San Diego Restorative Justice Health Impact …...An HIA is a way to come up with a prediction about how a proposal is going to\ഠimpact health and health for whom. In the case of
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San Diego Restorative Justice Health Impact Assessment Mid-City CAN
San Diego Restorative Justice Health Impact Assessment
Mid-City CAN
Mid-City CAN: Who We Are
A community collaborative in City Heights comprised of dozens of partners (residents, businesses, schools, faith and cultural organizations, and public and private agencies).
Mission: To create a safe, productive, and healthy community through collaboration, advocacy, and organizing.
Outline of Presentation
Presenter
Presentation Notes
Introduction: Marlena (Introduce Aman and Sandra) First and Second bullet: What does that actually look like. We have four resident-led teams all dedicated to improving the lives of people in City Heights: transportation (no-cost youth bus passes) (access to healthcare) improving the quality and availability of food in schools (food justice) and implementing restorative justice practice in schools and the criminal justice system. The goals of each of these teams are geared to mitigating adverse health impacts on their communities. For example…However, we are here today to focus on one team’s efforts, Peace Promotion Team. This is a team that formed in 2010 and identified many problems in their community that they felt could be ameliorated by implementing Restorative Community Conferencing. The team had a pilot program implemented for juveniles at juvenile court. The pilot is entering it’s third year. As an important marker for evaluating the program Mid-City CAN conducted a Health Impact Assessment that addresses the health impacts of incarceration v. restorative conferencing. We are here to share our findings and recommendations in that report, as well as shed some light on the local landscape. Aman wrote the HIA (title too) Sandra is PPMT Organizer w/ graduate degree in restorative justice…
City Heights Restorative Community Conferencing (RCC) An explanation of restorative justice and Restorative Community
Conferencing (RCC).
Pilot Partners SD county probation, Office of the DA: juvenile division, Office of the Primary
Public Defender: Juvenile Division, School Police, Mid-City CAN, NCRC, SDYS
Status of the program
Presenter
Presentation Notes
Speaker: Sandra 1. What is restorative justice? What is RCC? 2. What are the benefits? Reduces recidivism (averaging a 12% decrease in recidivism rates) Costs taxpayers less Savings from Restorative Justice: $38k per Offender $35,500 for a first time offender v. $4,500 for restorative $16,330 for recidivism per offender v. $9,408 for restorative Total cost of criminal justice: $51, 830 Total cost of restorative programming: $13,908 Average restorative justice net savings: $37,922 Scaling Restorative Community Conferencing Through a Pay for Success Model: Feasibility Assessment Report. (2015, March). National Council on Crime & Delinquency (NCCD), 1-20, 13. Improved health for communities (High rates of victim satisfaction, as well as increases in offenders’ feelings of self-efficacy, hope, and optimism) 3. Status of the program: The pilots struggles – sealing of records, mediation company not earning as many referrals as anticipated, etc. The pilots successes (speak generally since Aman will cover) – Reduced recidivism (disclose the sample size), local support from elected officials, positive health impacts, which Aman will discuss 84 referrals
What is Health Impact Assessment?
The International Association of Impact Assessment defines Health
Impact Assessment (HIA) as “a combination of procedures, methods
and tools that systematically judges the potential, and sometimes
unintended, effects of a policy, plan, program or project on the
health of a population and the distribution of those effects within the
population. HIA identifies appropriate actions to manage those
effects.” (Quigley, 2006).
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Presenter
Presentation Notes
So what is an Health Impact Assessment or “HIA?” An HIA is a way to come up with a prediction about how a proposal is going to impact health and health for whom. In the case of RCC, how will RCC affect the health of our communities. It’s a pretty systematic process that uses a variety of data sources like public data bases, peer reviewed journals, and possibly new information and uses different types of analytic methods. It considers input from stakeholders in the community Determines the potential effects on the health of the population, and determines what the distribution of those effects looks like, and provides recommendations on monitoring and managing those effects. I had a college professor of public health that said we can look at many different issues and fields of study through a health lens. So why do we focus on Health? Health is an indicator of quality of life. A health lens can contribute to a new policy decision because it can highlight any unintended health consequences, disparities, or benefits, and it can provide an alternative to simple cost efficacy approach for decision making. Health is determined by more than just individual factors. In fact genetics, only determine for 30% of your health status. Instead, health can be influenced by public services, your living and working conditions, social, economic and political factors. Things like your education level, income, whether you have access to good transportation to do things like get to work or to a hospital and come together and predict your health. We call these your social determinants of health.
