Tag Archives: Racism

The Long Road Home: Decreasing Barriers to Public Housing for People with Criminal Records

For individuals with a criminal history, finding affordable and stable housing becomes extremely difficult in a place like the Bay Area, with high cost and limited supply. People with a criminal history can legally be excluded from housing. In a survey from the 2015 Ella Baker Center for Human Rights and Forward Together report, “Who Pays? The True Cost of Incarceration on Families,” 79% of people who had been incarcerated were either ineligible or denied public housing as a result of criminal history. More than half of those released from jail or prison have unstable or nonexistent housing.

Safe and affordable housing is a fundamental basis for success in all areas of life, and without stable housing, an individual’s health, employment and education opportunities, family reunification and social networks are compromised. In Alameda County, California, nearly 20,000 people are at risk of residential instability because of having a recent criminal history.

Having housing improves health directly and indirectly, decreases recidivism, improves the chance of becoming employed and having more income, and helps with family reunification. These factors, known in public health as the social determinants of health, create opportunities to succeed and are known to be important for health and wellbeing. For example:

  • Moving often affects recidivism. The odds of recidivism increase by at least 70% for every time someone who is formerly incarcerated changes their residence.
  • Six randomized control trials analyzed supported employment in public housing against other approaches to help residents find jobs, and found 58% of public housing program participants obtained employment compared to 21% in the control group.
  • More than 70% of those leaving prison indicated that family is an important factor in keeping them out of prison, and up to 82% of people leaving prison or jail expect to live with or get help from their families.
  • Having stable housing upon leaving jail or prison decreases a person’s chance of having their probation revoked.

It’s clear from the research; the lack of stable and affordable housing forces families to frequently move and live in unhealthy and crowded environments, increases stress and depression, and can lead to homelessness. Homelessness brings higher rates of infectious diseases; substance use and mental health disorders; exposure to violence; overexposure to cold and rain; and suicide. Studies show that 25% to 50% of people who are homeless have histories of involvement with the criminal justice system.

Public housing admissions screening policies play an important role in creating the conditions for successful reentry of people who were incarcerated. HIP recently released a report called, “The Long Road Home: Decreasing Barriers to Public Housing for People with Criminal Records” done in partnership with Ella Baker Center for Human Rights (EBC). I worked closely with EBC staff starting in September 2015 to complete this Health Impact Assessment (HIA), as part of my Health & Equity Fellowship with HIP. We studied the Oakland Housing Authority (OHA) as a case study to understand the impacts of screening policies on health.

To fully understand OHA’s admission and screening policies, HIP met with two staff from their office. We learned that OHA denials due to a criminal history in the first round of screening have decreased significantly from 12% to 0.8% between 2010 and 2012. Of those who were screened out by OHA due to a criminal history, 75% request an informal hearing, and 64% of those have the decision reversed, allowing them to continue on in the application process. This is a powerful statement for the presentation of mitigating circumstances; at OHA, when people are allowed to tell their story and present supporting documentation, it often results in a reversal. We know that historical policies have created racial inequities in housing and health outcomes. However, data on race and ethnicity is not being recorded or reported, making it impossible in OHA’s case to analyze inequities in screening practices.

While more people with criminal histories are able to move forward in the screening process when OHA allows them to present mitigating evidence, there are additional changes OHA and other public housing authorities can make to improve housing stability for individuals with criminal history:

  • Allow mitigating circumstances to be presented in the initial application for public housing
  • Ensure proper implementation of policies that allow individuals with criminal history to join their family in public housing, and eliminate any practices of evicting existing residents from public housing for allowing a family member returning from prison or jail or denying admission if there is no valid reason for doing so
  • Collect, track, and publicly report the race and ethnicity of applicants and those screened out due to their criminal history to examine the potential impact of screening policies on people of color with a criminal history

Read more of the findings & recommendations in the full report.

Addressing Race & Power to Advance Health Equity: An Infographic

As HIP works with more community partners and public health departments to advance health equity, we’re looking for new ways to talk with folks about what we mean by equity.

This Equity Infographic contains user-friendly, visual content to share with organizations or individuals who may be less familiar with the term.

