NEW YORK – The Vera Institute of Justice (Vera) today announced the launch of the Justice Reform for Healthy Communities initiative, which aims to raise awareness about the link between mass incarceration and public health, devise and share solutions that improve health outcomes, and increase the use of alternatives to incarceration. The national initiative will apply the tools of public health, coupled with new opportunities created by the Affordable Care Act, to address the challenges posed by mass incarceration.   

Mass incarceration is one of the major public health challenges facing the United States, as the millions of people cycling through the courts, jails, and prisons every year experience far higher rates of chronic health problems, substance use, and mental illness than the general population. Mass incarceration’s role as a driver of health disparities extends beyond the bars of prisons and jails as well, affecting the health of entire communities.  

“We are at a pivotal moment to take up this charge, as states and localities seek ways to reduce incarceration while the Affordable Care Act changes the healthcare landscape for millions of Americans,” Vera President Nicholas Turner said. “This initiative serves as an incubator for new ideas and more effective responses that advance social justice and improve the health of vulnerable populations while at the same time protect public safety.” 

In conjunction with the initiative’s launch, Vera released the first of several publications. “On Life Support: Advancing Public Health in the Age of Mass Incarceration” examines individual and community-level health impacts of incarceration with a focus on the relationship between mass incarceration and health disparities in economically disadvantaged communities and communities of color. Key findings include:

• Since the 1970’s, the correctional population in the U.S. has grown by 700 percent and since 2001, expenditures on incarceration have hovered around $50 billion. 
• Today, about 14.5 percent of men and 31 percent of women in jails have a serious mental illness such as schizophrenia, major depression, or bipolar disorder, compared to 1 to 5 percent in the general population. 
• Nearly 68 percent of people in jail nationally and more than 50 percent of those in state prisons have a diagnosable substance use disorder, compared to 9 percent of the general population. 
• An estimated 17 percent of all people with HIV living in the U.S. pass through a correctional facility each year. 
• In New York City, communities with the highest rates of incarceration also have the greatest rates of disease.

An advisory board comprised of policymakers, practitioners, researchers, and academics who span the disciplines of criminal justice and public health will guide the initiative’s work and advance its mission. The board includes:

• Steve Leifman, Associate Administrative Judge, Criminal Division, Miami 
• Glenn Martin, Founder and Chief Risk Taker, JustLeadershipUSA  Robert Fullilove, Associate Dean for Community and Minority Affairs and professor, Columbia University Mailman School of Public Health; Senior Advisor, Bard Prison Initiative 
• Jeremy Travis, President, John Jay College of Criminal Justice 
• Shira Shavit, Associate Professor, UCSF School of Medicine; Director, Transitions Clinic 
• Jim Pugel, Chief Deputy of the King County Sheriff’s Office; Former Chief of Seattle Police Department 
• Robin Steinberg, Founder and Executive Director, Bronx Defenders 
• Gretchen Rohr, Magistrate Judge and Chair, Mental Health Commission, Adjunct Professor of Law 
• Robert Cordero, President and Chief Program Officer, BOOM!Health 
• Tom Dart, Cook County Sherriff 
• Lisa Metsch, Chair and Stephen Smith Professor of Sociomedical Sciences, Columbia University Mailman School of Public Health

"The criminal justice system was never intended to serve as the safety net for the behavioral health treatment system, and to knowingly allow it to function in this manner represents an egregious misuse of public resources and a fundamental failure of public policy,” Judge Leifman said. “If a goal of criminal justice reform is to reduce the over-representation of people with behavioral health disorders in correctional settings, it is imperative that we re-examine current policies and practices from a public health perspective so that we may craft more sensible, equitable, and sustainable systems going forward."   

“Expanding medical coverage and guaranteeing access to substance use and mental health treatment will greatly improve health outcomes for historically under-served populations,” David Cloud, a Senior Program Associate at Vera who is leading the Justice Reform for Healthy Communities initiative, said. “But the ACA’s potential to greatly reduce mass incarceration and its associated consequences may prove just as important. This initiative—and the experts that guide it—will explore just what is possible under this new dynamic.”  

The ACA created the Center for Medicare and Medicaid Innovation Center to allocate $10 billion in federal funds to states and local reformers pursuing less expensive and more effective new payment and service delivery models.   The initiative continues Vera’s longstanding commitment to improving the health of underserved communities, as seen in previous projects such as Justice and Health Connect; the DC Forensic Health Project; the Los Angeles Jail to Community Reentry Project; and studies of public defenders for defendants with mental illness, correctional healthcare spending trends, and the effects of the Rockefeller drug law reforms in New York State.