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New Jersey Criminal Justice Reform Advancing Racial Equity (NJ CARE) Study

Jurisdictions across the country are striving to increase equity in their pretrial justice systems by reducing their use of pretrial detention and money bail, which affect Black people and other people of color disproportionately and are linked to negative health and well-being outcomes. Despite the intentions of these reforms, there is little rigorous evidence available about whether they do, in fact, improve racial equity.  

In 2017, the state of New Jersey implemented a sweeping set of reforms to its pretrial justice system to improve fairness in decision-making by judges, prosecutors, law enforcement, and other actors in the system while also protecting public safety and making sure people with open cases still appear in court. With these reforms, the state shifted from a system that relied on money bail to a system that uses a risk assessment tool to inform release decision-making. This study will assess the New Jersey reforms’ impacts on racial equity in pretrial practices and processes.  

The research team will work with individuals with lived experience in the justice system to contribute to a participatory action research-informed approach, with the goal of understanding how the impacts and policy changes uncovered translate into the human experience—including implications for well-being, health, and mental health. 

The project will answer the following research questions: 

  1. What is the impact of New Jersey’s reforms on arrest decisions, pretrial detention, and case disposition for different racial groups? What is the resulting impact on racial disparities? 

  1. How did the reforms’ effects on racial disparities in pretrial processes and outcomes vary across New Jersey’s 21 counties? What local, structural characteristics (for example, reform-oriented leadership, community-informed approach, police reforms) may explain any county-specific impacts observed? In counties with more equitable processes post-reforms, what types of approaches and local reform efforts were implemented and what was the community input process?  

  1. What did individuals’ criminal justice experiences look like across time, and what are possible health and well-being consequences? 

In assessing the extent to which New Jersey’s criminal justice reforms increased racial equity and identifying potential mechanisms that may explain any observed improvements, this study will help inform discourse around future reforms both in New Jersey and other states. 

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California Diversion: Mental Health, Racial Equity, and Criminal Court

On January 1, 2019, California Assembly Bill 1810 established a pathway to diversion for individuals whose mental illness had a significant role in the crime for which they were charged, with some violent crimes excluded. Mental health diversion is a process through which defendants can participate in community-based mental health treatment; if the treatment program is successfully completed, the charges are dropped. AB 1810 also provided $100 million for county programs to help divert defendants from jail into treatment. Due to COVID-19 and other factors, counties have been instituting new mental health diversion protocols and programs at varying levels, though, so California is still early in the implementation process. 

This project will study the implementation and impact of California AB 1810, asking: 

  1. How is the mental health diversion process functioning, particularly with respect to reducing racial disproportionality?  

  1. For those who participate in AB 1810 diversion, what are the effects on criminal behavior and social well-being (e.g., mental health, housing), especially for people of color?  

This research will provide actionable results as counties develop their mental health diversion policies and procedures in accordance with AB 1810, particularly as courts re-open in the wake of COVID-19. In so doing, this project will not only benefit racial justice in the criminal legal system in California but also efforts to pursue racial equity through the increased use of mental health diversion nationwide. 

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The Effects of Paid Family Leave on Infant and Maternal Health Outcomes

The U.S. lags far behind other countries in public policies that support parents in the crucial first days, weeks, and months of a child's life. Most notably, the U.S. is the only developed country that does not guarantee a period of paid and job-protected leave for new parents. As a result, paid family leave coverage is both limited and highly unequal. This situation, however, is beginning to change, as California, New Jersey, New York, and Rhode Island and a handful of U.S. cities now have paid family leave (PFL) programs.

Focusing on California, this study will examine the effects of the law on: breast-feeding; receipt of well-baby care and immunizations; and maternal mental health. It will analyze large, nationally representative datasets, using econometric procedures to determine causal impacts.

This research will obtain information on whether work-family policies, such as PFL, promote a Culture of Health and reduce disparities. This evidence will be important as other states and Congress consider additional legislation in this area.

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Diverting Opioid Addicts Away from Criminal Justice and Toward Treatment

In 2016, the Chicago Police Department developed a pilot pre-arrest diversion strategy, the Westside Narcotics Diversion and Treatment Initiative (WNDTI), to respond to the opioid crisis in underserved Chicago neighborhoods. The goal was to encourage police officers to redirect low-level drug offenders (users and sellers) to treatment, instead of jail and prosecution. This strategy was modeled after a promising program in Seattle, the Law Enforcement Assisted Diversion (LEAD).

However, Chicago’s target population differs significantly from the one served by Seattle’s LEAD program. Thus, the Chicago Police Department partnered with the University of Chicago's Crime and Health Lab to evaluate and test the expansion of its diversion strategy. Researchers there will focus on three questions:

  1. Does diversion to treatment for individuals who experience substance use disorders impact health outcomes?
  2. Is diversion more cost effective for the community than incarceration?
  3. Can the lessons learned from this program help improve health equity on a larger scale?

Within the last several years, views on substance abuse have shifted, with law enforcement recognizing substance abuse as a public health issue, rather than a purely criminal justice issue. Many other cities are piloting harm reduction interventions, and this rigorous evaluation should support them in their efforts to design effective policies and programs. 