HIA Addresses Determinants of HealthHow does the proposedproject, plan, policy affect
lead tohealth
outcomesrecommendations
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Presentation Notes
Here’s a visual overview of what HIA does An HIA predicts how a new project/plan policy affects those social determinants of health that we talked about, lead to different health outcomes, and the purpose of the prediction is so you can make recommendations to improve the proposal for health.
Social Determinants of Health
Restorative Justice
Recidivism
Family and Community Cohesion
Perception of Crime
and Safety
Education
Why HIA?
Presenter
Presentation Notes
HIA is a collaborative process that is heavily guided by the input of the stakeholders. A group of justice partners, residents, members of the PPMT and others came together to figure out what the thought was important to study and the came up with 4 Social Determinants of Health to study based on the literature and what was important to them. Why was the HIA important to City Heights?
City Heights Demographics59
%
17%
11%
10%
3%
30%
16%
6%
44%
4%
33%
11%
4.00
%
47%
5%
RACE AND ETHNICITYCity Heights City of San Diego County of San Diego
San Diego County City Heights
Low-Income Households 28% 60%
Limited English Proficiency 61% 73%
Median Income $63,996 $33,409
Median Age 34.9 29.7
% of Population Under 18 16.30% 42%
Presenter
Presentation Notes
City Heights is a neighborhood of the City of San Diego and is made up of a population of 77,697 residents[1]. It is an ethnically and racially diverse neighborhood with a large immigrant and refugee population, it is low-income area, and its population is very young. Latinos make up 59% of the population, which is significantly more than the 33% in the county of San Diego. African Americans make up 11% of the population of City Heights which is higher than the 4% of the county’s population. In addition to being ethnically and racially diverse, about 73% of families in City Heights have limited English proficiency. City Heights also has a very young population. City Heights The median age is 29.7, 30% of the population is under 18, and 42% of the population is under 25 SD County The median age is 35.3 23% of the population is under 18, and 35% of the population is under 25 These young people are the “future” of the demographics of San Diego. How their health is impacted will have a huge bearing on the overall health of San Diego in the future.
Why use HIA for the RCC Pilot? City Heights youth are most
affected by the juvenile justice system San Diego County had the
highest juvenile arrest rate of 23.7 per 1,000 in comparison to other large California counties in 2014. Despite a 50% decrease in arrests since 2010.
In 2015 the City Heights zip code 92105 was one of the three zip codes in the county with the highest concentration of youth under supervision by the probation department. East African and Latino youth in zip code 92105 are most affected.
Presenter
Presentation Notes
City Heights youth are most affected by the juvenile justice system San Diego County had the highest juvenile arrest rate of 23.7 per 1,000 in comparison to other large California counties in 2014. Despite a 50% decrease in arrests since 2010. In 2015 the City Heights zip code 92105 was one of the three zip codes in the county with the highest concentration of youth under supervision by the probation department. Because of the incredible diversity in City Heights, its youth are most affected. East African and Latino youth in zip code 92105 are most affected.
What leads to the incarceration of youth?
Disproportionate Minority Contact In 2008 the San Diego Association of Governments (SANDAG)
conducted a study to assess disproportionate minority contact (DMC) in San Diego. They found DMC at three points in the juvenile justice system: at arrest, pre-adjudication (after arrest), and institutional commitment.
Black youth made up 6% of the population, 17% of arrested youth, and 24% of institutionalized youth. White and other races were under-represented in both the population of arrested youth and institutionalized.
Race was found to be a predictor of being detained pre-adjudication with Hispanic youth 2.8 times more likely to be detained compared to White youth and Black youth 1.8 times more likely to be detained compared to White youth. Although Black youth were significantly more likely to be institutionalized, race was not found to be a predictor of institutionalization. However, race was associated with other factors such as level of offense, and a host of other factors that were predictors of institutionalization.
