 I'm role playing for Mark Siegler. It's actually our total pleasure and privilege to introduce Harold Pollock to this seminar series, who's going to be talking about violence as a health disparities issue. For those who don't know, Harold Pollock is the Helen Ross Professor at the School of Social Service Administration. He's also faculty chair of the Center for Health Administration Studies, Chaz. And for those who don't know, they just put out a call for proposals for grants. So you should be looking on the web. Professor Pollock is also co-director of the University of Chicago crime lab. He is published widely at the interface between poverty policy and public health. His recent research concerns HIV and hepatitis prevention efforts for injection drug users, drug abuse, and dependence among welfare recipients and pregnant women. Professor Pollock has been appointed to two committees of the National Academy of Science Institute of Medicine. Before coming to the University of Chicago, Professor Pollock was an RWJ Foundation scholar in health policy research at Yale University and toward health management and policy at the University of Michigan School of Public Health. We're delighted to hear you speak. Thank you. Thank you very much. Thanks very much. Can you hear me in the back? Can you hear me in the back? Thank you, everybody, for coming. This is, I think it speaks both to the severity of the topic and also to the quality of lunch that's being served. So I think we all appreciate both. I generally start off with more jokes given the topic. I'll probably be somewhat less humorous than I normally am, but for some of you that may be an advantage. I should say that I am the co-director of the crime lab, but everything I'm going to say today is just me. And I actually had originally intended to sort of go through a trial that we're doing, when I will tell you a little bit about that. But it's not quite out of the oven yet, so I'm going to talk about some of the policy issues that we have. We have a good group of people here. A lot of friends came. I appreciate you coming. And so I think we can have a good conversation about a lot of policy issues that come up. Yeah? How long has the University of Chicago had a crime lab? Since 2008, in spring 2008, Jens Ludwig is the director. It was set up in cooperation with Mayor Daley and with a lot of agencies around the city. We do a lot of work with local partners who are willing to have their interventions subject to a randomized trial, which, if you think about it from the point of view of a local social service agency, is a fairly terrifying thing to do. And we really have some fantastic partners. And I don't know whether I'm heartened or I'm discouraged by meeting all of the really talented, dedicated people working on this problem. Because on the one hand, I'm really heartened to see that. On the other hand, the problem is as bad as it is, despite the fact that there are a lot of really smart people who've been working for decades trying to address it. And it is not the case that we ever walk into a room and suggest some idea. And people at the Chicago Police Department or Chicago Public Schools or wherever say, gee, that's a good idea. We never thought of that. Usually it's, yeah, we've tried that five times. And here's our experience with it. So I'll sprinkle some of my crime lab experiences in here. The disparity issue is important, I think, for really three different reasons that are worth thinking about. And I won't give equal weight to all three in my talk today. But I at least want to mention them. The first is that it turns out it's just a really large public health problem. Homicide is not just a problem that's important because we're interested in CSI, Miami, or whatever. If you actually count up the number of dead bodies and particularly the number of life years lost, homicide is a significant public health threat. And it requires a systematic, determined response. And of course, homicide is only one type of violence. And it's really the reflection of a lot of other things that are happening that are a little bit more difficult to capture. It's also a window into and a reflection of lots of other kinds of inequality. It didn't just happen to be the case that in the first south side of Chicago or the west side of Chicago, we have an astronomical homicide rate compared to everything else in the city. There's a whole history behind that. There's a set of reasons. I don't like to use the word structural because it's such a silver dollar word that I don't have the right doctoral degree to fully understand. But we know in Chicago we have a history that is deeply implicated in that problem. And thirdly, the homicide problem and the violence problem is a fundamental obstacle to a lot of other things we need to do to improve this city, both in terms of economic development, in terms of educational improvement. It is really, really hard to develop a neighborhood when the store owners are saying, we can't stay open after 7 PM at night. Or you try to improve a school. You spend $10 million on the school and the kid gets shot nearby. And it just undermines everything you're trying to do in terms of getting the community they're feeling safe in that school. It's hard to get teachers to stay in a school where they don't feel physically safe walking to their car after hours. The population of Chicago is smaller than it otherwise would be because people are afraid of crime. And Jens Ludwig and Phil Cook have a study where they estimate that every gunshot wound to a person has a cost to society of about $1 million. So we have an estimate that violence in Chicago, by that estimate, would cost every household in Chicago about $2,500. So it's a serious problem in all sorts of ways. Now, I also want to talk about disparities in incarceration and offending as well, because they're the flip side to the victimization story. Most of the crime that occurs is occurring within race and ethnic groups. And we have to think about the offending and the incarceration issue alongside the victimization issue because they're really so intimately tied together. And I'll make a few concrete suggestions, not necessarily the ones that I think are the most important or the most debated, but the ones that I've been thinking about that I hope will be provocative and useful for the group. And also, how to think about this problem? I actually think it raises some fundamental issues in thinking about inequality when we think about this problem and the urgency or the lack of urgency with which it is addressed. I think it's safe to say that everyone in the Chicago area feels really sad about the fact that a lot of kids are getting shot and killed. Yet that sadness does not convert itself into the kind of urgency and concerted action that it otherwise might. And that's not because people don't have good intentions, but it has a lot to do with who is being victimized by this and who is being victimized by our policy responses to this as well. So just for those of you that are flying in for the day and aren't familiar with life in Chicago, we're near Cottage Grove. And one interesting thing you might ask is, what is life like on east of Cottage Grove and west of Cottage Grove? So of course, there's a big difference in the poverty rate where the yellow is Hyde Park and whatever black, whatever color that is, is Washington Park. And we see Washington Park is much more African-American in its demographics. Homicide rate difference is fundamental. I mean, we're talking a factor of more than 20, depending on what year you look. And that's right here. That's all within a bicycle ride of this room. Now, one of the things that I did when we set up the crime lab, one of the less cheery days that I had. I went down with a graduate student to look through medical examiner reports. And I just read through 200 consecutive homicides to male adolescents and young adults. And the ME record, it has in it a couple paragraphs from the police report. It describes the wounds on the bodies. And it gives you a sense of what happened. And it's not a perfect record by any means, but it's a very useful record. And by the way, I must say it was a chastening experience for me. One of the things that I did not appreciate was just how lacerating the typical off-the-shelf pistol is to the human body. One of the things that's really striking is the typical wounds is from a semi-automatic pistol that you can buy a 380 pistol or a 9-millimeter pistol. Those of you that followed the Tucson