What Promotes healing among the wrongfully convicted? Results from a qualitative study of exonerated persons in California

Background: Exonerees are individuals who have been wrongfully convicted of a crime. Later found innocent and released from prison, exonerees often spend decades incarcerated. While limited, research suggests that the unique trauma of wrongful conviction has profound adverse mental health implications which challenge reintegration, well-being and healing. In this study we examined exoneree perceptions of their mental health and coping mechanisms used to support healing. Methods: We conducted a qualitative study utilizing a phenomenological approach to examine shared coping and healing mechanisms among exonerees. Twelve California exonerees participated in semi-structured interviews describing their experiences with coping and healing due to wrongful conviction. Interviews were audio recorded and transcribed, transcripts were coded with a hybrid coding scheme utilizing a thematic analysis. Results: Overall findings underscore the lifelong trauma and subsequent adverse mental well-being among wrongfully convicted exonerees, framed in association with depression, anxiety, post-traumatic stress disorder (PTSD) and hypervigilance. Three areas emerged as valuable coping mechanisms for exonerees that support a pathway toward healing: 1) Peer support and building community with other exonerees through organized meetings (convenings and healing circles); 2) Community education to build community awareness through storytelling; and 3) Advocacy engagement in the wrongful conviction movement and criminal justice reform. Conclusions: Complementing comprehensive mental health services with opportunities for peer support, advocacy, and community education through storytelling may help exonerees regain lives lost to their wrongful convictions

Developing a Health Equity and Criminal Justice Concentration for a Master of Public Health (MPH) Program: Results From a Needs Assessment Among Community Partners and Potential Employers

The United States has experienced a 4-fold increase in jail and prison populations over the last 40 years, disproportionately burdening African American and Hispanic/Latinx communities. Mass incarceration threatens the health of individuals, families, and communities, and requires a public health response. The Master of Public Health (MPH) Program at Touro University California (TUC) trains students to become skillful, socially-conscious public health professionals. We are developing a concentration focused on the public health impacts of incarceration. Along with the core public health curriculum, students of this new Health Equity and Criminal Justice (HECJ) concentration will receive training in criminal justice, reentry, reintegration, recidivism, restorative justice, structural racism, and social and community impacts of incarceration. Our study gauges interest in an HECJ concentration in our local community, including potential employers. We surveyed a cross-section of community partners including public health departments, other governmental agencies, California correctional facilities, county jails, community groups, health clinics, and hospitals. A majority (89%) of respondents consider mass incarceration a public health problem and 86% believe specialized training would make graduates employable by criminal justice related organizations. The HECJ track will fill a gap in the field and train a future generation of public health professionals to address the epidemic of mass incarceration

Exploring the Role of Neighborhood Collective Efficacy on Resident Health and Well-Being: Implications for Public Health Research and Practice

The adverse health effects of living in under resourced neighborhoods has been well documented. While structural factors, such as concentrated poverty, have received the most investigation, research points to neighborhood social dynamics as a potential mechanism that influences health. Collective efficacy is one such social dynamic considered for its association with individual health outcomes. Collective efficacy refers to the social cohesion among residents and shared expectations that residents will come together for the good of the neighborhood. As the link between neighborhoods and health has become more established, place-based strategies are being employed to improve the health status of residents living in under-resourced neighborhoods. Collective efficacy’s unique feature of mobilizing residents to achieve neighborhood goals may be an important component of neighborhood quality and opportunity for neighborhood change. Much of the empirical evidence on collective efficacy comes from cross-sectional studies, therefore we do not know if collective efficacy can change and whether this change leads to improved health. In addition, we lack an understanding of how community change initiatives are attempting to promote and enhance collective efficacy as a strategy to mobilize residents toward community change. This dissertation aims to address these gaps in knowledge. This dissertation uses multiple methods to deepen our understanding of the role of neighborhood collective efficacy on the health and well-being of residents. The first paper is a systematic, interdisciplinary review of the literature on collective efficacy and health and is one of the first to synthesize this literature. The review aims to assess the evidence of a link between collective efficacy and health, and to provide areas for future research. The second paper is a multi-level longitudinal analysis exploring whether collective efficacy changes over time in low income communities in seven U.S. cities. This paper takes advantage of a unique data set from the Annie E Casey Foundation’s Making Connections Initiative that surveyed residents across three waves over eight years. The third paper explores how community change initiatives are promoting collective efficacy among residents in their target neighborhoods, and how residents experience this work. The research employs a case study approach with semi structured interviews and observations to illuminate the role of collective efficacy as a strategy to promote neighborhood change

Exploring the Role of Neighborhood Collective Efficacy on Resident Health and Well-Being: Implications for Public Health Research and Practice

The adverse health effects of living in under resourced neighborhoods has been well documented. While structural factors, such as concentrated poverty, have received the most investigation, research points to neighborhood social dynamics as a potential mechanism that influences health. Collective efficacy is one such social dynamic considered for its association with individual health outcomes. Collective efficacy refers to the social cohesion among residents and shared expectations that residents will come together for the good of the neighborhood. As the link between neighborhoods and health has become more established, place-based strategies are being employed to improve the health status of residents living in under-resourced neighborhoods. Collective efficacy’s unique feature of mobilizing residents to achieve neighborhood goals may be an important component of neighborhood quality and opportunity for neighborhood change. Much of the empirical evidence on collective efficacy comes from cross-sectional studies, therefore we do not know if collective efficacy can change and whether this change leads to improved health. In addition, we lack an understanding of how community change initiatives are attempting to promote and enhance collective efficacy as a strategy to mobilize residents toward community change. This dissertation aims to address these gaps in knowledge. This dissertation uses multiple methods to deepen our understanding of the role of neighborhood collective efficacy on the health and well-being of residents. The first paper is a systematic, interdisciplinary review of the literature on collective efficacy and health and is one of the first to synthesize this literature. The review aims to assess the evidence of a link between collective efficacy and health, and to provide areas for future research. The second paper is a multi-level longitudinal analysis exploring whether collective efficacy changes over time in low income communities in seven U.S. cities. This paper takes advantage of a unique data set from the Annie E Casey Foundation’s Making Connections Initiative that surveyed residents across three waves over eight years. The third paper explores how community change initiatives are promoting collective efficacy among residents in their target neighborhoods, and how residents experience this work. The research employs a case study approach with semi structured interviews and observations to illuminate the role of collective efficacy as a strategy to promote neighborhood change