Presenter
Presentation Notes
Race and ethnicity are definitely associated with various criminal justice system. In 2008 the San Diego Association of Governments (SANDAG) conducted a study to assess disproportionate minority contact (DMC) in San Diego. They found DMC at three points in the juvenile justice system: at arrest, pre-adjudication (after arrest), and institutional commitment. Black youth made up 6% of the population, 17% of arrested youth, and 24% of institutionalized youth. White and other races were under-represented in both the population of arrested youth and institutionalized. Race was found to be a predictor of being detained pre-adjudication with Hispanic youth 2.8 times more likely to be detained compared to White youth and Black youth 1.8 times more likely to be detained compared to White youth. This was after controlling for various other variables associated with the outcomes. Although Black youth were significantly more likely to be institutionalized, race was not found to be a predictor of institutionalization. However, race was associated with other factors such as level of offense, and a host of other factors that were predictors of institutionalization.
Juvenile Arrest Rates in San Diego County
17.4
87.6
27.2
10.1
White Black Hispanic Other
2014 Juvenile Arrest Rate per 1,000 Youth in San Diego County
Juvenile Arrest Rate per 1,000 Total Arrest Rate in San Diego
23
15
49
2
10
47
4
33
11
5
0
10
20
30
40
50
60
White AfricanAmerican
Latino Asian Other
JUVENILES WHO WERE REFERRED TO PROBATION BY ETHNICITY
Probation SD County
Juvenile Arrest Rate for San Diego County:
23.7 per 1,000 in 2014
Presenter
Presentation Notes
Despite the report in 2008, We still see a huge disparity by race and ethnicity in both arrest rates in San Diego and the Number of Youth on Probation. The juvenile arrest rate for San Diego County in 2014 was 23.7 per 1,000, but it varied by race and ethnicity. African American youth had the highest arrest rate of 87.6 per 1,000 compared to White youth who have an arrest rate of 17.4 per 1,000. Hispanic or Latino youth had an arrest rate of 27.2 per 1,000. Other races had the lowest rate of 10.1 per 1,000[6]. Juvenile arrest rates in San Diego County decreased by 113% from 2010 to 2014, but also varied by race and ethnicity. White youth, Hispanic or Latino Youth, and Other youth experienced a 104%, 123%, and 117% decrease in arrest rates respectively while African American youth experienced only a 60% decrease[6]. What else leads to incarceration of youth? It’s difficult to determine what factors are part of the cause of incarceration, but other social determinants discussed in prior slides have also been considered causes.
What leads to the incarceration of youth?
Trauma
According to a report by the Justice Policy Institute, youth who experience trauma have disproportionate contact with the justice system.
Youth who experience trauma are more likely to have more involvement with the justice system because of the neurological, psychological and social effects of trauma.
People who experience childhood trauma are also more likely to develop psychiatric conditions, developmental delays, and decreased cognitive abilities.
75% to 93% of youth entering the juvenile justice system have experienced at least one traumatic event.
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Presentation Notes
They reported that In the United States, between 14 to 34% of children have experienced at least one traumatic event, but 75% to 93% of youth entering the juvenile justice system have experienced at least one traumatic event. Some studies found that 50 to 79% of men who experienced maltreatment before 12 years of age became involved in serious juvenile delinquency. Studies have shown that people who have experienced trauma have elevated levels of stress hormones that may interfere with brain development. People who experience childhood trauma are also more likely to develop psychiatric conditions, developmental delays, and decreased cognitive abilities. These youth are also more likely to have problems in school, and have dropout rates and expulsion rates that can be up to 3 times the rates of those who have not experienced trauma.
Health Outcomes Associated with Incarceration
Increases the likelihood of suicidal tendencies.
Increases the likelihood of human immunodeficiency virus (HIV), and other infectious diseases such as tuberculosis, violence, reproductive health problems, and other chronic diseases.
Exacerbates mental illness and substance abuse
Impedes education.
One study found that neighborhoods with high levels of incarceration were associated with psychiatric morbidity even among community members that were not incarcerated.
