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Public Health Policy Project

“The problems that exist in the world today cannot be solved by the level of thinking that created them.”   — Albert Einstein


Public Health Policy Project (PHPP) creates an alternative analysis that posits that within communities of color, alcohol and drug problems result as much from historical trauma, economic and political disempowerment and cultural demoralization as from biological vulnerability.

This view recognizes that historical trauma, and cultural and economic oppression elevate risk factors for substance abuse and erode resiliency factors that operate as a protective shield against alcohol and drug problems and speed their natural resolution.

The purpose of the project is to develop a non-traditional public health alternative to incarceration for people with substance abuse challenges.

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Our first PHPP convening was hosted by Dr. Fullilove of the Mailman School of Public Health at Columbia University.

Our first formal convening was hosted by Dr. Robert E. Fullilove, Associate Dean, Community and Minority Affairs Professor at CUMC of Sociomedical Sciences at the Mailman School of Public Health, Columbia University in the fall of 2013.

Currently, the Center for NuLeadership on Urban Solutions is working to a) develop a Public Health Task Force with academics, policymakers, system stakeholders and advocates in the field of public health and criminal justice, b) finalize a concept paper for public review, and c) carry out a research project to demonstrate our thesis.

** If you are interested in donating to support our Public Health Policy Project, please click here Thank you for your interest and support!

In the meanwhile, please find below an excerpt from “Developing a Public Health Model for Drug Policy and Human Justice in an era of fiscal crisis and paradigm shifts” concept paper.

I. Introduction

There is almost universal agreement that the criminal punishment (justice) system is fatally flawed. It incarcerates far too many people, costs too much, is racially discriminatory and does not produce measurable outcomes that consistently enhance public health or public safety. The research tells us that a total of 7.3 million individuals are under the control of the U.S. criminal justice (punishment) system: more than 2.3 million people are behind bars, 800,000 are on parole, and another 4.2 million are on probation. Foremost within the criminal punishment and prison system, in terms of cost and cell space, is the treatment of people who suffer from problems of addiction. In But They All Come Back, Jeremy Travis, president of John Jay College of Criminal Justice in the New York City and the leading policy guru for “reentry” has written, “In 1981, 9 percent of prison admissions were for drug crimes; by 1996, the share of admissions that were drug offenders had risen to 30 percent” (Travis, 2005). In many jurisdictions in the United States today, chemical dependency offenses, often referred to as “substance use or abuse,” account for upwards of 60 percent of the total prison population.

Developing a public health agenda, for drug policy and criminal punishment of people who suffer from the chronic health disorder of chemical dependency, is a timely response to current policies that have not been able to produce reliable, positive, quantifiable outcomes. Such an agenda consists of policy reform and system realignment. Of necessity, it includes several paradigm shifts. Chemical dependency is a public health problem. Continuing to treat it in a criminal punishment context is poor public policy.

This “working concept paper” addresses the need to develop a New York State public health model – with national implications – for the treatment of people who suffer from the chronic health disorder of substance abuse. Such a project must, in our estimation, evolve from the experience of communities of color, inclusive of historical trauma, institutional racism and cultural competency. The population most impacted, currently is serviced within the criminal punishment system instead of within the public health system. In view of the recent changes in drug laws in New York State, its subsequent national influence, the fiscal crisis with which the state is faced and the need to make more efficient use of existing state resources, creating a public health first option to incarceration is a viable and necessary strategy.

Clearly, major portions of the current criminal punishment system need to be deconstructed and another policy established in its place. In its inception, this new construction involves moving away from the present criminal punishment model to a public health one, yet it must also move us from the current acute care approach to a more comprehensive model of sustained recovery management. Among its goals must be developing innovative, non-traditional, concepts for transforming policy, practices, services and systems toward a recovery oriented paradigm; articulating guiding principles and measures of recovery that can be used across programs and services; and, generating practical cost effective ideas for advancing recovery-oriented systems of care in various settings and systems.

One of the organizations seeking to facilitate this change is the Center for NuLeadership on Urban Solutions, an independent, activist, policy reform and advocacy group formerly at Medgar Evers College in the City University of New York. The Center has established a tradition of challenging the underlying assumptions of existing traditional criminal “justice” paradigms, especially punishment and welfare “risk based” and “needs based” models that produce racially disparate consequences and questionable outcomes. NuLeadership maintains — as it always has — that any movement towards developing a public health approach must include, and be directed by, those most adversely affected and those who have borne the dire consequences of past destructive policy.

This paper is structured in five sections: (1) introduction, (2) problem statement, (3) discussion, (4) two policy corollaries and (5) policy development: next steps. It proposes an outline for the discussion of creating a public health agenda for drug policy and human justice in an era of fiscal crisis and paradigm shifts. It introduces five interrelated themes:

  1. Historical Trauma Theory
  2. Cultural Competency and Questions of Race
  3. Principles of Recovery Oriented Systems: Recovery Management vs. Acute Care
  4. Reducing Racial Disparity and Disproportionality
  5. Fiscal and Economic Factors

The paper explains each of these themes and describes how they fit into an integrated whole comprising a fundamental shift away from punishment and penal incarceration towards a public health model. Each of these themes requires more extensive discussion, analysis and critique, and will be expanded upon in subsequent research, papers and discussion groups.

** If you are interested in donating to support our Public Health Policy Project, please click hereThank you for your interest and support!