Massacre, that's pretty typical in terms of the ballistics of what people buy. And you'd see two bullets, seven bullet wounds in the body. And we think that three of them were the fatal shot, but we're not exactly sure. And it's kind of pointless to really distinguish that. We also found, by the way, although I won't say much about this today, the issue of alcohol surprised me as well. 35% of the bodies, there was presence of alcohol. Almost none of them had heroin or cocaine in their systems at that time. A lot of them had marijuana. We actually didn't have marijuana toxicologies. They just didn't do them routinely. The issue of alcohol as a criminogenic substance is something for another talk, but it was really striking how present that was. And it related to a lot of the little vignettes about what at least the medical examiner thought happened, because so many of these homicides just didn't have to be. Two guys are arguing in a basketball game, and they disagree about a foul call. And one of them ends up killing the other one. A guy is embarrassed in public, goes home, gets a gun, comes back. The variations on that story are amazingly common. One of the stories that Jens likes to tell is a kid who lost a dance contest, goes home, gets hold of a gun, comes back, and shoots the guy who won in front of a whole crowd of witnesses. And the kinds of crimes that speak to what is going on in the heads of people that lead to these crimes is something that I really wrestle with. And some of the intervention that I'll talk about speaks to the kind of self-regulation impulsivity issues that are part of this. Some of the crimes, by the way, are much more straightforward relating to the supply side of the drug economy. Young man is standing out in front of a building, a guy drives up in a car with a black cloth over the license plate, comes out, puts three bullets in the kid's head, drives off. That's a different category of beast. But we'll talk about that as well. But the thing that really jumps out was the unbelievable disparities in who's getting shot. So in 200 cases, 11 non-Hispanic white out of 200. Of those 11, probably a few of them were Latino and misclassified. Although we can't exactly be sure. But non-Hispanic whites account for about 4% of Chicago homicides in a given year. And African-Americans are accounting for about three quarters of the homicides. And that disparity is very consistent. By the way, the Latino is in between. One of the interesting things is when I go and I speak to Latino groups and I say, you know, the rate among Latinos is actually not quite as high as you might think. I sort of get a mixed reaction because the violence prevention folks want to say, no, this is a really bad problem. There's nothing worse for a foundation when you're fundraising than to say, the problem that you're working on isn't that bad. No, this is terrible. And actually, it is. There's a lot of violence in the Latino community that results in fewer dead bodies. And that's one of the interesting issues. A lot of gang issues that lead to lots of violence, lots of intimidation, lots of problems, fewer corpses. It's really striking non-Hispanic whites in Chicago live in terms of homicide, live a life that's not that different from the life that people live in a lot of European cities. Now, I give the comparison to London, England. I'll show you in a minute. That's a little bit unfair because London is actually a more dangerous place than you might think. Western Europe is not what it looked like from a 1950s movie. If you sort of imagine going over on vacation with Doris Day, that's not what London or Paris, or that's not what they're like anymore. And if you want to get mugged in London, it's quite easy to do. If you want to get your car stolen in Stockholm, it's easier to do than in Chicago. But they don't get shot in these places. So someone will beat you up, but he won't pull out a gun and shoot you. But the disparities are really quite dramatic. And I'll come back to that. By the way, the juvenile arrest rate, this is the United States now, is also pretty dramatic. This is rates per 100,000. And among African-Americans, you see quite high rates. And I'll talk about this bump in a minute. In the late 80s, early 90s, that'll come back. But if you look at the number of cases in the United States, if you look at the white rate for males and the black rate for males, they're quite different. Now, here's the age-adjusted homicide rate. I'm going to show you this in a couple of ways. I don't want to spend huge amounts of time. I think probably a lot of us have been. How many of you have been in a room where you've been showing lots of depressing disparity statistics? Well, this is that portion of today's talk. And so there's always the question, why am I showing you this? And it's a fair question. These disparities are really dramatic, even compared to the other dramatic disparities that you've already seen. And you'll see, there's another reason I'll show you in a moment. So what we have over here is homicide rates among males age 15 to 24, which is the peak year of victimization and offending. And so the blue line is African-American, 87 per 100,000 per year. These are all age-adjusted mortality rates. There's nothing else done, but they're age-adjusted. And then the middle one is Latino, and this one is non-Hispanic white. So you see, by the way, the black-white disparity is about 10 to 1 in homicide. We're really concerned about cardiovascular disparities, other things. You don't see 10 to 1 in other kinds of disparities the way that you do for homicide. So this, by the way, is over the 1999 to 2000 period. Now let me show you another thing, which is kind of interesting. Here's the same graph. This is exactly the same graph on the left. But what I have over here is diabetes mortality and HIV mortality. Now, of course, a lot of people have diabetes and might die of a heart attack. And there's a question about what's listed on the death certificate. Death certificate is an administrative construct, since I use the word structural after you use the word construct. But what you see is, among African-Americans, that homicide is of the same order as diabetes and HIV in terms of mortality risk. In fact, in 2004, more African-Americans were killed from homicide than died from diabetes or cerebral vascular disease or HIV. And of course, this is really concentrated in the younger ages. And of course, there's also lots of non-lethal violence that is part of that. So in terms of just as a public health threat, this is really significant. And in fact, it's the majority of deaths to African American men aged 15 to 24. It's more than every other cause combined. And among other ethnic groups, homicide is an issue, but it's way down there on the list of things. And the disparity, by the way, is also astonishing. When I read the little reports, one thing I forgot to mention, there were almost no reports of middle class person going to a money machine in the loop and getting shot. These are African-American young men, typically in low income communities, but often not the intended victim. Sometimes it's just somebody standing in a crowd. And we only looked at young men, but there's, of course, lots of other cases, one of the most poignant being the little girl who sat down to tie the shoe of her blind little sister and was killed by a stray bullet that was fired by one gang member into the rival gang territory without sort of thinking about, well, the bullet actually kind of lands someplace, a couple of miles away from where it was fired. And here's what's happening in incarceration. When I started, I read a lot of criminology books that said, one of the constants in American history, it's like pie, Planck's constant or something, is that we incarcerate about one in a thousand Americans. And that was true from the 1920s up to about 1970. And somewhere in the mid 1970s, things started to accelerate. And this is what we're now incarcerating about five times as many people in America as we have historically. And I'm going to show you some data about what can we do to bring this down. One of the chastening things, I have a paper that I have some, I'll show you some results from with Peter Reuter and Eric Savingy, where we try a bunch of numerical analyses to say, how can we bring that rate down? And it turns out to be really hard once you're in this place, it turns out to be hard to bring that down. But that's really, this is one of the most important trends in American society over the