Content in the infographic is from HIP Co-Director Jonathan Heller’s article, “If we want to advance equity in public health practice, we must address race and power.” The infographic was designed by UC Berkeley School of Public Health Center for Health Leadership consultants Billy Luong, Briana Levin, and Carlos Cerda using Paper by FiftyThree.

Together we are Stronger: Intersectionality of Immigration and Incarceration

Last week the Haas Institute for a Fair and Inclusive Society launched We Too Belong: A Resource Guide of Inclusive Practices in Immigration and Incarceration Law and Policy at a half-day event that brought together the contributors to share their stories, their work, and engage in meaningful dialogue.

Immigration is often thought of as a Latinx issue, and incarceration thought of as a Black/African-American issue. However, the event centered on the intersectionality of these issues and highlighted that the immigration and criminal (in)justice systems are highly racialized. For those of us who have been impacted and involved in one movement or another, this is nothing too new — we’ve experienced the entanglement.

Experiencing the entanglement of immigration and incarceration is one thing, but this event generated the necessary uncomfortable conversations about how the systems have us working in silos, pointing fingers at one another, and fighting for resources. These approaches perpetuate oppression, fuel violence, hate, and pin us against each other. Working together makes us stronger, and is a key part of the process for liberation. I believe that these conversations need to be had among groups and organizations working on social justice and public health issues.

Particularly, I want to share a few nuggets of wisdom that panelists at the event announced and that I think anyone working for a more just and equitable society could reflect on:

  • Build transformational relationships instead of just transactional ones. We need to show up as much as possible for our partners; our work is not over after we’ve completed a project.
  • Elevate lived experiences, highlight non-traditional and inspiring stories, and create unified narratives. This is quite a task to accomplish especially while also recognizing that communities are not homogenous, even within the immigrant community, for example.
  • Expand the level of human concern in the policy work we do. This means making sure we use inclusive language and check ourselves.
  • Work towards what we want, not just towards what we don’t want or what we’re fighting against. Let’s use our energies effectively!

The overarching message I took was that while we work to dismantle oppressive systems, we must remember that at the core of it all are individual humans. Yes, poverty and racism are hurting and killing us, but we should equally acknowledge that we are also strong, resilient, and powerful.

The communities most impacted by policies are the ones with the solutions, we are not saving anyone—this was very clear based on the faces, stories, and histories panelists shared. Our task in public health (or whatever sector we work in) is to elevate that strength. By elevating community strength, we elevate our collective strength.

After each presenter shared their work and their story, the event attendees repeated these beautiful phrases, that reminded us how intertwined our work together is. I invite us all to contemplate these words as we continue our work together: Thank you. Thank you for your story. Thank you for your work. My freedom is bound to yours.

Strategic Questions to Ask To Explicitly Address Racism and Power in Your Public Health Practice

A few months ago, I wrote about the need for public health practitioners who want to advance equity to explicitly address race and power in their work. I received positive feedback, but also found that people are interested in how to actually do this. I recently created some materials for a training and it went well.

So, here goes an attempt to share it with a broader audience…

Let’s say you and your team – a team that hopefully includes people with a variety of skill sets and perspectives, including people from communities facing inequities – are working on a project on a particular social determinant of health in a particular location. As an example, let’s use policing, and mass incarceration more generally (i.e., the determinant), in Cincinnati and Akron, Ohio (i.e., the location). (Disclaimer, these examples stem from a recent HIA HIP released).

Questions about Underlying Issues

As you begin thinking about your project, here are a set of strategic questions that you can discuss with the team that get at the underlying issues of racism and power that are at play for virtually all social determinants of health:

1. What is your long-term equity goal, as it relates to the issue in that place?
2. What is the historical and current racial context for the issue, at the structural, institutional, and interpersonal levels?
3. What is the historical and current context with regard to other forms of oppression (class, gender, age, sexual orientation, disability, etc.) for the issue at the structural, institutional, and interpersonal levels?
4. Have race and/or other forms of oppression been used as political tools in decision making around the issue? If so, how?
5. Do you have the votes or other measures of buy-in to advance your equity goal? Explain.
6. Do you have a network of organizations and individuals strong enough to advance your equity goal? Explain.
7. What is the current societal narrative as it relates to your equity goal? Does it work in your favor or against you?

