically, is a growing area of interest for researchers, and there is much scope for future research to continue to consider these topics through the lens of health and social justice. It is our hope that this article offers a small contribution to this vital area of study.