past three decades. And in fact, it's so large that if you want to look at an issue like African-American male unemployment, one of the real issues that people debate in the labor economics literature is, do you count the guy who's sitting in a jail cell as unemployed? If you don't, then you're saying, hey, we're making all kinds of progress. These are all people leaving the workforce, leaving the denominator of unemployment. Here's President Clinton's presidency. You know, African-American male unemployment, listed African-American male unemployment, really came down. Part of that story is, a lot of the guys who used to be unemployed are now out of the labor force locked up. So this is a really serious problem. And so here's, let me give you some more. This is another depressing statistic slide. This is something that Bruce Western computed. Is it OK for me to move in terms of the film? Am I doing OK? Let me know if I can improve your viewing pleasure. So what this is, is cumulative risk of incarceration for different cohorts of men. And I have high school or GED graduates no more. The colleges are quite small. And I have high school dropouts. And we have the 1945 to 49 cohort and the 1965 to 69 cohort in there. And the major thing that jumps out is, among African- American high school dropouts who were born in the late 1960s, 59% of them have been incarcerated. If you look right now, at African-American high school dropouts age 20 to 34. One third have been in jail this year, this past year. So it is, and by the way, among whites it's also gone up. By the way, these numbers among whites are quite high. But the difference, it is a normative experience for young men in low income neighborhoods in big city America, in each city you can identify four or five of these neighborhoods. It is a normative experience for young men to spend time in a secure facility. This does not count, by the way. On any given day, the majority of people who are under criminal justice supervision are not incarcerated. They're sentenced to parole, probation, various kinds of supervision that don't involve being locked up. So this is just a locked up piece. Over your lifetime, have you ever been locked up? By the way, the population that is incarcerated is also becoming increasingly non-white. And this is a part of the story that when you think about the politics of this, is not irrelevant. If you look at the percentage of Americans who were incarcerated, the percentage of incarcerated prisoners, what race were they? Taking into account, yeah, these statistics are probably not that great, but they're pretty telling. As recently as 1970, you look and you say 60% of the prisoners were white. When you look today, it's more like 30%. And you see a large increase in Hispanic-Latino, although this is actually considering the changes in the American population. That's not that dramatic. But you see that African-Americans have been creeping up and are now almost half. And more than 2 thirds of the American incarcerated population is non-white. Now the thing that's so strange about some of these incarceration trends is that crime is not going up. Now part of this is we're locking up more of the bad guys. There's a supply and a demand side of this. But if you account for that, it's still clear that if you look at since the mid-1990s and early 1990s, crime has dropped. And yet incarceration, over the same period, if I superimpose the graphs, incarceration is going like that during a period where crime is actually dropping. And that's something that's really, the lack of correlation between the prison population and the crime, what's that? Which came first? Is that because of the age of the increase and the crime came down? Or the other way around? Some of that, there is no doubt there is. Some of that is that incarceration has increased. But when people have tried to back that out, that doesn't account for very much of it. There's no question that I believe that there's a thing called deterrence. And there's no question that people starting in the mid- 1980s, the criminal justice system became more severe in a way that made itself felt. And I'm sure that had a deterrent effect. But it doesn't account for all of it. And if you look at who is being incarcerated and what they're in for, there's also a kind of mismatch there, which I'll get to. But by the way, I would say that we don't fully know. There's a big debate about what caused this crime drop in America. One of the things Jens likes to say is, in the 1970s and 80s, every police chief in America was a complete idiot. And in the 1990s, they were all geniuses. And it was the same people. So a lot of what happens, it's like, I don't know. There's a lot of things that brought that rate down, the economy being one, a lot of different things, more aggressive policing being another, public and private. But it is really striking that we have this really large prison population in a time when crime is not that bad. And so here's, by the way, I should tell you that all the depressing statistics I showed you, if I did the same presentation in 1992, it would have been much, much worse. The homicide rate among African-Americans is much better than it was in their early 90s when we had the crack epidemic. So those numbers that I showed you, we've seen worse. It goes from 180 to about 100. This line here is black males age 18 to 24. So it's really striking that these trends are really striking. Now, why is this a problem? A couple of reasons why incarceration is especially concerning. One is it really affects the relationship between communities and the police in a profound way. And I was on a television show called Need to Know. Does anybody watch PBS? I don't know if at this point it conflicts with various MTV reality shows. So I know that David's missed it. So I was on the show and the host is showing me this clip and asking me to comment. And it's a clip that takes place in Chicago outside of a ceasefire office where a young man, men and some other young men, and there's a fight. And he's brought into the ceasefire office, and they start to take him to the emergency room because he's got a fat lip and a couple of teeth knocked out. And while this is happening, his sisters show up, and they're looking for the guys who beat him up. And the sisters, by the way, are dragging four and five year old kids with them. And they're cursing out the guys who, and there's this whole Donnie Brook that takes place on the street, which is being filmed and which involves maybe 30, 40 people in a major street. And he's asking me to comment on this, and I'm watching this, and it's going on five minutes, 10 minutes, and there's no police. And the police station, by the way, a couple blocks down. And there's two things. One is the police had already been there and left. But the second is people do not call the police in this place, in this neighborhood. The ceasefire people were there trying to take care of it themselves. And it actually was pretty close to somebody really being hurt. People had weapons that weren't used, but might have been. And you imagine on 57th Street, imagine a Donnie Brook in front of Medici's that involves 10 people. It would not be going on for any length of time before there were a really large number of police intervening. And without people in the surrounding community saying, well, there's something bad happening, I really better call the UCPD and have them come and help. And when people in the community do not see the police in that way, then it becomes really, really hard to protect public safety. So that's one aspect of it. When the police start to be seen as the people who come removing the young men from our community, that just becomes a very poisonous dynamic. There's no black hat in the story, necessarily. But it's just that's the way it is. Incarceration is a very serious blot on people's records. I think probably the incarcerated ex-offenders are the last group of people that get hired in the labor market. And in case you didn't notice right now, the labor market's not doing real great. And so we have all these ex-offenders in the city of Chicago who are trying to get jobs in an economy with an unemployment rate that's over 10% locally. And that is a real problem. We also remove young people from school. One of the ironies is we arrest. So we take a juvenile offender. Well, some kid does a real crime and gets sent to a juvenile detention for two weeks. Pretty common scenario. That's not really long enough to deter your hardcore gangbanger