You may have heard the phrase “social determinants of health”. It is the idea that social factors – such as poverty, access to education, where you live, and whether you face discrimination – have a huge impact on your health and life expectancy.
These determinants explain why poorer health outcomes persist for some groups of people despite incredible advances in medical care. This insight has contributed to improving health policy Australia and abroad.
We wanted to explore that idea in relation to incarceration. That is, to quantify which social factors increase one’s likelihood of ending up in prison, and use that to improve policies and reduce the harm and costs of incarceration.
Because while crime rates are falling and governments have committed to it reduce recidivismthe incarceration rates of certain groups of people remain embarrassingly high. These groups include Native peoplethe one with mental and cognitive disabilityand people experience addiction And homeless.
Our findings, published Todayreveal a criminal “justice system” that is far from just.
Read more: Giving ex-convicts public housing reduces crime and re-incarceration – and saves money
What we did
We analyzed studies of a dataset containing information on 2,731 people incarcerated in NSW.
The data comes from government agencies: NSW police, courts, corrections, and health and human services, such as housing and child protection. The data set is longitudinal. This way we can see which contacts people have had with services and institutions over time. From contacts with child protection services and the police to admissions to hospital and a stay in detention.
We identified eight factors as “social determinants of justice”. Our analysis showed that your chance of ending up in prison is greatly increased by:
- received (foster) care outside the home
- get a bad education
- being indigenous
- early contact with the police
- with unsupported mental health and cognitive disability
- problem alcohol and other drug use
- experiencing homelessness or unstable housing
- from or living in a deprived area
And more importantly, we found that the more of these factors you experience, the more likely you are to be incarcerated and re-incarcerated.
The people in our dataset are often in pre-trial detention (not yet convicted) and move in and out of the system on a criminal-legal assembly line for minor offenses. This damages lives and does not make our communities any safer in the long run.
Why these factors?
We know from decades of work on the social determinants of health that our health outcomes are strongly influenced by our health social and economic context.
People who work in this field have developed the concept of the social determinants of health inequality. Poor nutrition can contribute to chronic disease, but we did learned it just doesn’t help narrate people to eat healthier because there are many barriers to doing that. Policy must focus on making nutritious food affordable and accessible to really make a difference.
There are also structural factors at play for the results of the judiciary. For example, someone with a cognitive disability who grew up in a middle-class family with access to early help is very unlikely to go to prison, even if they are involved in a crime. They have more access to social benefits than, say, an Aboriginal with a cognitive disability from a remote town with many police officers, but few social services.
From government data we can see how many people end up in juvenile and adult detention after child protection, education, care for the disabled and health care they fail. Activists and advocates from racialized and underprivileged communities have been speaking out about this for years.
All this highlights that we need broader system and policy changes to reduce the unacceptable social and economic costs of incarceration.
We have further developed the concept of the social determinants of justice to identify the “causes of the causes” of those who go to prison. These are:
entrenching poverty and inequitable access to resources in families and neighborhoods
structural racism and discrimination, particularly experienced by Aboriginal and Torres Strait Islander communities and people with disabilities
not responding adequately to the abuse, violence and trauma experienced by so many children and young people
functioning of the criminal justice system itself in the sense that it is criminogenic; that is, it increases rather than decreases the likelihood of future incarceration.
The social determinants of justice emerge in the over-monitoring of certain communities, lack of access to well-funded legal representationnot granted diversions and bailand limited specialist services and support.
To really make a difference on one of Australia’s most pressing policy challenges – the shamefully high rates of incarceration of Indigenous peoples and people with disabilities and mental health issues – we need to focus our efforts and resources on tackling these social determinants.
To really reduce the harm and cost of incarceration, we can’t just roll out behavioral change programs in prisons. And we can’t just focus on what the police are doing or what happens to people in court – although these are important.
In addition to a major overhaul of the criminal justice system, we Also must ensure that other government agencies and non-governmental organizations are held accountable; that people get the services and support they need for they end up in jail.
The social determinants of justice can influence policies to ensure that the police are not the frontline service for people in crisis.
It could lead to changed government procurement processes that recognize the value of Aboriginal-controlled organizations providing culturally-led support.
It could serve as a guideline for a holistic case management model for people at risk of coming into contact with the criminal justice system. It can be used when evaluating a distraction program to make improvements.
It could represent a government-wide approach to empowering people to thrive in their communities instead of wasting lives and billions of dollars through incarceration.