Presenter
Presentation Notes
Not only does incarceration have direct health outcomes like the ones mentioned, it also has indirect effects on health through other social determinants of health because it impacts family structures, education, employment and income, political participation, and normative community values around sex, drugs, and violence. Main Point: The more we can deter youth from incarceration the less we will see these health impacts in our communities. Health Impacts on Communities: In addition to affecting the health of the individual who is incarcerated and his or her direct family, incarceration can affect an entire community. One study found that neighborhoods with high levels of incarceration were associated with psychiatric morbidity even among community members that were not incarcerated. The study controlled for both individual and neighborhood level risk factors and found that individuals living in neighborhoods with high prison admission rates were 2.9 times more likely to currently have major depressive disorder and 2.5 times more likely to have any lifetime history of major depressive disorder across 3 waves of follow-up. Similar results were found for generalized anxiety disorder, individuals living in neighborhoods with high prison admission rates were 2.1 times more likely to currently have generalized anxiety disorder and 2.3 times more likely to have any lifetime history of generalized anxiety disorder across 3 waves of follow-up.
Recidivism
Existing Conditions:
California: 62.2% of the youth were re-arrested one year after release
SD Probation: 31% of juvenile have true finding while under probation supervision
Findings:
Of the 17 youth that completed the program at least one year ago, 12% (2/17) were rearrested. Youth who were referred to the RCC pilot program, but did not participate in the program had a 24% (4/17) re-arrest rate one year after referral to the program.
“When you get a chance to say I did this, this is what I am going to do fix it. It’s a lot better than let’s lock you up and you’re criminal and you’re in here with all these criminals, everybody here is a criminal. So, your self-esteem is really low and the self-esteem issue for me is a big part of who he is. It makes him a better person to accept responsibility for himself. Whereas in the criminal justice system, you did it, here’s your punishment, you did your punishment and you’re out there but you’re still the same person, the same person who is going to do it over and over again if something doesn’t change, And this program was that change for him.”
Presenter
Presentation Notes
A study was done by the state of California and The one year re-arrest rate for youth that were released in 2008 was 62.2%. They found that over three years 80% of the youth were rearrested, and well over 50% were re-sentenced to a State institution (juvenile or adult). In San Diego the Probation Department 31% of juvenile have true finding while under probation supervision. It is important to note that over the last 5 years crime has been steadily decreasing and is about 50% lower, but the recidivism rates have hovered around 50%. It’s a real indicator that our current policies and programs are not improving recidivism. Recidivism rates are lower for responsible youth who complete RCC. All youth who were referred to the pilot program were tracked for a year to assess recidivism. A total of 83 referrals were sent to the RCC Pilot Program between May 2014 and July 2016, and 46 youth participated in the program. Of the 17 youth that completed the program at least one year ago, 12% (2/17) were rearrested. Youth who were referred to the RCC pilot program, but did not participate in the program had a 24% (4/17) re-arrest rate one year after referral to the program. The recidivism rates for RCC pilot youth are lower than their non RCC pilot counterparts, but the number of cases is too low to determine statistical significance.
Perceptions of Safety
Existing Conditions: In 2009 69% of children and teens in City Heights felt safe in their neighborhood
compared to 91% of children and teens in San Diego County.
26% of the children and teens surveyed felt safe at nearby parks and playgrounds at night compared to 52% of children and teens in San Diego County.
Parents with children under 18 in City Heights were less likely to report that they trusted their neighbors in comparison to parents in the County of San Diego or the state overall.
Findings: Youth in our focus groups commented on feeling safer in their neighborhoods after
going through the RCC program due to their newfound connections to community members that cared about them in their conference.
One youth said, “Before I would probably be a little sketched about my neighborhood and, iffy about it but now it’s okay, now I could walk around there like really positive and see good things, not bad.”
Health Outcomes Associated with Perceptions of Safety
In a literature review conducted in 2008 thirty-seven of forty-five studies found a relationship between neighborhood characteristics and depression after controlling for individual level characteristics.
In 2011, a study of older Korean adults in New York City found that after controlling for individual level variables, individuals who were less satisfied with their overall neighborhood environment were more likely to have a negative perception of health and depressive symptoms. They also found a strong link between perceived neighborhood safety and depressive symptoms.