from doing a whole lot. But it's a long enough time so that it completely screws up their ability to function in the classroom. And they're much more likely to fail a few more courses and to drop out of high school. Because it's really, really hard to maintain that kid's academic trajectory when this is happening. And at a less tangible level, one of the things that concerns me a lot, although I don't have the right expertise to say a whole lot that's interesting about this, but as incarceration becomes a normative experience, one of the things that concerns me is it becomes part of the common language and life of a lot of young men. If you listen to hip-hop music, you watch. I was watching two fighters. If anybody hears a boxing fan. But these two guys were boxing, and they were basically trading prison trash talk. And this is not a healthy thing when incarceration becomes such a common experience that it's part of the common life of the community. And when you see juries, for example, hesitating before convicting people who are obviously guilty, you're getting a sense that there's a lot of people in communities who are saying, this is really tipped in a way that we don't like. By the way, one other thing I should also mention, there is a public health literature that's starting to emerge that there's some specific public health threats from bringing people into prison and then bringing them out. Rucker Johnson and Steve Raphael have some interesting HIV work where they've tried to trace guys' experience in prison with subsequent HIV transmission. There's not a lot of drug use in prison, but there is drug use in prison, and the drug use that takes place in prison is really, really risky. Syringe is a weapon, so the prison authorities try to keep them out. So if you have one in there, you share it. You pass it down the cell block, and a lot of people use it. And that's the same with the tattoo gun, which a lot of guys are thinking about the syringe, are not thinking about the tattoo. So what can we do about this? So is everybody thoroughly depressed as I've spent the past half hour on this? This is a really bad set of problems. What are some things we can do that can be productive? I think there's a couple of things that we have to do. There's no silver bullet, so to speak, to this problem. One of the problems in this whole area is that everyone is looking for the next home run intervention, which doesn't exist. There's this desire to find the next Perry preschool, or the next whatever, the next superstar thing that's going to solve this problem, and there isn't one. But there's a bunch of useful things that we can do. First of all, providing realistic pathways to employment. I'm a big believer in, at the 50,000 foot level, in the kind of work that William Julius Wilson has done, looking at neighborhoods and communities. It's not so much that you need to have the doctors living cheek by jowl with the poor people to be there as role models and so on. You need to have the guy who's the mechanic, who's basically having a pretty good life, who's a person a lot like this kid, who is doing OK, but not great in school. You need to give kids a sense that there's a realistic pathway that is valuable for them. And it's often not there. I won't say much about that today, but that's clearly a fundamental challenge. Helping young people approach peers and adults in ways that reduce rather than escalate conflict is another issue. And I'm going to hear Ducogne and Behavioral Therapy, by any chance, a few. So some of the issues that you try to deal with in CBT are the kinds of issues that are not usually conceptualized in a mental health way within low income communities, but they're there. And one of the things that's really striking is if one of the children of someone in this room went and punched somebody, we would say, oh my god, this poor kid, what's his mental health problem? And we'd better get him some help because he went and punched somebody. And if some kid down in Fanger High School punches somebody, the reaction is not, this kid has a mental health problem. We'd better lock this kid up, depending on who is punched and why. And we do have to think about some of those issues more systematically than we do. Treating guns with the same determination that we treat drugs. We'll see how much time we have to talk about that. Approaching drug enforcement differently. I think there's actually a debate. People who do drug policy, I was just on an NAS panel about drug policy. Most people who spend a lot of time thinking about drug policy don't talk about legalization versus prohibition, something like that. Because there's an extreme polarity. Nobody really wants to have cocaine at Walmart where you can just walk in and buy it. I certainly don't. But maybe some of you are hoping that we should save some money. But there's different ways you can approach drug enforcement. And there's this problem that you cannot regulate what you've prohibited that actually turns out to be a problem in some ways. And I'll come back to that. Larger police departments deployed in a more balanced way. In case you didn't notice, I'm a left wing kook in terms of my own political views. Hopefully not a kook too much. I'm actually a big believer in a larger police department. And I'll talk a little bit about why that's important. And then finally, different ways to supervise criminal offenders. Gary Becker in 1968 wrote a wonderful paper about the economics of crime. And where he derived in a very persuasive way that the best way to control crime is you have a really low risk of a really high penalty. And a risk averse offender will not commit the crime. This is a fantastic way to deter Gary Becker from committing a crime. And I actually think it's a good theory actually for a lot of things. For example, white collar crime, I think putting people in jail for white collar crime has an incredible deterrent effect. If I said to someone in this room, you'd have to spend a week in Cook County Jail. A lot of us would be like, wow, that's a big deterrent. I'm not going to cheat on my taxes right now. But it turns out that a lot of the people who commit violence, if you're talking about people who are impulsive, who have self-regulation issues, the idea of imposing a draconian penalty is exactly the wrong way to go. And so I'll talk about that. So the idea of swift and certain and mild sanctions is really important because a lot of the people who are committing the crimes, we actually know who they are. And the reason we know who they are, they have a parole officer. They have a probation officer. They reported last week to something, or at least they should have, but we're not actually sure whether they did or not because their parole officer's got such a high caseload that he didn't really know if the guy came or whatever the issue was. So let me say something about reducing incarceration. This is actually today's biostatistics moment. Has anybody here written any paper that has the term length bias sampling in it? What's length bias sampling? Anybody have a sense? This is today's didactic moment for survival analysis. So if I went into the hospital today and I said, what's the length of stay of every patient that I find that's lying in a bed? I'm going to get a really long number compared to the average among all the people who are admitted today. Because the people who have really short hospital stays left before I could come in and survey them. Are we cool with that? That's exactly the way prison works. So a lot of people say, what we really need to do to reduce the incarcerated population, get all those low level drug offenders out of the system. And we would have fewer people in prison. And the answer is no. You would have fewer people going into prison. But the actual population at any given moment of the prison won't go down much because it's really weighted towards the robbers and the murderers and the people committing more serious crimes. The population of people in the cross-section does not look like the population that are going to be sentenced today. It's a more serious group. It's a really basic concept of survival analysis. But it turns out to drive, it turns out to really make it hard to reduce the prison population. So there are some populations that either don't need to be in prison or probably more to the point, they don't need to be in prison for as long as they're being incarcerated. There's a question, should you lock this guy up? But should you lock this guy up for 15 years? It's