Example: Here are some quick and oversimplified answers for policing in Ohio:

1. Long-term equity goal? Eliminate the use of policing and incarceration as a form of control of black communities. Invest in necessary jobs, housing, education, etc. instead.
2. What is the racial context for the issue? FDR’s compromise with southern Democrats, who were segregationist (interpersonal racism), led to housing policies at HUD that have allowed whites to build wealth and simultaneously led to white flight and disinvestment from inner cities (institutional racism). Many communities of color, like those in Cincinnati and Akron, now suffer from lack of opportunity – in jobs, housing, education, etc. – and high crime rates (systemic racism). This has led to excess policing and incarceration. Listen to this NPR piece, for example, for more details.
3. What other context and forms of oppression are important to consider? The following populations have also been over-policed in communities of color and other communities: youth, men, LGBTQ, those with mental illness, and low-income whites.
4. How have race and other forms of oppression been used as political tools? Think of who the language of “tough on crime”, “war on drugs”, “super-predators” was really about (dog-whistling). Think about how heroin addiction – which is thought to be used more by whites – is treated as a health issue, in comparison to crack addiction – which is thought to be used more by blacks – which is criminalized.
5. Do we have enough votes or buy-in to advance our equity goal? No! Most people – including people of color – consider policing to be the best solution to addressing public safety needs in inner-city communities of color.
6. Do we have a network of organizations strong enough to advance our equity goal? No! This issue is just beginning to bring people together and a movement is starting. But still, policing and incarceration are seen as separate issues from jobs, housing, and education. We are still too siloed in our work.
7. What is the current narrative? It includes “Be afraid of black people”, “us vs them”, “individuals are at fault – they choose to commit crimes and are bad people”, “punishment deters crime”, and “we are protecting the innocent”. We see these themes everywhere – in the news, on TV, and in the movies. There is a lot more that could be said about this, but the way crime and policing are now thought of, we will have a difficult time achieving significant reforms.

After going through this exercise, your team will most likely have a better and a common understanding of the barriers you face in achieving your equity goal. That understanding should inform the approach you take.

Questions to Overcome Barriers Identified

If your project includes conducting research, like a Health Impact Assessment, a next step is to think about how you can use your research process to overcome these barriers. For example, your team could discuss the following questions.

How can you use your research process to:

1. Bring attention to the current and historical context regarding racial and other forms of oppression around your issue?
2. Unite people across the boundaries of race and other forms of oppression?
3. Diffuse the ability of opponents to use race or other forms of oppression as a political tool to block your ability to move your equity goal?
4. Build your ability to advance both your short-term and long-term equity goals by:
a. Winning enough votes or other measures of buy-in?
b. Building relationships and infrastructure to change what is on the political agenda?
c. Changing the dominant narrative related to your issue?

Example: Again, here are some quick and oversimplified answers for policing in Ohio:

1. How can we bring attention to the current and historical context of oppression? We can: discuss these with our steering committee; reflect them in our recommendations (e.g., recommend that communities come together to talk about this history); and have a section in our report that discusses this history.
2. How can we unite people across boundaries? We can discuss how both black communities and the police are negatively impacted by current forms of policing. And we can use the steering committee to start bringing people together and build trust.
3. How can we diffuse the ability of opponents to use oppression as a political tool? We can discuss approaches to overcoming dog-whistling during our research process. We can make recommendations about further and broader discussions about the use of race as a political tool as it relates to policing. We can also share information about how unconscious bias plays out today in terms of policing.
4. a. How can we build our ability to win enough votes or gain buy-in? We can use the HIA process to engage communities most impacted and help our partners build their leadership and sense of agency.
b. How can we build our relationships and infrastructure? By developing and engaging a diverse steering committee.
c. How can we use the research process to change the dominant narrative? This is hard! We can start to change the “us vs them” mentality by discussing that we are all impacted. We can humanize everyone. We can talk about wanting to have policies that improve everyone’s health and that address underlying social causes.

