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Using a Medical Care Analogy to Reduce Crime

You never know where you will get some ideas that will help develop public policies concerning crime and delinquency.  Yesterday I was listening to National Public Radio (NPR)'s "Fresh Air " program and the subject was providing quality health care.  The guest was talking about focusing on patients with the highest medical costs, which he called "The Hot Spotters." He was talking about a unique doctor in Camden, Ohio who began to do some research on health care costs in his city.  

His research discovered that most of the costs were concentrated in just a small percentage of the population.  Specifically, he discovered that just two city blocks, which had about 1,000 people living in them, accounted for $200 million in health care costs over a five year period.  More specifically, about 1% of the population accounted for 30% of the health care costs. Further investigation found that within this area was a low-income housing project and a large nursing home.

Using a technique police call "hot spots" (where a lot of crime is located and therefore more police resources are concentrated) he decided that in order to cut down on costs health care efforts should be concentrated in this medical "hot spots."  These areas contained people who were living in extreme poverty and used emergency rooms as the primary place where they received health care.  

One case was a man who weighed 560 pounds, spent half of the year in the emergency room, and suffered from drug and alcohol problems.  He was basically homeless and lived in and out of "welfare motels." The doctor decided to concentrate on providing this man (and others) with quality health care by assigning a nurse and social worker to his case.  It took three years but he lost 220 pounds, got rid of his drug and alcohol problems and is leading a more normal life.

While listening to this program it dawned on me that this is exactly the approach we should be taking to reduce serious crime, as it is concentrated among relatively small areas within the worst urban slums.  The police already assign extra resources to these "hot spots" so why can't we concentrate non-police resources to these same areas?  For the most part this is exactly what CJCJ's program does.  Why not expand this model nationally?  In cooperation with police and probation departments along with other social service agencies we could provide needed services (including medical care) to youth and families most in need.

This is not really a novel idea for it has been spelled out many times before under the general slogan "an ounce of prevention is worth a pound of cure."  Yet we rarely apply this simple principle.

Keywords: racial disparities, Randall Shelden, rehabilitation, youth

Posted in Blog, Social Justice

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