A study conducted using 2008 Arizona Health Survey Data found that the safer an individual felt in their neighborhood the less psychological distress they experience. They found that relationship could be partially mediated by feelings of powerlessness, social isolation, and mistrust.
Presenter
Presentation Notes
There have been numerous studies that examine the relationship between physical environment and health outcomes. They have found an association with perceptions of safety and depression and psychological distress.
Social Cohesion
Existing Conditions:
60.5% of students in City Heights area schools said that they feel close to people at their school
34% of City Heights students reported that their school has a process to confidentially and safely resolve conflicts
Findings:
Many of the youth said they learned patience, confidence, and that there are people that would listen to them.
Others said that they learned communication skills and were better able to express themselves.
Some parents of youth said that they were more open, and talked to their siblings more often whereas before they used to argue more and be aggressive.
Presenter
Presentation Notes
While the evidence is limited, there are findings to suggest that RJ improves school climate. For example, for a pilot study of a restorative conferencing program in Minnesota, McMorris and colleagues (2013) report increased school connectedness and improved problem solving among students in a six-week follow up. Jain and colleagues (2014) also note that two thirds of staff perceived the RJ program as improving the social-emotional development of students, and 70 percent of staff reported that RJ improved overall school climate during the first year of implementation. However, when the participants were asked if these skills could transform a community their responses were varied. Some said yes, or it depends on the individuals, and others said no. One youth was very certain that his neighborhood would be transformed by a more restorative approach. He said that his neighborhood doesn’t have a lot of people that would say “Hi” or “Good morning!” or “How’s your day?” but he was sure that his neighborhood become friendlier if more people were able to go through restorative community conferencing. First bullet: One youth said that he was shy and would look the other way if he had to speak to a large audience, but now he can look them in the eyes and has better communication skills. Another youth shared that he learned to shake people’s hands and it was a way for him to practice showing respect and behaving more maturely.
Education
Population over 25 years old City Heights SD County
High School Diploma or Equivalency 67% 87%
Bachelor’s Degree 14% 42%
City Heights High Schools San Diego Unified SD
Graduation Rate 82% and 79% 89%
Dropout Rate 5.3% and 9.7% 3.5%
Findings: Youths reported high self-motivation, self-confidence, self-worth, and determination after RCC.
Youths reported positive impacts on their education. Before the program they were not as engaged, but after RCC look forward to school more. They said that RCC helped make them aware of opportunities available to them if they kept going to school. They also had added confidence to strive for better grades.
Some youth said that they were able to get a tutor or join programs at the library as a part of their action plan and it improved their schooling.
Parents reported improvement in school. One parent mentioned that her youth was truant often, but now he goes to the learning center, gets up at 7 am to attend school, and is now interested in becoming a veterinarian.
Existing Conditions:
Presenter
Presentation Notes
In City Heights 67% of the population over 25 years old has at least a high school diploma or the equivalency, and in SD County 87.3% have at least a high school 13.5% have at least a bachelor’s degree. These are lower proportions than the City of San Diego’s, where 87.3% of the population over 25 years old has at least a high school diploma or the equivalency, and 42.3% have at least a bachelor’s degree. San Diego Unified School District had a graduation rate of 89.4% for the class of 2014-2015, but the graduation rates at the two City Heights high schools are slightly lower. Hoover High School and Crawford High School have graduation rates of 82.6% and 78.5% respectively [20]. San Diego Unified School District had a dropout rate of 3.5% for the class of 2014-2015, but the dropout rates at the two City Heights high schools are higher. Hoover High School and Crawford High School have dropout rates of 5.3% and 9.7% respectively[20]. One youth said, “RCC helped me motivate myself, like Francisco [The RCC Pilot Program facilitator] telling me about my work and what kind of college I want to go to and stuff really helped me like look in the text book and actually do my work.” “Just self-confidence helped improve my grades just because I… had more worth I guess, I thought of myself as more worth going to school and trying to go to college instead of just going to school for your high school diploma and doing something after that.” The parents said that participating in the RCC program helped their youth because the facilitators asked what their youth were interested in and were able to connect them to people in those careers. It made their youth feel that they can have future. One parent mentioned that her youth was truant often, but now he goes to the leaning center, gets up at 7 am to go to school, and is now interested in becoming a veterinarian. Another parent said that her youth already had good grades, but by learning to control himself it is helping with his education even more. Why are the educational impacts so important? According to a policy brief by the National Poverty Center an addition four years of schooling lowers the probability of reporting being in poor or fair health by 6 percentage points. This means that if graduation rates were increased in City Heights due to restorative justice, then the percentage you people reporting fair or poor health in City Heights would decrease from 25% to 19%. This would bring it closer to the averages seen in the San Diego County. They also found that people who are better educated are less likely to report a past diagnosis of both acute and chronic disease, and less likely to report anxiety and depression. In addition they found that an additional four more years of schooling also report healthier behaviors. They are less likely to smoke, to drink a lot, to be overweight, or to use illegal drugs. The associations between education and health held up even after controlling for job characteristics, income, and family background.