As you can see, these are difficult questions and advancing equity by addressing race and power is not easy. But this work is necessary and it is worth struggling – together – to figure out how to do it.

Tools You Can Use

In case it is useful, we’ve pulled these questions together as a worksheet to use with your team. And for HIA practitioners, after you go through these questions, you may want to use the Equity Metrics for HIA Practice as a planning tool for your project.

Let us know if you use these tools and, if so, what feedback you have for us! Thanks!

If we want to advance equity in public health practice, we must address race and power

This week’s blog post was originally posted on The Pump Handle on January 7, 2016.

Most public health practitioners, and those who work on health impact assessment specifically, want to improve the health of vulnerable populations. Most efforts to do so are well-intentioned, yet they often don’t lead to significant change. What do we need to do differently? Below is an analysis we at Human Impact Partners put forward. Read more…

Building Hope with Community: The Right to Affordable Housing in South Central Los Angeles

This week’s blog is a repost from Esperanza Community Housing. The post discusses the right to affordable housing in South Central Los Angeles and preliminary findings from HIP’s HIA on a development in the area

The narrative of South Los Angeles has been one of serial displacement. Community residents, primarily low-income people of color, have systematically been priced out of our homes and neighborhoods to make way for industry and for gentrifying trends. We’ve faced higher rents, skyrocketing property values, and a cost of living that has become unmanageable — even when working multiple jobs. This combination is a result of the city’s poor planning and spot-zoning policies, and the real estate development industry’s unchecked pursuit of profits without consideration of the human cost of housing, health, and security. This has put not only our homes at risk, but also our health, our identities, our livelihoods, and our environment. Read more…

Dignified & Just Policing: Gang Injunctions and Other Policing Practices Have Uncertain Impacts on Community Safety and Health

Today, HIP and Santa Ana Building Healthy Communities (SABHC) released a report on the health and equity impacts of a gang injunction in the Townsend-Raitt neighborhood of Santa Ana, California.

A gang injunction is a controversial policing practice that essentially acts as a group restraining order against alleged gang members within a safety zone, a specific geographic area thought to be “controlled” by a gang. Since the 1980’s, over 60 gang injunctions have been imposed in California in an attempt to curtail a historic spike in violent crime in the state (and in the nation) during the late 1980’s and early 1990’s, a topic we tackled in a previous blog post.

The injunction in Santa Ana, the city’s second, would prevent alleged gang members from associating with each other or carrying out certain illegal and legal activities within the safety zone. The injunction has stirred up heated debate in Santa Ana since June 2014, when it was first implemented, and has been a flashpoint for controversy more recently amidst allegations of police brutality. Supporters of the injunction say it will lead to decreased crime and violence for all residents, while opponents say the injunction fails to address the root causes of crime and may lead to increased police mistreatment of local youth.

The HIA, which worked locally with SABHC, Chican@s Unidos de Orange County, KidWorks, Santa Ana Boys & Men of Color, Latino Health Access, UC Irvine’s Community Knowledge and Community & Labor projects, and the Urban Peace Institute, examined the impact the gang injunction would have on crime, safety, community-police relationships, education and employment, and collected data on community safety through surveys, interviews and focus groups. The HIA focused on populations that may be disproportionately affected by the gang injunction, including youth, undocumented immigrants, transgender or queer-identified people, the homeless, and those with physical and mental disabilities. Members of these groups fear that increased police presence in the neighborhood will exacerbate the potential for profiling and discrimination.

The HIA concluded that the injunction is unlikely to bring about significant and lasting reduction of serious crime, based on the outcomes of other gang injunctions and input gathered from residents, city officials, community organizations and police. On the contrary, the injunction could have negative effects on public safety, public health and public trust.

