This week I spoke at the opening of the Faces of Urban Health Forum here in New York. It was a space intended for communities and their partners to focus on strategies to address health inequity. It was a powerful experience for those involved, mainly because space of this nature is very hard to find. I made my case about how we should all be partnering with the intention of addressing systems-level change. Then I was thrilled to hear about the current work of the Harlem Community Academic Partnership (HCAP).
I used to work with HCAP seven years ago, and amazingly they are still not just in partnership, but still working on the seemingly intractable policy barriers to re-entry for people coming home from jail and prison. Sister Mary Nerney presented some of the (unfunded) research that the policy work group was doing into the attitudes of residents of public housing toward people who have been incarcerated. This research is amazingly well conceived to both have a long-term impact on policy and to possibly smooth the road of people coming home right now. Living in public housing after being convicted of a felony is against regulations, however many people do return to the projects after jail. In fact, 40% of the public housing residents in in the focus groups for this research were formally incarcerated. Once the system of how to get and stay into public housing is better understood, service providers working with people coming home can better facilitate that process. At the same time, a clear case for changing the policy can be laid out for policymakers.
Sister Mary mentioned that 10 years ago, when we started the policy work group, we tried for and won some easy victories. This was such an important perspective to hear. Because Sister Mary is now working on housing for people coming home from jail and prison, which is an extremely hard nut to crack, she feels like the other policies were easy in comparison. I reminded her that they were not.
In fact, in the three years I spent working with HCAP we saw exactly zero policy change. However, we contributed to a groundswell of activity around criminal justice reform, and were able to raise the profile of community reintegration as a public health issue. This lead in the following years to many changes in policy from Medicaid status of releasees to changes in the phone rates from prison to discharge planning. These were in fact large and hard won victories that impacted tens of thousands of people.
It is so important when doing policy work to really savor victories, while at the same time demanding more. What many of us in public health work or social justice work seek is transformative change. But as Obama said on the Daily Show, much transformative change started with incrementalism. Programs for widows and orphans grew into a safety net (albeit one with many holes). Civil rights continues to progress and regress in fits and starts. And yet, we are undeniably better off than we were 100 years ago.