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The Effect of Minimum Wages on “Deaths of Despair”

In 2017, economists Anne Case and Angus Deaton coined the phrase “deaths of despair” to describe a troubling rise of Americans dying from suicide, drugs (including opioids) and alcoholism. Experts across the country are now attempting to tease apart the complex factors driving these trends, but until now, no one has examined the potentially causal effects of decreases in real minimum wages in relation to this trend or the potential benefits of rising minimum wages in counteracting other drivers of this trend, despite a strong evidence base linking income and health.

Recently-enacted higher state and local minimum wage laws—in the $12 to $15 range—are increasing incomes of low-income families by more than government spending on the three main safety net programs—Temporary Assistance for Needy Families, Earned Income Tax Credit, and the Supplemental Nutrition Assistance Program—combined. The research team will take advantage of historical and recent policy shifts to examine the relationship between changes to federal, state, and local minimum wages and overall death rates, using CDC Vital Statistics data. Their exploration will help us understand a potentially critical factor driving US mortality trends, and add to the existing literature about the reverberating effects of income policies on people’s health and well-being.

Principal Investigators: Michael Reich, University of California, Berkeley

Date Funded

Better Supporting the Needs of Children in Tennessee

There is an urgent need to understand long-term health, developmental, and educational outcomes for children who experience early life stressors. In Tennessee alone, over 22% of all children live in poverty. The number of children born between 2001 and 2014 with neonatal abstinence syndrome (NAS) increased 25-fold, and children of immigrants, 36% of whom live in poverty in Tennessee, often struggle to access the social services they need to thrive.

To fill this gap, the multidisciplinary research team will work alongside key state partners to develop an actionable research portfolio that clarifies the long-term effects of these early life experiences and illuminates the ways state policies can be adapted or modified to better serve the needs of Tennessee families.

Leveraging more than a decade’s worth of data, the researchers will examine relationships between at-risk children’s health and education outcomes, as well as access to public services. This is vital information as states across the country, and Tennessee in particular, adopt new laws and resolutions that encompass a wide range of policy actions related to child health and education.

Although the research portfolio will evolve with input from partners including state agencies and non-profits focused on child outcomes, the team will focus their initial efforts around several key issues:

The Opioid Epidemic

Tennessee is one of the states most affected by the opioid epidemic, particularly among its children. Opioid-related policies operate amid a backdrop of public programs like the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and The Early Intervention Program for Infants and Toddlers with Disabilities (IDEA Part C), which seek to mitigate health and educational disparities between opioid-exposed children and non-opioid-exposed children.

The research team will begin by examining longitudinal health outcomes for opioid-exposed children, assessing how likely they are to have developmental delays, special health care needs, and adequate utilization of preventive services. The team will also examine whether county-level trends in the proportion of children with attendance and discipline problems and low test scores correlate with periods of time when neonatal abstinence syndrome (NAS) reached epidemic proportions in their counties. They will then use linked TennCare Medicaid and educational data to undertake individual-level analyses of differences in educational outcomes (e.g., attendance, discipline, and test scores) between children born with NAS and children not born with NAS.

Access to Public Services

Past research has shown that children living in poverty are less likely to complete secondary and tertiary education and more likely to lack health insurance. Children of immigrants who are eligible for public programs and benefits may also need additional support in accessing those benefits, which in turn could aid families in creating a healthier and more nurturing home environment for their development.

Since 2009, Tennessee has introduced more than 20 legislative actions addressing eligibility verification for public program participation. To better understand the impact of these policies, the research team will examine associations between these policy changes and children’s access to Medicaid coverage and other social services in Tennessee, particularly for special needs children.

In addition, the team will investigate ways to improve children’s access to essential health, education, and other social services in Tennessee by conducting key informant interviews with state and local agencies that administer programs, along with school district personnel and nonprofit organizations that assist families in accessing program benefits for children.

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“Stop, Question, and Frisk”: The Health Effects of Police-Citizen Encounters

In recent decades, the “broken windows” approach to policing has led several large U.S. cities to employ the proactive policing program known as “Stop, Question, and Frisk” (SQF). The New York City Police Department (NYPD) made over 5 million such stops between 2002 and 2016.

At this time, there is little known about the health effects of these kinds of programs. To fill this gap, the research team will use millions of observations of police-citizen encounters contained in the NYPD’s SQF database from 2008-present, and Medicaid patient claims from 2008-present, to assess the effect of police encounters on individual health outcomes. To causally identify this effect, the team will exploit an unanticipated change to the NYPD’s protocol for making pedestrian stops. On March 5, 2013, the NYPD suddenly mandated that officers provide thorough narratives justifying the reasons for pedestrian stops. In addition, officers were required to photocopy and submit these narrative descriptions to supervisors after each shift. Following this procedural reform, the number of stops abruptly decreased and the rate of stops producing evidence of suspected crime increased.

The team will map pedestrian stops to the neighborhoods surrounding Medicaid recipients’ home addresses to see whether Medicaid claims for trauma and anxiety to decrease after the NYPD’s procedural reform reduced the incidence of pedestrian stops.

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