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EpiCrim 101Why Epidemiological CriminologyMatters to Health ProfessionalsEpiCrim is aframework forbetter understandingthe roleof public healthin criminal justiceand vice versa.by Mark M. Lanier, PhD, and Thozama M. Lutya, MSAnew field called epidemiological criminology isbeing developed by both public health and criminaljustice scholars. What utility does this new academicdevelopment have for health care practitioners? Forpeople actually working in the field? This article will defineEpiCrim and illustrate how it is useful for health care administrators,staff and clients by providing specific examples:1) assistance with securing grants, 2) forming and facilitatinginterdisciplinary teams, 3) replacing and/or explainingredundant terminology, 4) exposing harmful criminal justicepolicy, 5) highlighting the correlates between disciplinesand 6) identifying crime victims.Both policy and practice evolve with changing administrativeand legal mandates; this is especially true for healthcare policies involving “unwilling subjects” such as inmates.Policy is shaped in response to different historical realities,whether cultural, political or economic in nature. This listincludes various short- and long-term public health andcriminal justice demands that guide actual workplace practice.Consider, for example, how HIV/AIDS has changed theday-to-day practices of everyone in both health care andcorrectional jobs. Health issues that impact society, such asHIV/AIDS, have a magnified effect in correctional environments.Consequently, health issues are forcing modificationof correctional policy and practice.The concept of epidemiological criminology is presentedas a bridging framework for better understanding the roleof public health in criminal justice and vice versa. For generations,the theories and methods advocated by epidemiologyhave served a legitimate role in the study of diseaseprocesses and tracking. Criminal justice could very wellapply the same theories and methods to track things suchas the spread of specific types of crime (e.g., crystal meth inthe Appalachian region, home invasions in Orlando).This has been done before; in the 19th and early 20thcenturies, the fusing of public health theory and methodsto crime control was a common practice. Benjamin Rush,a 19th century physician, was instrumental in developing atheoretical model on crime. His conceptualization of crimeas a “moral disease” informed crime control policy and thedesign of the American penitentiary system. And the firstwomen’s prisons in England were heavily influenced by psychiatricnotions of the criminality of women. The ideologiesof doctors and psychologists in this era were extremelyimportant in creating therapeutic regimes and shapingcontemporary thinking on women in prison. After thisearly linkage of health and corrections, the two disciplinesdiverged. EpiCrim seeks to reaffirm these connections.Defining TermsCriminology refers to the systematic study of the nature,extent, cause and control of law-breaking behavior, whilecriminal justice refers to the crime control practices, philos-10<strong>Fall</strong> 2009 • CorrectCarewww.ncchc.org
ophies and policies used by police, courts and corrections.Criminology is more concerned with theory (policy) whilecriminal justice is more concerned with practice.Public health is devoted to the prevention and eradicationof diseases that may infect communities. Epidemiologyis, above all else, a methodology. It is the study of variablesand factors that affect health. Epidemiology has traditionallyserved as the foundation for public health interventions.Epidemiology could be considered policy while publichealth is practice.In our view, epidemiology/public health and criminology/criminal justice issues are closely related and often inseparable.EpiCrim is the merging of these disciplines. EpiCriminvolves the study of anything that affects the health of asociety, be it crime, flu epidemics, global warming, humantrafficking or HIV/AIDS. Consider the following examplesthat illustrate how health care professionals may benefitfrom EpiCrim.Hepatitis C, tuberculosis, aging prison populations andsubstance abuse are just a few of the health issues that arestraining and subsequently altering correctional policy andpractice worldwide. By necessity, public health is becominghighly important as a funding source, for technicalexpertise, for medical staffing and for policy making withincorrectional institutions. Numerous research reports andfunding trends have documented this health-mandatedchange. The Federal Bureau of Investigation has even usedpublic health analogies.Furthermore, most destructive crime-related behaviorshave strong ties to mental and physical health problems.For example, driving under the influence of intoxicatingsubstances is a destructive behavior that affects the mentaland physical capabilities of the driver. Interventions aimedat reducing this dangerous trend should consider mentaland physical factors contributing to the use of intoxicatingsubstances. Then a combination of criminological and publichealth factors may shed light on the reasons behind thereasons for drunk driving.How EpiCrim Benefits Health ProfessionalsExample 1: Securing GrantsBecause it is difficult to separate the criminal justice andpublic health behavioral correlates, the interdisciplinarynature of many funded research projects should comeas no surprise. In fact, the <strong>National</strong> Institutes of Health’s“Roadmap Initiative” encompasses not only the biomedicalsciences, but also their relationship to the epidemiological,behavioral and social sciences. What percentage of yourfunding is grant-related or agency-dependent? Having anew, solid and exciting theoretical basis for grant proposalsgreatly strengthens their odds of being funded.Example 2: Interdisciplinary CollaborationEpiCrim encourages a paradigm under which disciplinaryboundaries are blurred or even eradicated. Whileother scholars have made linkages between health andcriminology, we seek to clarify and expand on what theyhave observed. HIV/AIDS and other health maladies havebeen examined by interdisciplinary teams combiningpublic health, medicine and criminology for over 20 years.However, most prior connections have dealt with specificproblems. EpiCrim is by nature interdisciplinary and soallows correctional and health care workers a commonground as opposed to the traditional custody vs. healthcare conflicts. This blending of disciplines should reduce theinherent conflicts.Example 3: Sharing TerminologyHealth care professionals and criminal justice workers oftenfocus on the same issues and use similar approaches, butthey view things through different lenses and use differentlexicons. For example, when criminal justice professionalstalk about addressing the “root causes” of crime, they meanthe same thing as “primary care” to health professionals.Likewise, “tertiary care” is analogous to specialized communitypolicing units. Each discipline can learn from eachother and increase its capacity by recognizing the commonalityin approaches, methods and techniques.In illustration, factors that increase epidemics such asHIV/AIDS are entwined with factors contributing to sexualexploitation of women and girls. Violence toward womenaffects their physical, sexual and reproductive health.Substance abuse is likely to diminish inhibitions, drivingusers to commit crimes such as rape, intimate partner violenceand child abuse. An EpiCrim approach identifies theseinterconnected factors and encourages development of“primary care” strategies to prevent the root causes.Example 4: Exposing Harmful PolicySome criminal justice policies may actually harm publichealth care efforts. One convincing argument is that currentlaw and law enforcement strategy promulgate, rather thanreduce, drug abuse in America. These policies implicitly,and unknowingly, incorporate elements of public healthand criminological theory. By making these linkages explicit,an EpiCrim approach may reveal to policy makers thatmany criminals may benefit more from less criminal justiceintervention. This approach would also be useful in reassessingcounterintuitive policies such as prohibitions againstneedle-exchange programs and condoms in prison.Similarly, the prosecution of human traffickers throughcriminal justice channels only is not likely to reduce theoccurrence of this crime. In South Africa, women and girlsare more often trafficked by family members than by organizedgangs. Reasons for this include children left behind byparents who have died of HIV/AIDS-related diseases, unemploymentof primary caregivers, lack of finances to sustainlarge families and absolute poverty. Prosecuting traffickersthrough criminal justice processes may be the least likelymeans to prevent this crime.Example 5: Highlighting CorrelatesAs disciplines such as criminology, psychology, publichealth and sociology became more specialized, scientistsbegan looking within their own fields and few externalmethods and approaches were used to help explaincontinued on page 12www.ncchc.org<strong>Fall</strong> 2009 • CorrectCare11
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