As we wrote about previously, the NYU Wagner Policies for Action Research Hub aims to bridge the divide between academic researchers and government agencies that shape policies on the ground. Researchers can rarely predict the most pressing questions that agencies are grappling with; likewise, government officials may not have access, time or expertise to conduct complex research themselves.
In the case of our criminal justice research, we are working with two local agencies, the NYC Mayor’s Office of Criminal Justice (MOCJ) and the NYC Department of Health and Mental Hygiene’s Health Access Equity Unit (HAEU) within the Division of Prevention & Primary Care. Our hub, in collaboration with NYU’s Health Evaluation and Analytics Lab (HEAL), has formed a cross-agency and cross-sector team with researchers and policy experts from criminal justice and public health. Together, we aim to describe the present health needs of New Yorkers at various levels of justice system involvement and to analyze their historic health care and criminal justice trajectories. These data will ultimately help city agencies design tailored interventions and allocate resources appropriately for these groups. So far, we have:
- linked hundreds of thousands of jail admissions and discharge records from NYC’s largest jail, Rikers Island, to New York State Medicaid claims;
- designed and selected outcome metrics that reflect highly actionable data points for both agencies; and,
- drafted presentations and research reports for a range of criminal justice, health policy, and academic audiences.
But it wasn’t easy.
From the very beginning, this partnership presented both tremendous opportunities and challenges. Early on, each organization hosted a training session for the research team to learn about the data that group collects or maintains; hear about the history of policies in the sector; and consider the current pressing research needs from each group’s perspective. Our team walked away from these trainings both excited about the possibilities for the partnership and versed in the historical context of health services for justice-involved New Yorkers.
At the same time, however, our collective imagination for what was possible ballooned into an impossibly daunting list of potential research questions. Moving forward productively required each organization to carefully articulate and prioritize outcomes and subpopulations of interest. This process of winnowing down the research agenda across a diverse group of governmental and academic stakeholders was a challenging but necessary exercise. It opened our eyes to the vast range of perspectives and priorities that can arise around a single policy issue or vulnerable population.
Our collective imagination for what was possible ballooned into an impossibly daunting list of potential research questions.
Scarlett Wang, assistant research scientist at NYU HEAL, has been in the thick of the messy data linkage, cleaning, and analysis processes. This role has given her the opportunity to reflect on both the challenges and rewards of collaborative research. She says, “Everything from linking the datasets to performing the data analysis could not have been possible without MOCJ and HAEU. Their knowledge and expertise have inspired us to analyze and present the Medicaid claims data in novel ways. As a team, we put together two datasets with more than 10 years of information about this vulnerable population. Although the process has been long and filled with trial and error, with these two datasets in hand, we are able to ask, explore and test many relevant and necessary research questions to understand the health needs of the jail population.”
Formulating these questions together has resulted in a more scientifically rigorous, more policy-relevant, and more enjoyable research experience for all. As Ashwin Vasan, Executive Director at the Health Access Equity Unit within the NYC Department of Health & Mental Hygiene put it: “Our collaboration with NYU and the Mayor’s Office of Criminal Justice has allowed us to ask questions of public health importance for people with a history of justice involvement, and to apply a broader public health lens to analyses of health care utilization, cost, and incarceration patterns. In doing so, we better understand the associations between jail exposure, disease and health care use, and can better identify opportunities for high priority interventions to improve the health and social welfare of people and of families involved in the criminal justice system.”
Partnering with city agencies has also helped us focus on the information policymakers need for decision-making and intervention planning. Ayesha Delany-Brumsey, Director of Behavioral Health Research and Programming at the Mayor’s Office of Criminal Justice, has been one of our key partners in keeping our research policy-relevant. As she says, “There are many pathways in and many pathways out of the justice system. Our work with NYU will help us find routes away from jail that also serve to connect people with quality health care, housing, and employment…so that, as we are working to reduce justice-system contact, we are also promoting overall well-being and stability. Guiding people into quality community-based supports is a core component in the City’s plan to close Rikers, and understanding the health care needs of justice-involved people will help us reach our goal.”
“There are many pathways in and many pathways out of the justice system. Our work with NYU will help us find routes away from jail that also serve to connect people with quality health care, housing, and employment.” - Ayesha Delany-Brumsey, Mayor’s Office of Criminal Justice
For example, by stratifying our health outcome analyses by jail admission frequency, we learned more about the needs of those who fall in the top 10 percent of jail admissions – those with six or more jail admissions in a five-year period. For this particular population, mental health diagnoses and Emergency Department visits were far more common than for all justice-involved groups. To adequately serve the needs of this subpopulation, policymakers may need to take a very different approach than for other justice-involved New Yorkers.
The journey of cross-sector research requires openness, trust, and patience. But the results can be rewarding and inspiring. Alongside our MOCJ and HAEU partners, we hope to continue to delve into the data in ways that will allow policymakers to be armed with the information they need to take action.
The NYU Wagner Research Hub will be publishing some of their initial findings in an upcoming report in partnership with the NYC Mayor’s Office of Criminal Justice (MOCJ) and the NYC Department of Health and Mental Hygiene’s Health Access Equity Unit (HAEU). Learn more about their hub here.
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