Health Outcomes Associated with EducationHealth
Heart Disease ↓ 2.0 percentage points
Diabetes ↓ 1.3 percentage points
Reporting fair or poor health ↓ 6.0 percentage points
Sick Days per year ↓ 2.3 days
Health Behaviors
Smoking ↓ 11 percentage points
Drink a lot ↓ 7.0 percentage points
Overweight or obese ↓ 5.0 percentage points
Use illegal drugs ↓ 0.6 percentage pointsSource: Cutler, D.M. and A. Lleras-Muney, Education and Health, in Policy Brief. 2007, The National Poverty Center.
Presenter
Presentation Notes
According to a policy brief by the National Poverty Center an addition four years of schooling lowers the probability of reporting being in poor or fair health by 6 percentage points. This means that if graduation rates were increased in City Heights due to restorative justice, then the percentage you people reporting fair or poor health in City Heights would decrease from 25% to 19%. This would bring it closer to the averages seen in the San Diego County. They also found that people who are better educated are less likely to report a past diagnosis of both acute and chronic disease, and less likely to report anxiety and depression. In addition they found that an additional four more years of schooling also report healthier behaviors. They are less likely to smoke, to drink a lot, to be overweight, or to use illegal drugs. The associations between education and health held up even after controlling for job characteristics, income, and family background. The differences in health due to education based on this study are summarized in the table below
Health Impact Assessment Findings for RCC
Reduced recidivism rates.
Juveniles developed ownership of responsibility for their actions.
Juveniles were inspired not to reoffend.
Juveniles and their families expressed improved self-worth.
Juveniles perceived their communities to be safer.
Victims feel whole.
Victims are less fearful of the offender.
Victims have less fear and anger towards community overall.
Increased motivation to succeed in school.
Juveniles from high crime neighborhoods feel safer in their communities.
Presenter
Presentation Notes
Policies and Recommendations
Continuing to implement and expand RCC throughout San Diego.
Recommending funding to community based organizations specializing in restorative justice to provide training for law enforcement and referring agencies.
Expansion of the RCC pilot program should be focused on high crime areas in order to see the largest health impacts.
Support legislation that provides funding and structural support for restorative justice programs. Ideally prioritizing pre-charge programs, before a youth ever has to be exposed to the court system.
Presenter
Presentation Notes
Marlena First bullet: (Lay of the Land) San Diego County has $2.8 billion in reserve funds… -Training is important (for School Police especially) because School Police is likely to become the largest referring agency to RCC Local Efforts: PPMT is in the process of writing a SCBOR and trying to get it passed as a resolution in December. San Diego landscape- State Legislation: (make sure to take the brief with me, so I know what bill numbers to refer to) Federal: Supporting Youth Opportunity and Preventing Delinquency Act (HR 5963) “At the federal level, we must continue to incentivize a focus on evidence-based prevention and intervention initiatives which reduce delinquency and save money.” Since 1974, the Juvenile Justice and Delinquency Prevention Act has coordinated federal resources aimed at improving state juvenile justice systems with a focus on education and rehabilitation. While many of these state juvenile justice programs have been able to help children develop the life skills they need to hold themselves accountable and achieve success, not all programs have seen the same results.