The HIA found that:

  • The evidence is insufficient that a gang injunction will reduce violent crime, gang activity or gang membership, or that it will improve community-police relationships.
  • An injunction could make some in the community, particularly parents, feel more safe, but members of marginalized groups may, in contrast, feel more threatened by increased police presence.
  • An injunction could lead to significant disruptions to education and employment opportunities for those named in the gang injunction, with immediate harm to their health and well-being and long-term harm to their chances in life.
  • Young black and Latino men who experience repeated, unsubstantiated searches and other forms of suppression-based policing may experience higher levels of anxiety and depression than their peers.
  • An injunction could divert funding from community programs that address the economic and social problems that are the root causes of much crime and a detriment to public health and well-being. In contrast to the mixed evidence on the effects of policing strategies on crime, there is solid evidence that correlates reductions in crime with environmental, educational and economic factors.

Our findings led us to make specific recommendations for the police and other law enforcement and criminal justice agencies, city officials and community organizations. Our partners plan to use the data from the HIA in their campaigns on healthy policing practices and in upcoming court proceedings to determine whether the gang injunction will be upheld or reversed.

This report marks HIP’s third HIA on criminal justice policies, with a fourth HIA on policing in Ohio in the works (stay tuned!).

The efforts of groups such as those in Santa Ana to evaluate the public health impacts of policing practices, especially on communities of color, help to move us forward into rethinking how to best promote community safety for all.

Fair Housing for Better Health

One year after Michael Brown was killed by police officer Darren Wilson in Ferguson, Missouri, galvanizing the Black Lives Matter movement, the role of housing segregation in perpetuating racial injustice is in the news. Residential segregation is one of the major mechanisms that produce racial health disparities in the United States, but there is some reason for optimism that new national policy efforts will challenge ongoing segregation.

Last month, the U.S. Department of Housing and Urban Development (HUD) announced the Affirmatively Furthering Fair Housing (AFFH) rule. This rule comes on the heels of the Supreme Court’s June decision that affirmed the legal rights of plaintiffs to challenge housing policies with racially “disparate impacts” – without being required to show that racial discrimination was intentional. A non-profit called the Inclusive Communities Project brought the suit against the state of Texas Department of Housing and Community Affairs, arguing that Texas was allocating too many of its federally funded tax credits for affordable housing -housing for low-income, predominantly Black residents- to developments in poor, urban neighborhoods. This decision in turn came shortly after the release of a study out of Harvard’s Department of Economics, showing that moving from a high poverty to a low-poverty neighborhood as a young child led to measurable benefits in adulthood. These included better educational outcomes and higher incomes – two of the strongest predictors of health outcomes.

With these findings in mind, the AFFH rule is designed to reduce racial and economic residential segregation, and work towards achieving the unfulfilled promises of the 1968 Housing Act, so that more children gain the benefits of living in high opportunity, low poverty neighborhoods. AFFH asks cities to generate plans for reducing segregation, and connects municipalities to HUD data and support to design and implement these plans. This Supreme Court case, and HUD’s policy response, will be equity wins if they can open up some of America’s wealthy, exclusionary and generally White neighborhoods to affordable housing development. Policy conversations about racially concentrated poverty have too often veered towards pathologizing poor Black communities – created through decades of explicitly racist housing policies – without examination of the processes of exclusion that create concentrated affluence. Sociologist Patrick Sharkey writes forcefully that,

“Living in predominantly black neighborhoods affects the life chances of black Americans not because of any character deficiencies of black people, not because of the absence of contact with whites, but because black neighborhoods have been the object of sustained disinvestment and punitive social policy since the emergence of racially segregated urban communities in the early part of the 20th Century. Residential segregation has been used consistently over time as a means of distributing and hoarding resources and opportunities among white Americans and restricting resources and opportunities from black Americans.”

This “hoarding” creates racially concentrated areas of affluence, dominated by White residents. And these communities receive plenty of government housing subsidies, in the form of mortgage interest tax deductions. One of the ways that rich White neighborhoods maintain their boundaries is through zoning restrictions that make it difficult if not impossible to construct affordable multifamily housing (whether subsidized or not.) Hopefully the AFFH can work towards ensuring that some of these neighborhoods become more racially and economically inclusive.

