New York City’s health department is warning the public that contact with the criminal justice system — everything from police stops or searches to incarceration to having a jailed relative — poses a public health risk.
“The data show that involvement with the criminal justice system — even brief contact with the police or indirect exposure — is associated with lasting harm to people’s physical and mental health,” said health Commissioner Oxiris Barbot in a statement sent to BuzzFeed News.
The announcement by the New York City Department of Health and Mental Hygiene comes after San Francisco’s Health Commission took on incarceration as a public health issue in March, and Seattle essentially turned its juvenile justice system over to public health officials in 2017.
“What New York is doing is smart — people don’t often see how the health care system and criminal justice are interlinked,” University of Georgia sociologist Sarah Shannon, who studies the health effects of incarceration on prisoners and families, said. “But especially in our era of mass incarceration, there has been a lot of evidence they have to affect each other.”
The Department of Health and Mental Hygiene estimates around 577,000 people, 9% of New Yorkers, have been physically threatened or abused by the police. Overall, 29%, roughly 1.9 million people, report even being stopped, frisked, or questioned by the police.
Those people have higher rates of heart disease, diabetes, drug abuse, and mental illness, warns the department, which is starting a new public health campaign focused on educating health care workers about chronic health conditions linked to these patients. Around 27% of those formerly incarcerated, for example, reported poor mental health, compared with 13% among the never incarcerated (the national rate for mental illness is 19%). And 29% of those reporting threats or abuse by the police had poor physical health, compared with 12% of those who hadn’t.
The health department’s “Criminal Justice Action Kit” will be discussed with health care workers over the next month in around 160 primary care and family medicine practices in Brooklyn, the Bronx, and Manhattan.
“We as a public health department have really been trying to frame criminal justice system involvement as an exposure,” health department epidemiologist Kimberly Zweig told BuzzFeed News. The department aims to raise awareness about the risks of long-term conditions such as high blood pressure, diabetes, and depression in particular. The health department consulted on the effort with the Manhattan District Attorney's Office, which last year started a $7.2 million initiative to improve housing, employment, and health conditions for people leaving jail.
“This is the first time we are reporting on the health implications of involvement with the criminal justice system in over a decade,” said Zweig.
The US has the world’s largest prison population, with more than 2 million people incarcerated. There is long-standing concern about the health impacts of mass incarceration policies, going back to the 1990s. More than 48,000 people were held in New York state prisons last year and more than 8,400 in New York City jails — about 90% of those people black or Latino. Black New Yorkers are almost twice as likely as white ones, 14% versus 8%, to have been incarcerated or under community supervision.
The city’s public health campaign and survey results come as New York has steeply decreased its incarceration rate, but follows public outcry over brutality at the city's Rikers Island jail and the death of Eric Garner in police custody in 2014. A BuzzFeed News investigation last year found that New York City police officers who committed serious crimes were often reinstated without public notice.
“We have a health department saying here what public health researchers have shown for 20 years, or more, about the increased health risks that involvement with the criminal justice system brings,” Rutger University sociologist Frank Edwards told BuzzFeed News. “There is a great deal of research pointing to illness tied to exposure to the criminal justice system.”
“The department of health really focusing on this is tremendously important,” Cornell University social scientist Christopher Wildeman told BuzzFeed News. “New York City is a leader here, but it is deeply troubling to think of other health departments [that] haven’t identified this as a problem.”
Some of the health impact numbers reflect the reality that physical or mental disorders, notably drug abuse, are much more widespread among people likely to get arrested than among other people, Wildeman and other experts agreed. But studies have shown that incarceration, or the stress of daily lives subject to heavy police involvement, is associated with worse health not only for those directly affected but also for the entire population.
About 40% of the formerly jailed people in the survey of 2,300 New Yorkers report that health care providers discriminate against them because of a criminal record. “We certainly would always consider housing, poverty, education, even the neighborhoods that people live in, to be important,” health department epidemiologist Maria Baquero told BuzzFeed News. “Criminal justice involvement is another piece of that.”
She added that although, in the past, researchers have focused on what factors led people into the criminal justice system, the health department hopes to see more observers viewing such contact as an exposure to an added risk for obesity, depression, and other ailments. “Coming into contact with the justice system is a traumatic event.”