Time Mag: How Community Health Workers Can End Mass Incarceration and Rebuild Public Safety

Investments in community-led care also have enormous potential to reduce out-of-control U.S. health care spending. This could then free up additional resources to use for further supporting communities rather than continuing to see trillions swallowed by the cost of simply treating the medical consequences of public abandonment.

What about the data for built environment and neighborhood design as violence prevention? Recent studies in Philadelphia, Baltimore, and Youngstown, for example, have all found that maintaining green space and repairing damaged houses dramatically reduces crime. In Philadelphia, a project to repair abandoned homes was associated with a 39 percent reduction in firearm assaults. The project returned hundreds of dollars for every dollar invested in the program.

Within healthcare writ large, access to mental healthcare and addiction treatment are especially significant determinants of precarity and associated risk-taking criminal behavior. This is evident, for example, in a 2021 study that showed expanding outpatient mental healthcare offices substantially reduces crime and crime-associated costs to communities. And two recent studies show that expanding access to substance use treatment has parallel crime-reducing effects.

If we want to make America safer, we need to break down this false division and embrace what data make clear: Health policy is safety policy. A large body of research shows that the lack of safety in our communities is inseparable from the fact that the U.S. remains the world’s only industrialized nation to refuse to provide universal health care as a basic public service to its citizens. As a result of this policy choice, there are now over 31 million U.S. residents without health insurance.

Abundant evidence shows that cash transfer programs and robust welfare systems are extremely effective policies for reducing homicide, assault, property crime, overdose deaths, and intimate partner violence. This should come as no surprise to anyone who is remotely attuned to human reality. Indeed, the logic of cash transfer programs as anti-violence policy is so self-evident that its elaboration feels redundant: Cash transfer programs reduce economic inequality.