An assessment of the barriers and successes that public health departments have experienced in participating in criminal justice system reform, with recommendations for action.
Introduction
The numbers outlining what happens in the criminal justice system are well-known. The United States imprisons more people by far than any other nation. The criminal justice system in every state has disproportionate impacts on people of color. There is devastating consistency in how we criminalize these communities. The Supreme Court of the United States ruled that the State of California was violating the constitutional rights of people in prison through inadequate medical services and widespread prison overcrowding. The Court mandated that the State decrease its prison population.
Incarceration, criminalization, and all involvement with the criminal justice system is intricately tied to physical and mental health outcomes; health inequities by race; family unity; and social determinants such as the ability to access adequate housing, a job with sufficient income, and benefits and services. Improving health and health determinants is the mission of public health, yet it is an open question what role public health departments could and should play in reforming the criminal justice system in ways that improve health and decrease inequities.
To better understand this, Human Impact Partners had conversations with three local public health department collaboratives in California: San Joaquin Valley Public Health Consortium, Bay Area Regional Health Inequities Initiative, and Public Health Alliance of Southern California. The state health department also participated in one of these sessions. We discussed the successes public health departments have had in criminal justice system reform and the barriers they faced. We started the conversations by describing examples of criminal justice system reform work using research and the engagement of affected communities and their advocates – for example, related to Prop 471 and community-police relations. See Appendix 1 for the questions we used to guide the conversations with health departments. After sharing their successes, barriers, and observations, all of the collaboratives communicated a desire to overcome the barriers and start or continue their work on criminal justice system reform.
This report is the result of those conversations. It summarizes our findings and includes recommendations for ways that public health departments can get started to work on criminal justice system reform. All quotes in this report are from the conversations and do not necessarily represent health department policy.
We can all agree that mass incarceration is a public health problem.
A public health department in our focus groups across California agreed that the way the current criminal justice system operates, sometimes referred to as “mass incarceration”, is a public health problem. Even more pronounced, public health departments see that the criminal justice system is a major driver of health inequities, and that reforming the criminal justice system is a health equity issue of highest concern.
The criminal justice system shows who we punish and who we criminalize – and who we don’t. And how much attention we as a society place on equity, because we can see who the criminal justice system is rigged against.
Additionally, public health departments understand the value and necessity of engaging in policy and systems change for the criminal justice system.
Public health can be a strong proponent in those conversations because we sit in these systems. We also understand the social conditions. All the things we look at – social determinants of health – we know you can’t be healthy if… [criminalization affects] all these things. So we participate in conversations around violence prevention. Around housing. Around all of that. That’s what health looks like. So generally, we are systems approachers.
Some health departments in California are making inroads into changing criminal justice system practices, but as they told us, it is slow work. Many are facing obstacles to having those conversations and doing the work. Health departments have a stake in changing the conditions that create crime and violence, yet face barriers to speaking out. In our own work to reform the criminal justice system, Human Impact Partners has encountered difficulty engaging public health departments as partners and spokespeople for reform.
However, public health departments have power – they have data and resources, they are experts at collaboration, and they are often viewed as a trusted voice. If they applied this power and their health perspective to reform efforts, it could be a game-changer for vulnerable populations who are disparately impacted by the criminal justice system.
Criminal justice [reform] work is pivotal in the work we need to do in health equity.
As we continue our work toward a transformative vision of health equity and racial justice, we also continue to shift and evolve our own frameworks, language, and vision — especially with respect to our Health Instead of Punishment work. Because we know that to transform public health, we must be in a continuous process of transformation ourselves. Part of that process means reflecting on past work, and acknowledging shifts in our learning and language. Learn more about the evolution of our analysis and our current framework and thinking here.
This resource is representative of an earlier stage in our journey. The research, data, and learnings here hold strong, but the report may include past frameworks, specifically regarding racial justice and the criminal legal system.
View our latest work and framing here.
