Estimating the impact of the school-to-prison pipeline on adolescent health: racialized,spatial disparities in policing, school discipline, substance use, and mental illness

项目摘要：美国有1000多万学生在有警察的学校上学，但没有辅导员、护士、 心理学家或社会工作者。然而，在接受疫苗治疗的青少年中，超过三分之一的人 他们需要的物质使用治疗(6%)只在学校获得；他们不成比例地是黑人和低- 收入。因此，学校是药物使用和精神健康的重要公共卫生干预目标 其中的治疗、预防和健康公平。但相反，许多青少年将学校视为一所学校- 通向监狱的管道；一套将青少年定为犯罪并使他们陷入法律困境的政策和做法 它不是为潜在的教育和发展需求提供支持，而是为系统提供支持。以学校为基础的逮捕 在过去的40年里，增加了300-500%，排他性的学校纪律(停学和开除)翻了一番 好几年了。其他情况下，黑人学生被停学或开除的可能性是白人学生的三倍多 同样，退学的学生在同一个月被逮捕的可能性是 那些没有被移走的。我们的初步证据表明，从学校到监狱的管道 青少年吸毒和精神疾病的不明人口驱动因素。此外，这条管道恰好与 随着学校周围社区进攻性社区治安的增加。然而，目前还没有研究表明 关于这些交叉趋势对公共卫生的影响。在建议的R01中，我们将与 纽约市学校健康办公室(OSH)量化积极的社区警务、 学校纪律，以及纽约市的学生药物使用/精神疾病。我们将创建一个独特的地理编码2000- 2022年数据集连接所有警察拦截/逮捕；学校和学生层面的排他性纪律；受限学校- 青年危险行为调查(YRBS)数据(例如，烟草、酒精、大麻、其他药物使用)；以及职业安全和健康 学生健康服务记录数据库(例如，护士、辅导员访问、精神健康/物质转诊 使用治疗)。我们将(目标1)描述社区警务和社区警务之间的直接和中介关系 学校一级的学校纪律和(目标2)学生一级的药物使用和心理健康结果；以及测试 (目标3)学校周围治安的强度是否改变了学校纪律和学校纪律之间的关系 学生物质使用/心理健康。在所有目标中，我们将测试警察中的结构性和制度性种族主义 学校的纪律改变了假想的关系。这一高影响力的项目回应了NIDA对 改善学校和少年司法系统中弱势群体的可持续发展的待遇，以及 利用数据科学来改善对SUD的预防。我们多元化的跨学科团队，由早期阶段的 调查员Pi，具有物质使用、精神病学和社会流行病学；学校卫生；社会学方面的专业知识 人口健康、教育和治安方面的种族主义差异；空间流行病学/卫生地理；以及 数据科学。政策制定者和项目利益相关者(包括市、州和联邦政府)将利用调查结果 政策制定者)努力结束从学校到监狱的管道，并防止青少年吸毒/精神疾病。

PROJECT SUMMARY: Over 10 million students in the US attend schools with police but no counselor, nurse, psychologist, or social worker. Yet, more than a third of the low proportion of adolescents who receive the substance use treatment they need (6%) access it only at school; they are disproportionately Black and low- income. Schools are thus crucial public health intervention targets for substance use and mental health treatment, prevention, and health equity therein. But instead, many adolescents experience school as a school- to-prison pipeline; a set of policies and practices that criminalize adolescents and ensnare them in the legal system rather than provide support for underlying educational and developmental needs. School-based arrests increased 300-500% and exclusionary school discipline (suspensions and expulsions) doubled over the past 40 years. Black students are more than three times as likely to be suspended or expelled as white students, all else equal, and students removed from school are more than twice as likely to be arrested in the same month than those not removed. Our preliminary evidence suggests that the school-to-prison pipeline is a previously unidentified population driver of adolescent substance use and mental illness. Moreover, the pipeline coincides with rises in aggressive community policing in schools’ surrounding communities. However, there is no research on the public health implications of these intersecting trends. In the proposed R01, we will collaborate with the New York City Office of School Health (OSH) to quantify relationships between aggressive community policing, school discipline, and student substance use/mental illness in NYC. We will create a unique geocoded 2000- 2022 dataset linking all police stops/arrests; school- and student-level exclusionary discipline; restricted school- level Youth Risk Behavior Survey (YRBS) data (e.g., tobacco, alcohol, cannabis, other drug use); and OSH’s database of student health services records (e.g., nurse, counselor visits, referrals to mental health/substance use treatment). We will (Aim 1) characterize direct and mediated relationships between community policing and school discipline on school-level and (Aim 2) student-level substance use and mental health outcomes; and test (Aim 3) whether the intensity of policing around schools modifies the relationship between school discipline and student substance use/mental health. In all aims, we will test whether structural and institutional racism in policing and school discipline modify hypothesized relationships. This high-impact project responds to NIDA’s interest in improving SUD treatment for vulnerable populations in schools and the juvenile justice system, as well as leveraging data science to improve SUD prevention. Our diverse, interdisciplinary team, led by an early-stage investigator PI, has expertise in substance use, psychiatric, and social epidemiology; school health; the sociology of racialized disparities in population health, education, and policing; spatial epidemiology/health geography; and data science. Findings will be utilized by policymakers and project stakeholders (including city, state, and federal policymakers) working to end the school-to-prison pipeline and prevent adolescent substance use/mental illness.