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

项目概述：美国有超过1000万学生在有警察的学校上学，但没有辅导员，护士， 心理学家或者社工然而，在接受教育的低比例青少年中， 他们需要的药物使用治疗（6%）只能在学校获得;他们不成比例地是黑人和低收入者， 收入因此，学校是药物使用和心理健康的关键公共卫生干预目标 治疗、预防和健康公平。但相反，许多青少年把学校当作一所学校- 将青少年定罪并使其陷入法律的陷阱的一套政策和做法 而不是为基本的教育和发展需求提供支持。学校逮捕 增加了300-500%，排斥性学校纪律（停学和开除）在过去40年翻了一番 年黑人学生被停学或开除的可能性是白色学生的三倍多， 平等，从学校退学的学生在同一个月被逮捕的可能性是 那些没有被移除的。我们的初步证据表明，学校到监狱的管道是一个以前的 青少年药物使用和精神疾病的不明人口驱动因素。而且，管道重合 学校周边社区的积极社区警务活动有所增加。然而，没有研究表明， 这些交叉趋势对公共卫生的影响。在拟议的R 01中，我们将与 纽约市学校卫生办公室（奥什）量化积极的社区警务， 学校纪律和纽约市学生物质使用/精神疾病。我们将创建一个独特的地理编码2000- 2022年数据集链接所有警察拦截/逮捕;学校和学生级的排他性纪律;限制学校- 青年风险行为调查（YRBS）数据（例如，烟草、酒精、大麻、其他药物使用）;以及奥什 学生健康服务记录的数据库（例如，护士、顾问访问、转介精神健康/药物 使用治疗）。我们将（目标1）描述社区警务和 学校纪律对学校层面和（目标2）学生层面的物质使用和精神健康结果的影响;以及测试 (Aim 3）学校周围的治安强度是否改变了学校纪律与 学生物质使用/心理健康。在所有目标中，我们将测试警务中的结构性和制度性种族主义是否 和学校纪律会改变假设的关系。这个高影响力的项目响应NIDA的兴趣， 在学校和少年司法系统中改善对弱势群体的特殊和未成年人的待遇，以及 利用数据科学来改善SUD预防。我们多元化的跨学科团队，由一位早期的 研究者PI，具有物质使用，精神病学和社会流行病学的专业知识;学校卫生;社会学 人口健康、教育和治安方面的种族差异;空间流行病学/健康地理学;以及 数据科学决策者和项目利益相关者（包括市、州和联邦）将利用调查结果 政策制定者）努力结束学校到监狱的管道，防止青少年使用药物/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.