But some have responded to AFFH as if it’s an indication that building affordable housing in high poverty neighborhoods is necessarily wrong. It’s true that housing alone will not reverse “sustained social disinvestment” in poor Black communities, nor will it transform a punitive criminal justice system into one designed to support health. But good housing combined with sustained and comprehensive investment in public services – services that focus on community well being rather than punishment and incarceration – could work to ensure that people who do live in these neighborhoods also have the opportunity to live healthy lives. Furthermore, as previously high poverty urban neighborhoods across the United States gentrify, permanent affordable housing means that low-income families can stay in these neighborhoods and actually gain some of the benefits of new investments. Building racial and economic health equity will require both approaches – dismantling the policies that allow resource-rich places to exclude poor people, but also directing resources to communities that need them the most.

Was “Race Together” Wrong?

Starbucks’ short-lived “Race Together” campaign, in which baristas wrote the phrase on coffee cups, generated lots of conversations – and lots of controversy.

Was it a good idea, but poorly implemented? Did it succeed, however slightly, in nudging the nation to talk about racism? Or was it a marketing move that prompted more talk about Starbucks than racism, and was not grounded in a plan for more significant action?

Whatever you think, it’s an opportunity to reflect and learn. Public health practitioners wrestle continually with this question: Should we talk about racism? If so, how?

In an open letter, Race Forward offers smart ideas on what we can learn from Starbucks’ campaign in the movement for racial justice. Their thoughts, as well as recent conversation with the Public Health and Equity Cohort that HIP has blogged about here, prompted some of my own thoughts, illustrated with examples gathered from public health colleagues.

  • Keep the dialogue – it’s how we reach hearts and minds and come to understand our role in serving the public.

Health departments and agencies nationwide are hosting public screenings and conversations around the Raising of America documentary, about how improving the social and economic conditions that shape childhood and childcare can create a safer, healthier, and more equitable future for our nation. The Kansas City, Mo., screening and conversation brought together multiple health departments, an organization that advocates for racial and economic equality, educators, legislators, clergy, and the public. The conversation ended with more than 90 people committing to take action.

  • Productive dialogue, particularly between people with different levels of power, is often accompanied by discomfort. But done in a supportive setting, it can be valuable for moving forward.

Since 2005, the Ingham County, Mich., Health Department has hosted Health Equity / Social Justice Workshops that use facilitated dialogue to have structured, strategic conversations among the health workforce and with interested community members. The dialogue builds the capacity of participants to talk about differences like race, class, and gender and their impacts on community health, as well as strategies to engage other individuals on these issues.

  • Beyond dialogue are structural solutions that require commitment to a larger, coordinated, long-term strategic plan that involves staff across levels and community partners.

In 2006, the Alameda County, Calif., Public Health Department launched the Place Matters initiative to address the social factors that shape health. As described in Public Health Reports, three factors created a strong foundation for the initiative: senior leadership dedicated to ensuring strong government-community partnerships and to building employees’ skills in advancing health equity; identifying inequities at the neighborhood level; and a strategic plan to achieve health equity that included policy change.

That strong foundation has translated into action. Alameda County Place Matters staff have provided testimony locally to successfully protect tenant housing rights. They have provided findings from data collection and suggested policy solutions to federal agencies, including U.S. Housing and Urban Development and Health and Human Services. And they continue to partner with community organizations to identify policy solutions to persistent problems of landlord retaliation, displacement, and deportation, as well as a lack of affordable housing that force people to live in unsafe and unhealthy housing.

Like Starbucks, public health practitioners are advancing conversations about race – hopefully, in more comprehensive and strategic ways. One place where we agree with the Starbucks campaign is in being impatient. We can’t wait for change.

An Uncomfortable Truth – Our Failure to Address Racism

This blog article is a re-post of an open letter to the public from Dr. Muntu Davis, who is the Health Officer and Director for Alameda County Public Health Department in California. Dr. Davis offers the kind of public health leadership we love, linking common health issues with their social determinants like racism. 

Dear Alameda County residents, partners, colleagues, and friends,

Everyone should live in conditions that support and foster living a healthy, fulfilling and productive life. These conditions include clean and safe environments, good education, good quality housing, stable employment, an income to pay for basic daily goods and services, such as food, shelter, clothes, and healthcare, among others – all of which should be free from discrimination, whether explicit or not. Read more…