Addressing Criminal Legal System Health Inequities Through Redirection

The criminal legal system and youth delinquent systems (CL/DS) are increasingly recognized as a primary sources of racial/ethnic inequity (REI) in health. Research funding institutions are beginning to focus on the CL/DS as a social determinant of health, some CL/DS officials are centering equity as a core concern, and some problematic CL/DS practices are being rolled back. However, the impact of such efforts may be limited because they typically focus on the most visible manifestations of inequity but often fail to address root causes and complex system dynamics. More meaningfully reducing CL/DS-linked health inequities requires a better understanding of their complexity and barriers to change. Preparatory work is needed to develop appropriate information, communication strategies, and collaborative partnerships. To support these arguments, we offer an evaluation of our ongoing qualitative and quantitative research in New Mexico, which focuses on practices that redirect individuals from typical CL/DS practices in ways that minimize CL/DS involvement and its consequences. We review the sources of REI in CL/DS redirection practices, discuss how increased collaboration between public health and public safety agencies may impact REI, describe how differences in values, priorities, and strategies toward issues of equity pose barriers to REI reduction efforts, and discuss important building blocks for reducing siloing and working toward greater health equity through redirection from the CL/DS.