a different question. So we actually did a number of simulations. We used 2,004 surveys of state prison inmates. Now our paper was really by drug offenders. We spent a lot of time trying to understand the potential of drug courts and innovations like that. But we also generated some results that are very pertinent to the black-white disparities in incarceration. So the most obvious things you would try to do turn out to not work that well. About 2% of African-American state prison inmates are sentenced for non-trafficking drug offenses and have no concurrent sentence for a more serious crime that you'd basically have them locked up. Here's a list of serious crimes. Most of them are pretty serious. Ranging from homicide to drug trafficking and sex crimes to blackmail or extortion. So serious stuff. So it turns out that if you get rid of all the obvious people, doesn't affect racial disparities and incarceration that much. And it also turns out some of the methods that are really valuable for individuals that are diversion programs for heroin users say, instead of sending you to prison, we're going to send you to a drug treatment program and a judge is going to make sure that you keep going. Those kinds of programs, they're really valuable at the individual level. At the population level, they don't change the numbers that much. There's about 55,000 people in drug courts in America right now. And we've got an incarceration population that's like 2 million. So it's just not big enough to do much. And the people that are in these interventions are the lowest level offenders who would not make up a lot of prison years anyway. What you could do with a lot of these measures, though, is you could reduce the inflow into prison. And we might want to think about that as a distinct policy goal. Because the experience of having the cuffs put on and going through that prison intake and having to put down, I've been convicted of a felony. That's a big deal for a lot of people. That's a life-changing event. And if we could do that for fewer people, that would be good. And so we did a bunch of simulations. And we actually find that although there are no obvious people that you could kind of release today and feel good about, that we did feel that maybe a third of the inmates in state prison, there's nothing that you can find when you look through their complete jacket where you say, wow, this person is a real menace. So about, here I broke it, this is non-Hispanic white, black, and Hispanic. If you say, you sent for a serious crime, and by a serious crime, this is the list of serious crimes here. Sorry for those of you on the floor, you can't really see. But take my word for it, it's stuff that you don't want your next door neighbor to have been convicted of. About a third of the state prison inmates are not in prison for a really serious crime. And in fact, about a quarter of them have no past violent crime also. And they have no what's called a sentence enhancement, which is basically you had a gun, you committed a crime when you were on parole, various things that make you a no-good-nick in terms of the criminal justice system. So there is a group that's probably about a quarter of the inmates where you say, boy, why are they locked up given where we are in 2011 in America? But they're not a huge group. Because remember, we've gone up by a factor of five. So I'm saying basically there's a third of them or a quarter of them that I say, I don't understand why this guy is still in prison. Another effective idea is changing supply side drug enforcement. And one of the ideas that I would love to see, which I don't think we're ever going to see, is applying the same evidence-based standard to law enforcement that we applied to prevention and treatment and substance abuse. One of the frustrating things in substance abuse is you say, I want to give methadone to criminal offenders to do X, Y, or Z. And somebody says, where's the clinical trial that that's effective? If you say, I want to spend $2 billion to have AWACS planes flying around the Mexican border looking for Mexican drug smugglers. Nobody ever says, where's the randomized trial that showed you that that worked? And now, in fact, we do have some real data. The street price of heroin and cocaine is a lot lower than it was 25 years ago. So in one sense, we are failing. If our goal is shift the supply curve and raise the equilibrium price so that fewer people use drugs, we have definitely failed. But we now incarcerate more people for drug offenses than Western Europe does for everything. And they have a lot of crime and violence, but somehow they're able to incarcerate fewer people and deal with it. And one of the problems, I actually think I would incarcerate more people than they do, but one of the problems with the way we enforce, there's a couple of problems with the way we enforce that's not good from a violence control perspective. If you view drug enforcement as the fundamental problem is are we controlling violence? You would do it differently. And I think a lot of criminologists would say, instead of, let's not make our goal, we're going to stamp out the heroin market in Chicago. First of all, we're not going to stamp out the heroin market in Chicago. But secondly, we have to think about what do we care about with the heroin market? So what we care about are people who have open air drug markets right off of 94. We care about people who hire teenagers. We care about people who use guns in violence. And we care about people who sell adulterated drugs that kill people. There was a fentanyl epidemic that killed hundreds of people, and if you apply enforcement resources more selectively, you probably have a better chance of reducing violence. So I'll give you an example that's not about disparities, but which makes the point. Right now in Mexico, there's a little mini war going on between drug-selling organizations. And the DEA has made it as a goal. We're trying to stamp out the drugs that are moving through Mexico. What that has done is it's really disrupted a lot of the existing competitive arrangements that have been reached, and they're killing each other trying to find new routes through. And if we said we're going to focus all of our enforcement resources not on the biggest organizations, but on the ones that kill the most people, you would get a different result. You would actually find we would get more drugs being brought through Mexico, but the organizations would get a message, if we don't kill people, we won't get quite the same enforcement attention. That doesn't mean that you ignore those people. Heroin is a real problem that a lot of people are going to die from heroin if we have widespread heroin use, but we could be more selective about it. There are also particular mechanisms in the way we sentence people, which one of the most ridiculous is the mechanical way that the weight of the drug that you have when you are arrested plays a big role in your sentencing. I can tell you that if anyone in here decided to retire from the University of Chicago and become a drug kingpin, the first thing that you would do is you would get some junior graduate student to carry all of your drugs for you. And the fact is the weight of the drugs that you carry has nothing to do with where you are in the drug hierarchy. Yet that is the way that, particularly on the federal side, that is the way that a lot of sentencing is done. And so if we redefine the job of supply-side drug enforcement, we could do better. Focusing on parole, probation, and community corrections. We go to one, we go to five o'clock, is that right? So I mentioned before there's this literature in behavioral economics that says swift, certain, and moderate sanctions are the most effective way to influence people's behavior. There's a lot of offenders who have a drug problem or some other problem who are under criminal justice supervision. And what typically happens is they get released from jail or prison, and the first month they're pretty scared that they're going to get caught doing something bad, and they're kind of keeping their nose clean, trying to rehabilitate themselves. But then they start smoking a little weed or whatever it is that they do. And the first time they get caught, they're really scared. And the first time they get caught, their parole officer or their probation officer says, you really shouldn't be smoking weed. And they say, wow, I got a finger wagging. That's really scary. And the next time it happens, they get another finger