“It’s green”. Years later those are the words that still go through my mind. They were the words said to me by those police officers right before I was apprehended, even though I was innocent. The police had shown up at our complex that evening looking for someone else, but somehow, I was the one leaving in the back of their car. I was taken to the station where I sat for hours before they let me go. That one night, all those years ago, was the beginning of what I consider to be my downfall.
The night of the paint incident did not come as a surprise to me. My distrust of the criminal justice system has been engraved in my mind from the beginning. The fear of the law became not only a part of who I was as a black man, but who all black men were. That one night became the night I lost everything. I lost my scholarship, I lost my neighbor’s trust and I lost all my friends, or at least the people who I had believed to be my friends. Not to mention, I didn’t get to go to college, I didn’t get to pursue my passion and I never got to leave that sorry neighborhood. That night turned into one of many nights and ultimately became my new reality.
I began to spend my life bouncing between minimum-wage jobs, jail cells, and the hospital emergency room. By the time I was in my mid-twenties, I had more run-ins with the law than I could even count. I never stayed in jail long, but each time was just long enough to wreak havoc on my life. Each time I was admitted and released from jail, I became sicker and sicker. I would sometimes think about doing something about it, but I knew seeing a doctor wouldn’t do much for me. I began to treat my feelings, with alcohol, which only made my health worse. Which in turn, leads to more involvement in the criminal justice system. I had been brought into the hospital emergency room by the police and concerned citizens many times. Just like
every other event in my life, each hospital visit, I faced discrimination and I quickly became known as the drunk, uneducated black man, who came in more times than not.
My life continued this way for many years, I would wake up, and attempt to go to work during the day at whatever job I held down at the time, followed by a night of excessive drinking. It wouldn’t happen every time, but it seemed more times than not, I would end up in the back of a police car, and either thrown in jail for the night and released the next day or admitted to the hospital for temporary care and discharged as soon as the doctor arrived. It was a vicious cycle that I could not escape.
After years of this cycle, and with the way my life was going, I knew I didn’t have long to live. I finally decided I would attempt to seek help after a night of heavy drinking.
I had woken up that morning in an isolated jail cell. I began to think that maybe it was time for a change. I decided when I was released, I would head over to the hospital emergency room and start the process of recovery.
After waiting many hours, I explained my situation to the doctor, as if he hadn’t already seen me multiple times over the years. Being a regular patient at the hospital combined with my criminal past, the doctor dismissed me. To my surprise, he sat down and gave me less than two minutes of his time. He told me to ease up on the drinking and handed me a prescription, that to this day I am not sure what it was for. He showed me the door as he left to treat the next patient in the waiting room. I was finally seeking help, and because of who I was, this was the way I was treated. Most people, or at least people not in my situation, would have been referred to specialists and they would have been given information on programs and treatment options however, that was not my case. When I walked out of that hospital, I immediately threw the prescription away, I shouldn’t have even taken it. I was bouncing between jobs and had no health insurance, there was no way I’d ever be able to afford that medication. So, with that, I went on with my day the only way I knew how to drink, and I continued this way for many more years.
Today, I reflect on my life, from that one paint night to that hospital visit, and realize it’s how I’ve gotten here. From my teenage years and into adulthood, I was never given the opportunity to fully live my life. To this day, I am an ill, poor, and uneducated old man in my late sixties with numerous untreated health issues. I look back on all the negatives in my life and wonder what would have happened and where would I be if my situation would have been different.
Academic Commentary
The social determinants of health are broadly defined as the economic and social conditions that influence the health of individuals and their communities (Raphael, 2016). These social determinants impact the health outcomes of each member of society. Individuals, such as Victor, who experience compromised social determinants are at a greater risk of experiencing barriers in their everyday lives. The compromise of Victor’s social determinants resulted in poor development and hindered many of his future successes. While focusing on the improvement of Victor’s health outcomes, it is not only important to identify and take action on the social determinants of health but to also identify and address the social determinants of criminal behavior (Caruso, 2016).
Each individual is exposed to the criminal justice system in their own unique way. Victor’s involvement with the system began at an early age and continued throughout his life. The injustices experienced by Victor caused significant short- and long-term health effects. Victor mentions how he still hears the words that were said to him by the police, the night he was apprehended. His encounter that night was just the beginning of what turned into his severe substance use and health problems. Research conducted by Jones-Webb and Wall (2008) found children and adolescents that are exposed to such violence are at risk for abiding behavioral and mental health outcomes regardless of whether they are victims, direct witnesses, or hear about the crime. As a result of his race and community, Victor’s fear of the criminal justice system had been instilled in him as his exposure to the system began at an early age.
Along with exposure to the criminal justice system, the experiences and causes of substance abuse are unique for each individual. Often there is a combination of biological, psychological, and social factors that contribute to substance use (“Addiction and Substance,” n.d.). Understanding these factors is key to reducing the number of people, such as Victor, who experience substance abuse. It is very clear that Victor suppresses all of his problems with the use of alcohol. Victor’s struggle with addiction is a result of his inability to cope with his previous experiences of trauma. The negative outcomes of his apprehension during the paint night, his voluntary hospital visit, and the events throughout his life resulted in his constant substance use. It could also be said that the healthcare system failed Victor during his involuntary visits to the hospital, hindering his ability to begin improving his place in life.
Patterns of heavy alcohol use by individuals of low socioeconomic status are complex, along with the health risks related to alcohol. Socioeconomic status underlies three major determinants of health: health care, environmental exposure, and health behavior. A recent Canadian study showed higher rates of mortality among men with less income, less education, and lower occupational status with a variety of causes of death, all of which were receptive to medical treatment (Wood, Sallar, Schechter, & Hogg, 1999). Throughout Victor’s life, he had jumped from job to job, all of which were of a minimum wage. His inability to maintain a steady job contributed to the demise of his health. During his voluntary hospital visit, the emergency physician was able to give him a prescription, but Victor disposed of it as he did not have the means to afford the medication and therefore continued to self-medicate with alcohol. As a result of his encounter with the police in his late adolescent years, Victor’s scholarship was revoked, resulting in missed educational opportunities and ultimately low socioeconomic status.
Given the health impacts of involvement in the criminal justice system, establishing healthcare systems tailored to the distinct needs of the justice-involved population are crucial. Individuals should have access to prevention programs that reduce their likelihood of involvement in the criminal justice system. It does not come as a surprise that individuals with roles in the criminal justice system are interested in reviewing past interactions, as well as, preventing any future ones. However, the action taken by these officials is minimal and is not being done appropriately. Achieving a model for the implementation of these programs should effectively address health and criminal justice policies.
To begin this initiative, investment and implementation in comprehensive health strategies research is needed at all government levels. Following this extensive research, government decisions should be established with a thorough understanding of the causes and effects of criminalization (“Mental Health,” 2013). Police officers, at both the municipal and provincial/territorial levels, should receive ongoing training to address the over-representation of racialized communities in the criminal justice system and the impact this has on their health. Along with training at the government level, these over-represented individuals should have access to appropriate and comprehensive services, treatments, and supports that meet their diverse needs. Ultimately, additional research is necessary to increase the evidence base for what is required to reduce the effects of crime and violence on health outcomes and disparities. This additional evidence will facilitate public health efforts to further address crime and violence as social determinants of health.