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Principal Investigator: Monica E Swilley-Martinez
Organization: UNIV OF NORTH CAROLINA CHAPEL HILL
Fiscal Year: 2024
Award: $41,253
Funding agency: National Institute on Minority Health and Health Disparities
PROJECT ABSTRACT
Formerly incarcerated people are highly vulnerable to drug overdose and suicide deaths upon release from
incarceration, yet there are few interventions to address these concerns. Existing programs in the criminal legal
system, such as post-release supervision (PRS), can be improved to help acclimate individuals to life back in
the community. While PRS helps individuals reintegrate into the community, it also significantly increases their
risk of reincarceration. Moreover, systematic and individual racism in the criminal legal system has led to
overrepresentation of racially minoritized people in prison and among individuals receiving PRS. Augmenting
the length of the PRS sentence can allow optimization of PRS’s benefits to harms. My study proposes a way to
reduce suicide and overdose mortality risk among the formerly incarcerated by providing evidence-based
recommendations to modify existing PRS policies.
The objectives of this proposal are to (1) determine and understand predictors of post-release supervision
(PRS) assignment length, (2) establish how to optimize NC’s existing PRS program to reduce suicide and
overdose mortality among formerly incarcerated people through altering their the PRS assignment length, and
(3) identify optimal PRS terms that minimize the difference in risk of suicide and overdose mortality and
reincarceration rates between white and racially minoritized groups, without increasing rates for any racialized
group. To accomplish these aims, I will apply advanced causal inference methods to a linked dataset
containing administrative and death records for all persons released from prison between January 1, 2000 and
December 31, 2021. The completion of the proposed aims will significantly advance our understanding of
interventions aimed at reducing post-release mortality, as well as provide an evidence-base for future PRS
policy to reduce racialized disparities in not only PRS sentencing but also post-release suicide and overdose
mortality outcomes among formerly incarcerated people.
The training plan outlined in this proposal will equip the applicant, Monica Swilley-Martinez, with critical
knowledge on the intersection of criminal legal system involvement and racialized health disparities, necessary
skills in advanced epidemiologic methods and social and injury epidemiology, and experience with longitudinal
analysis using large population-based administrative data. This plan will prepare her to successfully complete
the proposed aims and to progress into a role as an independent, interdisciplinary epidemiologist working at
the intersection of criminal legal system involvement and racialized disparities in the US. The applicant is
incredibly well supported by an interdisciplinary group of epidemiologists and health disparities researchers,
with the requisite expertise to support her doctoral research and prepare her for the next phase of her career.
Terms: <Acclimatization><Address><Affect><Algorithms><Back><Black Populations><Black group><Black individual><Black people><Blacks><Cause of Death><Characteristics><Communities><Data><Data Set><Death Records><Dorsum><Drugs><Employment><Epidemiologic Methods><Epidemiological Methods><Epidemiological Techniques><Epidemiologist><Epidemiology><Ethnic Origin><Ethnicity><Evidence based practice guidelines><Future><General Population><General Public><Goals><Groups at risk><Guidelines><Health Inequity><Hispanic Populations><Hispanic group><Hispanic individual><Hispanic people><Hispanics><Imprisonment><Incidence><Individual><Inequalities in Health><Inequities in Health><Injury><Institutional Racism><Intervention><Intervention Strategies><Investigators><Knowledge><Legal system><Length><Life><Link><Logistic Regressions><Medical Rehabilitation><Medication><Mental Health><Mental Hygiene><Methods><Methods Epidemiology><NCMHD><NIMHD><National Center on Minority Health and Health Disparities><National Institute of Minority Health and Health Disparities><National Institute on Minority Health and Health Disparities><North Carolina><Outcome><Overdose><Overdose reduction><People at risk><Persons><Persons at risk><Pharmaceutical Preparations><Phase><Policies><Populations at Risk><Predisposition><Preventative intervention><Prisons><Probability><Process><Psychological Health><Race><Races><Racial Equity><Racial Group><Recommendation><Records><Rehabilitation><Rehabilitation therapy><Research><Research Personnel><Researchers><Risk><Risk Estimate><Risk Reduction><Role><Severities><Sight><Suicide><Suicide precaution><Suicide prevention><Supervision><Susceptibility><Systematic Racism><Systemic Racism><Training><Vision><Work><administrative data base><administrative database><analyzing longitudinal><career><community re-entry><community reentry><death risk><disparities in race><disparity due to race><disparity in health><drug/agent><epidemiologic><epidemiological><evidence base><evidence based guidelines><evidence based recommendations><experience><fatal attempt><fatal suicide><health care referral><health disparity><health inequalities><healthcare referral><improved><improved outcome><incarcerated><incarceration><inequality due to race><inequity due to race><injuries><intent to die><intervention for prevention><interventional strategy><longitudinal analysis><mortality><mortality risk><novel><overdose death><overdose fatalities><overdose risk><parole><policy recommendation><population based><prevent><prevent suicidality><prevent suicide><preventing><prevention intervention><preventional intervention strategy><preventive intervention><probation><programs><race based disparity><race based inequality><race based inequity><race disparity><race related disparity><race related inequality><race related inequity><racial><racial background><racial disparities in health><racial disparity><racial health disparity><racial inequality><racial inequity><racial minority><racial minority group><racial minority individual><racial minority people><racial minority population><racial origin><racial population><racial subgroup><racially unequal><racism><recommendation for policy><reduce overdose><reduce risk><reduce risks><reduce suicidality><reduce suicide><reduce that risk><reduce the risk><reduce these risks><reduces risk><reduces the risk><reducing risk><reducing suicidality><reducing suicide><reducing the risk><reduction in overdose><referral services><rehab therapy><rehabilitative><rehabilitative therapy><reincarceration><risk-reducing><skills><social><social role><substance use treatment><suicidal morbidity><suicidal mortality><suicidal risk><suicidality prevention><suicide death><suicide intervention><suicide morbidity><suicide mortality><suicide mortality rate><suicide rate><suicide risk><suicides><supported housing><supportive housing><visual function>