wagging, but this is if you do it again, you're really going to get a big finger wagging. And the third time they go in front of a judge who gives them a finger wagging. And the fourth time they get sent back to prison for four years. Or they go and they commit a serious crime that's related to the fact that they're now relapsed in their drug use. What we have done is we have conditioned them to believe that the system is a joke. Because the system is overcapacity and because they want to focus on the people who have actually committed the crimes, not the precursors to the crimes. People who don't show up to court, it's really boring to get the police to focus on the guy who just didn't show up to his parole hearing, something like that. Everything we know from behavioral economics suggests that we want to do the opposite. What we want to do is the first time you test positive for marijuana, guess what? Call your girlfriend and tell her that this Friday you're going to be spending 48 hours in jail. We're going to wait till your work is over so you don't get fired. We're not going to revoke your parole or probation, but we're going to give you something serious. And it turns out that in Hawaii, there's a program called the HOPE program in Hawaii that did a randomized trial of some of the most difficult parolees in the whole system. And what they found was by really monitoring people really closely and by having these really pretty to determine sanctions, you can imagine you might be nervous about what's going to happen. They're really pretty to determine sanctions. You can imagine you might be nervous about this, that people would end up going to jail a lot more because they are being monitored so much more closely. They actually ended up with many fewer prison days and lower rates of reoffending because they were really intensively monitoring the people and the people kind of got the message. It turns out especially because a lot of drug users are not actually chemically dependent on drugs. They use the drug, but they don't necessarily need a treatment program to stop using if you do intensive monitoring. And so they found a 50% reduction in prison days through better monitoring. And these are the kinds of things that we really need to do, but they're difficult. Thinking more creatively about older offenders. One of the things that's really unfortunate is the mismatch between things like the three strikes law and what we know about criminal careers in America, particularly about the age trajectory of violence. Violence is a young man's game in a lot of ways. If I'm a heroin user and I'm 21, I might be mugging people. When I'm 38, I'm really not mugging people anymore. It's kind of hard to be an old thug. And testosterone, there's a testosterone poisoning that we're all exposed to, which kind of ebbs. So violence is really focused in younger ages. But what happens is older offenders have this incredible overhang that they've been convicted of a bunch of stuff before. So what we're doing is guys are showing up towards the tail end of their criminal careers. If you're a heroin addict and you're 38, you're still stealing car radios. If you have a $1,000 a month heroin habit and you're unemployed, you're probably committing crimes of some sort to get that money. But you're not hurting people. So that guy gets caught stealing that car radio. And they say, well, there were those three felonies that you've already committed five years ago. And now we're going to give you a sentence enhancement as a habitual offender. And we've really managed to focus our attention on that guy just as he's sort of leaving the phase where he's the most dangerous. And that's especially a problem. So here's an example. We looked at drug offenders, drug abusing inmates. The blue line is did you commit a violent offense? And the red line is were you given a sentence enhancement because you're a habitual offender? And we could make the same graphs for lots of other ways that you got a more serious sentence. And what you find is here are these guys in their early 20s who are the peak violent offenders. And none of them are getting the sentence enhancements. And then you come out here and the violence rates are way down. And the habitual offender rates are way up. And there's this systematic mismatch. Do we really have to send that 45-year-old guy to jail with a 15-year sentence? What are we really accomplishing by doing that? There's an important... The Illinois Department of Corrections has an entire geriatric department which has nursing homes. It has, you know, dialysis. It has everything that you have in this building. And so we did lots of different ways we looked. We looked at inmates under 25 and over 35. And in every category we looked at, the younger guys, this was cocaine users, meth users, and heroin users, but we could have done anything we wanted to do. Red hats, black hats, we would have found the same thing. The younger guys were much more likely to be violence, 40% versus 16%. And the older guys were getting all sorts of additional sentences even though they were not being violent. And by the way, this interacts with what's happening to some of the drug use populations. Remember that bold that I showed you in the mid-1990s, early 1990s? That was the cocaine epidemic. Well, all those guys are still in the prison system. And they're getting older. The median age of cocaine users being sent to state prison went up by seven years over this period, 1986 to 2004. And so what's happening is all of these guys are suffering long sentences because they were really dangerous 20 years ago. And so that's, at least more police. President Clinton, somebody may remember President Clinton. He put, remember his 100,000 cops initiative? Well, they spend about a billion dollars a year in hiring grants to states and localities. And it turns out that when people went back and did cost-benefit analyses, they found, hey, those guys made a big difference. But the program ended basically by about the year 2000. Having a larger police department gives you a bunch of advantages. One of the ironies is you can actually be more progressive. Now, I've spent a lot of time in Chicago neighborhoods talking to families. And a lot of them say things like, well, what I really want as a police officer, parked on the route that my kid walks home from middle school because I don't want my kid to get beaten up and I don't want some crazy thing to happen on that route. But the police are saying, you know, we're responding to 911 calls. We've got a bunch of things that we've got to do and we only have so many people. So the idea that I'm going to go and hang out in your community just kind of sitting there parked is kind of hard for me to do. And a lot of community policing methods are very labor intensive. And so one of the reasons why, for example, New York City was able to lower their crime rates so dramatically, they have a huge police department, especially when you consider all the private police that complement what the police do. And I think that, I think progressives sometimes think that having more police means we're treating offenders more harshly. That's a totally different question. Promoting school attendance. I'll just say briefly, in Chicago, our graduation rate among black men is about 39%. The percentage of black men entering high school predicted to graduate from a four-year college is six. So we got it, and that is fundamental to the problem. This is showing you the obvious thing. High school dropouts are much more likely to be killed. This is 1996, but I could have made the same graph for any other day. And one of the things that we're trying to do in dealing with that school issue is to be focusing on what James Heckman calls non-cognitive skills. Social cognitive skill building to help people approach other people and situations in a more productive way. In some ways this is dealing with psychology in some ways it's dealing with some of the cultural issues that you have to deal with. I must say I'm glad I'm not a 17-year-old kid in a Chicago public school. You know, we spend a lot of time telling these kids not to be violent to be focused on school and so on. I've spent some time talking to kids. As I walk in I talk to kids. There's a room like this but the audience is a little different. And there's a bunch of kids in sort of dressed in urban American outfits. The first thing they notice is he's not doing a CSI thing. I'm really bored. Where's his infrared fingerprint detector. He doesn't have one. But