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ACP Policy Paper Addresses Criminal Justice as a Public Health Issue

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Final in series of policy papers offers recommendations for eliminating disparities in criminal justice policies and practices

March 5, 2021 (ACP) – In the United States, criminal justice and public health are closely intertwined as disparities in law enforcement, the judicial system and punishment threaten the well-being of at-risk populations. As part of its analysis of disparities and discrimination in medicine, the American College of Physicians is calling for policymakers to take steps to diagnose and repair these issues.

“ACP contends that criminal justice is a public health issue and it is appropriate for physicians and other health professionals to speak out,” said Josh Serchen, a health policy associate with ACP. “As we continue to better understand the role of social drivers of health and other non-medical factors associated with health, we are quickly realizing that caring for the health of our patients can no longer end at the office door. We strongly believe that a comprehensive and interconnected policy approach that targets all sources of health disparities is necessary, including those that arise from discrimination and inequities in the criminal justice system and the downstream consequences.”

Serchen is lead author of a new ACP policy paper titled “Understanding and Addressing Disparities and Discrimination in Law Enforcement and Criminal Justice Affecting the Health of At-Risk Persons and Populations.” The paper, which is available online via the ACP website, is one of a series of reports that comprise the “Comprehensive Policy Framework to Understand and Address Disparities and Discrimination in Health and Health Care.”

Law enforcement and criminal justice can affect health in numerous ways. “Some of the impacts of criminal justice policies and practices on health are more obvious, such as the loss of life and injuries through violent encounters with law enforcement and capital punishment,” said Serchen. “Interactions with law enforcement can negatively impact mental and physical health, especially when discrimination and profiling are involved. These encounters can cause harm to health and well-being even if the interaction does not involve a criminal charge or result in incarceration, including encounters with those who have a mental illness or who are experiencing homelessness.”

Disparities and discrimination, which disproportionately affect people of color, can have hidden effects too. “Incarceration is associated with high rates of numerous health conditions, mortality and morbidity,” Serchen said. “Incarceration also functions as a social driver of health and can have downstream cyclical effects, making it difficult to obtain employment, housing, education and other opportunities.”

What must be done? ACP is calling for an evidence-based policy approach to eliminate disparities in criminal justice policies and practices that addresses biases in the criminal justice system while also maintaining public safety, with the overarching goal of improving the health and well-being of all Americans. This includes evaluating new and existing policies and overhauling them if they result in disproportionate rates of interactions, sentencing, incarceration and harm for marginalized communities. “ACP believes a more innovative and proactive approach that addresses the socioeconomic factors that underlie many of these encounters and implements evidence-based best practices that draw on multidisciplinary professionals when appropriate is not only imperative, but incredibly necessary,” Serchen said.

ACP is calling for these changes, among others:

  • Study, implement and fund alternative models that deploy social workers and other mental health professionals specially trained in violence interruption, mediation, homelessness outreach and mental health.
  • Devote more funding and resources to address socioeconomic factors that are associated with crime, such as unemployment, homelessness and poor educational opportunity.
  • Reduce risks associated with incarceration – while ensuring public safety and justice – by implementing safe alternatives to incarceration, researching and adopting alternatives to cash bail, ending inequities in sentencing for capital offenses, providing for job training and other support in prison and upon release and removing financial barriers to accessing and improving the quality of correctional health care, among others.

Moving forward, Serchen said, “with a growing public consciousness and renewed national reckoning over racism in society, we are hopeful the new Congress and administration will pursue many of our recommendations. We are standing by and ready to assist them in doing so.”

More Information

The policy paper “Understanding and Addressing Disparities and Discrimination in Law Enforcement and Criminal Justice Affecting the Health of At-Risk Persons and Populations” is available on the ACP website.

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Back to the March 5, 2021 issue of ACP Advocate