Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, CT, 06510, USA.
Simmons College Department of Sociology, Women and Gender Studies, Boston, Massachusetts, 02115, USA.
J Racial Ethn Health Disparities. 2018 Aug;5(4):885-893. doi: 10.1007/s40615-017-0435-0. Epub 2017 Nov 9.
Past drug epidemics have disproportionately criminalized drug addiction among African Americans, leading to disparate health outcomes, increased rates of HIV/AIDS, and mass incarceration. Conversely, the current opioid addiction crisis in the USA focuses primarily on white communities and is being addressed as a public health problem. The 21st Century Cures Act has the potential to reduce racial health disparities in the criminal justice system through the Act's public health approach to addiction and mental health issues. The 21st Century Cures Act is a progressive step in the right direction; however, given the historical context of segregation and the criminalization of drug addiction among African Americans, the goals of health equity are at risk of being compromised. This paper discusses the implications of this landmark legislation and its potential to decrease racial health disparities, highlighting the importance of ensuring that access to treatment and alternatives to incarceration must include communities of color. In this paper, the authors explain the key components of the 21st Century Cures Act that are specific to criminal justice reform, including a key objective, which is treatment over incarceration. We suggest that without proper attention to how, and where, funding mechanisms are distributed, the 21st Century Cures Act has the potential to increase racial health disparities rather than alleviate them.
过去的毒品泛滥在很大程度上使非裔美国人的吸毒成瘾行为受到刑事定罪,导致健康状况出现差异、艾滋病毒/艾滋病感染率上升和大规模监禁。相反,美国目前的阿片类药物成瘾危机主要集中在白人社区,并被视为公共卫生问题。《21 世纪治愈法案》有可能通过其对成瘾和精神健康问题的公共卫生方法,减少刑事司法系统中的种族健康差异。《21 世纪治愈法案》是朝着正确方向迈出的积极一步;然而,鉴于种族隔离的历史背景和非裔美国人吸毒成瘾的刑事定罪,健康公平的目标有可能受到损害。本文讨论了这项具有里程碑意义的立法的影响及其减少种族健康差异的潜力,强调必须确保获得治疗和替代监禁的机会必须包括有色人种社区。在本文中,作者解释了《21 世纪治愈法案》中针对刑事司法改革的关键内容,包括一个关键目标,即治疗而非监禁。我们认为,如果不适当关注资金机制的分配方式和地点,《21 世纪治愈法案》有可能加剧而不是减轻种族健康差异。