these kids will say Dr. Pollock I'm so glad that you're here. There's too much fighting. There's too much violence. Everything you're saying my mom says to me, my aunt is really worried. We're really upset about all the violence in this community. And I'm so happy you're here and that you're doing that you're contributing to this community. The aspirational values of the kids are exactly what you want. But you should know Dr. Pollock that everything you're saying to me is probably pretty irrelevant to my life. And if some guy gets in my face in the hallway I've got to kick his ass because I've got a story this often told I've got a $70 jacket on and I've got to walk home. And my mom can't buy me another jacket if this gets taken from me. And if some guy punks me over something small that's a real problem for me. And that is a very real thing. We don't tell the kids don't fight. Because that's totally unrealistic for the world that they live in. And if you took any one of us and said okay go through four years at Finger High School or any number of the big high school, Marshall High School it would be hard. And it's not about changing the kids' values it's about changing the environment around these kids and giving them the tools that they need to navigate that environment more successfully. Because one of the problems we have with these kids is they learn how to deal with their peers to deter people from punking them. And then the teacher gets in their face and they might respond in the same way. That doesn't work so well. So we did this intervention called BAM Sports Edition. I should say we meaning other people. We partnered with an organization called Youth Guidance and World Sports Chicago. World Sports Chicago was the organization that did the Olympic bit. And they're very committed to improving sports opportunities for kids. And we did an actually an intent to treat trial with 2,600 youth in it. And we have three treatment arms and a control arm. It's sort of the wildest roller coaster ride of my research career. It's a very large experiment. We have weekly small group sessions during the 2009-10 academic year. We did a lot of work with coping and self-regulation. Focusing on integrity accountability, positive anger expression, visionary goal setting, trying to get kids to be more future oriented. We had a bunch of really cool counselors who worked with the kids. Did individual counseling if it was needed. Mediated with teachers. That turned out to be a big challenge. Teachers are really burned out and angry and afraid of the kids. And that was an issue for a lot of these schools. We also had an after school non-traditional sports component. But all of the things that were in the sports component were archery, wrestling, judo. We didn't have pistol shooting but we had everything short of that. We would have had a crossbow thing if we could have done it. I mean, I'm waiting for the knife fighting. And it turned out that the kids loved that and they responded really well. And the coaches were actually trained. We basically said here is Vince Lombardi. That's the opposite of everything we want you to do. And so we ran this intervention. This is the I don't know if you can see this but basically all of the places where we did this intervention, all places with really high homicide rates. There's Jordan High School up north but basically everything else was in the south and west side. And Fanger High School was the one where a kid got beaten to death and then someone videoed it. So and so we did that and as I said, not quite ready to tell you today. You have to come back for the next one. But the parts that I think we were the most successful in, really relate to these social cognitive skills, helping kids relate to the environment to avoid a lot of unnecessary confrontations that these kids are having. So I made this point already. Let me end with I'm going to end with some politics. So I mentioned what we have to change in these kids' heads about how they deal with other people. One of the problems that we have in talking about this issue is the reality that it is so concentrated among African-American youth and that makes it so that complicates so greatly our ability to talk about these issues. So one issue is how do you talk about a cultural violence? A lot of people in this room if you listen to a hip-hop record would say wow, there's a lot of stuff in here I don't like. There's a lot of stuff that might promote violence. And there's actually a real need for sort of culture talk about violence. But in the policy world it becomes a way it becomes a substitute for talking about political action and public action to deal with the underlying environment that these kids are trying to navigate that those hip-hop songs really come out of. And I cannot believe that if the people affected were a less marginalized group we would be responding in policy the way we are now. There was just a case in Columbia University where a bunch of Columbia students were rested for selling drugs. They had some sort of a club drug and heroin and I'm not exactly sure what they were selling but they decided to sell out of their dorm room and being not particularly skilled drug sellers they sent checks to each other and leave phone messages and texts and I'm sure the FBI really appreciated the bookkeeping that was done for them. You can bet that if that happens a lot that those guys are not going to get 20 years in prison. I will make a prediction that those guys will not be serving the kinds of sentences that a lot of other drug sellers are. These are good kids, they come from good families they're going to have good lawyers and there's a sense, which I would have by the way, if it were my child or my colleagues child like why would we send this guy to jail for 20 years over this? That's not the sense that people have every day with a lot of the other people in the system. And it used to be the case that racial animus was the real problem I think now it's just a case of people are sad that this is going on but there's no sense of urgency. I did health reform for the past two years and I'll ding the doctors for a moment. There's this the doctor fix sustainable growth rate the fix to Medicare which many medical organizations are really upset about. When you talk to people in Congress they are on this issue. There is no way that doctors will ever see a dramatic decline in Medicare reimbursement because of this sustainable growth rate thing. I think a lot of people in Congress say I will lose my job if this happens. People will be really angry that matter a lot. During the stimulus we lost a chunk of money for youth jobs in Chicago and across the country. It was cut out of the stimulus because a bunch of moderate Democrats wanted to spend less money on it. I don't think very many people felt if this money is taken out I'm going to lose my job. And yet the urgency of getting youth the summer job obviously means it's any less than the urgency of making sure that we have adequate Medicare reimbursement. But there's just a different response and you can see it and feel it in lots of ways. There's actually some work by Larry Bartell who's a political scientist at Princeton where he showed some pretty disturbing graphs where it showed if you track changes in public opinion over time among the affluent and you look at elected politicians there's a real correlation between how public opinion among the affluent moves and how votes move among our politicians. If you do the same thing for the political views of low income people there's basically no correlation with Senate votes. There's very little evidence that the political system is really responding to the urgency that low income people are feeling about this issue. And if you say why aren't we being more effective as a society I think the fact that the economic and political marginality of the victims and the offenders is fundamental to the story. And so I'm going to end on that somewhat politicized note but thank you very much for your attention. Harold Swift, certain and moderate punishment sounds to me precisely like what is encouraged as effective parental correction and I wonder if you could comment on the relationship between some of these trends and the decline in stable two-parent households and whether there are any policy policy changes that could remove disincentives to household staying together or incentivize them staying together. Well, so you're absolutely right the connection between parenting and Swift's certain and mild