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Health, Justice, and Incarceration
A unique collaboration between the Yale School of Medicine and Yale Law School has produced a new Center that will work to stimulate community transformation by identifying the legal, policy, and practice levers that can improve the health of individuals and communities impacted by mass incarceration. The newly launched SEICHE (pronounced “say-sh”) Center for Health and Justice will be directed by Emily Wang, MD, MAS, associate professor of medicine (general medicine). In the spirit of a seiche wave, or an oscillating wave that erupts from stagnant water to cause huge disruptions in the status quo, both schools will align their efforts through the SEICHE Center to bring together national experts on health and criminal justice systems to effect massive change to broken and entrenched systems.
The SEICHE Center will focus on identifying and applying strategies to improve the health of individuals and communities impacted by incarceration in Connecticut, nationally, and globally. At the core of this coalition will be Yale faculty, students, and staff who have been personally impacted by mass incarceration.
COVID-19 has unmasked health disparities fueled by our nation’s correctional system, and the recent deaths of George Floyd, Breonna Taylor, Ahmaud Arbery, and others have highlighted persistent societal racism. According to the Bureau of Justice Statistics, over six million Americans, mostly the poor and people of color, are currently under some form of correctional control, and tens of millions more are formerly incarcerated.
“Yale School of Medicine is committed to anti-racism and health equity,” said Nancy J. Brown, MD, Jean and David W. Wallace Dean of Yale School of Medicine, and C.N.H. Long Professor of Internal Medicine.
“This center will help address the deep-rooted racism in our country. It opens in a time where health systems must not only acknowledge their role in perpetuating the status quo, but also exert their collective power in dismantling it,” said Gary V. Desir, MD, Paul B. Beeson Professor of Medicine; vice provost of Faculty Development and Diversity, and chair of the Department of Internal Medicine.
The establishment of the SEICHE Center builds on years of clinical experience of Wang’s team focusing on the health impacts of incarceration. In 2006, the first Transitions Clinic program was started by Wang and a fellow resident to create a health home to address the adverse health effects she was witnessing in her patients returning from incarceration. Over a decade later, the initiative has grown into the Transitions Clinic Network (TCN), with over 40 clinics in 14 states and Puerto Rico, and growing. Interdisciplinary teams are the crux of the model, where community health workers with histories of incarceration are embedded within primary care teams.
The SEICHE Center, in partnership with the Solomon Center for Health Law & Policy at Yale Law School and Yale New Haven Hospital, will bring additional resources to their already-existing collaboration through the Transitions Medical Legal Partnership (MLP). With the hiring of a new dedicated attorney, the Transitions MLP will be able to address the civil legal needs of more TCN patients and work more broadly to identify and challenge health-harming policies which affect previously incarcerated people. The multidisciplinary MLP team also includes Yale law students.
The center will also work with legal scholars at two of Yale Law School’s other prominent centers, including the Justice Collaboratory and The Arthur Liman Center for Public Interest Law, to study how specific laws, practices, and policies impact health outcomes. These partnerships will work to ensure that advocacy efforts are robust and grounded in science.
The SEICHE Center’s research will be housed in the Health Justice Lab, which is focused on health services and outcomes research, as well as identifying assets in communities that have been impacted by mass incarceration that can become the basis of interventions to improve health.
“The epidemics of our time, including overdose and gun violence, can be attributed in part to structural factors facing vulnerable individuals and communities affected by mass incarceration,” said Patrick G. O’Connor, MD, MPH, Dan Adams and Amanda Adams Professor of General Medicine; and chief of the Section of General Internal Medicine. “These areas can be better addressed through targeted interventions and widescale policy changes – priority areas for Dr. Wang and her colleagues in the newly established SEICHE Center.”
“It is wonderful to partner with the Medical School on this extraordinarily important issue. This is a chance to bring theory and practice together in the finest traditions of both schools and to partner faculty from both schools who have devoted their careers to these questions,” said Heather Gerken, Sol & Lillian Goldman Professor of Law and dean of Yale Law School.
In addition to a research core and legal core, the center will also create educational programs to train a new generation of students in health equity and incarceration. YSM’s Lisa Puglisi, MD, assistant professor of medicine (general medicine) will direct education endeavors and will co-train Yale students, residents, and fellows alongside national leaders with a history of incarceration.
“This is an unprecedented opportunity for cross-institutional collaboration to address critical health needs of a vulnerable population and address racial equity,” added Dean Brown.
“Through its work, the Center can improve the health of entire communities affected by mass incarceration. We look forward to building this organization to lead change on a national level.”
As the leader of the new center, Wang said she hopes the launch of the SEICHE will mark an important milestone in effecting much needed change around the country.
“My hope is that when we look back years from now, we will have been part of a large and growing movement to decarcerate this country and confront our legacy of structural racism and violence,” said Wang.