sanctions and one of the issues that you have with a lot of young people is they're not getting the kind of organized household discipline that would really promote positive development and that is a real issue and in fact some of the effective interventions work with parents to try to help with discipline strategies. There's a lot of parents applying either harsh discipline or lax discipline but not the kind of consistent discipline you'd want to see. I don't know how to repair the American family or what exactly that means in 2011 is a fact that but I think that it is it is no question it makes our lives more difficult that we have the kind of unstable households that a lot of young people are in and a lot I think that's an issue that in public policy the levers seem to be pretty weak and that's the kind of thing that civil society kind of has to take the leadership on because I will say that if you go into when Barack Obama gave his father's day speech some of these themes came up and a lot of people were like wow that's really amazing a black man is talking about family divorce and single parenthood and I was like have you ever been in any church in America forever in your entire life because every church on the south side of Chicago every Sunday you would hear that and that's clearly it's not that the message isn't being transmitted it's that it's not clear what the right social response should be to these cultural trends so I'm babbling that means I have nothing to say about that. You started your slides with sort of the there was a depressing part and then there was some uplifting parts and then ending with some questions so I'm like a little bit of an emotional mess so how then yeah I'm going to reach out to a lot of people in the audience what is your outlook for the sort of Hyde Park, Washington Park area on sort of violence issues and disparities over the next I don't know pick a time horizon 5, 10 years well first of all I think Hyde Park actually it's pretty good in a lot of ways I think people we live in a safer society than we think in Hyde Park in some ways now I'm saying that knowing that lots of people in this room have individual episodes that they would be quite happy to have avoided I think we're going to bring the youth homicide rate down in Chicago there's a lot of people working on it I'm optimistic but I think there's no one thing that's going to do it I think it's going to have to be I think one of the things that's happening in a lot of communities is there really is a shift in norms that says I think if we could do something about guns for example that there's a lot of adults in Chicago who are engaged in various kinds of gang activity who are giving juveniles access to guns and that's a very discreet problem that Jody Weas is focusing on and I think it's going to be that David Kennedy has done a lot of work around the country on I think we're going to be successful in sending a message to adults that says if a young person that's connected to you commits a shooting you're going to be in big trouble and that adult is going to change their behavior so there's several things like that that make me optimistic that there's some avenues for intervention so the conversation around Woodlawn and Hyde Park I think is a question of that I didn't have you didn't quite see anything about it really the racism that allows the segregation that's according to Chicago and so Hyde Park people sort of live in this bubble and the most progressive of us think there's no racism but when you go across to the south side and the west side of Chicago you see that it's 98% black and once you cross a divide it's more than white so what do you think racism contributes to this and you wouldn't see that great divide in other cities like New York where the disparities isn't as profound well I think racism is I wish we had another word I think racism is an umbrella for so many different things I think there was a time at the University of Chicago where the university's official policies were ones that were quite problematic and were racially tinged and it's not that there's people used to talk about the transition between discrimination and contract and now it's discrimination and contact so contact versus contract what we have now I think is a lot of the worst ways that racial stereotypes and racism make themselves felt are being felt in a way that does not involve any particular person who really dislikes people of other races but we just in our lives make a lot of micro decisions that add up to high levels of segregation so each parent who takes their kid out of a school as that school becomes more black or brown there's a human being there who's making a decision that at a human level you can say I understand where this person's coming from and then the cumulative effect is terrible and I think we've given up on integration as an official goal of public policy and housing and education in the far south side of Chicago we could not tell in our data what the numerical classification for white was because there were so few white students in our study we weren't sure whether they were Native American or other or Filipino there were just no white kids to know there were seven kids is this the white category I don't know that Chicago did that and it's really hard to undo I'm a big believer in the movement opportunity and other approaches to that so you mentioned early on the statistic about every gunshot costs a million dollars and I just wondered what that was part of because if that's a I mean people do pay attention to their pocket books and if that does that account for lost wages or social costs payers spend or what is that and if that's anything people can hang their hat on maybe that could get people's attention business people will they pay attention with that million dollar number but one of the things that makes me optimistic about Chicago is people are really focused on this problem and want to own it so for example Chicago public schools has really embraced this problem even though the youth were being killed are not being killed at school all of them are not even in school in part because they realize hey we have to develop the city economically most of that million dollar figure is not lost wages emergency room expenses things like that it's all of the ways that we change our lives to avoid the risk of being shot so I commute every day 45 minutes each way because I'm afraid that you know I'm going to get shot if I lived in X community so there's people who don't live in Hyde Park because of personal safety if we're a long period of time spend a lot of time and money finding another place to live that's things like that are what's in that million dollars I wanted to revisit the idea of stability of families that we talked about earlier and I wanted to know if you thought that it was the mere act of someone being a single parent or is it more the social and political issues that tend to surround being a single parent so there well I think the important thing for kids is to have a stable environment that is in a relationship sense in an economic sense that the kid has a secure environment and the reality is in Chicago first of all the great great majority of kids in Chicago public schools are from single parent homes and that's the reality and that's going to be the reality for a long time and so the question for policy really is not am I happy or sad about that fact because I think that is a fact but it's really how do we help these moms be successful in creating a positive environment for their kids and that's a much more productive way to approach the problem because then I can actually say okay I can come to parents what are the issues that you're having what are the things that you need I'm afraid that one of the problems that we have is how would you how do you talk about how do we stay out of a kind of culture war that's been going on because that is we have to avoid that I think if we focus on so how do we create a way how do people live in Chicago how can I how can I be economically self-sufficient how can I make sure that my child has the kind of resources from me and from other people so my child can be successful a lot of these families are successful and are able in a difficult environment to succeed and so I'm not sure I'm not the best person to give a great answer to that question but I do think that we do have to the issue of two parent families at this point I don't quite know how to even address that given where we are in 2011 thank you so much