Over the last year, Chicago Area Health Education Center (Chicago AHEC) explored in detail the ways in which the Criminalization Pipeline – disproportionate minority contact, arrests and detainment, and sentencing and incarceration – serve as barriers to people of color navigating a Health Career Trajectory and ultimately impede the development of a diverse health workforce. Through this research and writing, it became clear that the effects of the criminalization of people of color can be felt by individuals and communities long before a criminal record is attained. Over-policing in black and brown communities and enforcement of zero tolerance policies in schools and communities combines with the stigma of arrests, convictions, and incarceration to create a reality in which a criminal record is only the final step in a pipeline of criminalization along the life course.

In 2016, roughly seven million Illinoisans had a criminal record. Despite the large amount of people with records, criminal records are still held as a barrier to entry to resources, such as higher education, loans, housing, and jobs. In a society in which a criminal record impedes access to basic resources, health workforce development organizations must critically analyze the toll that records have on the lives and career aspirations of those we seek to serve.

Once a person has a criminal record, the chances of that individual having access to a career in healthcare becomes highly unlikely. In fact, a 2015 study showed that the mere existence of a criminal record reduced employer responses to job applications by 50%. The job callback rate was reduced by 60% for Black male job candidates. In the city of Chicago, the negative impact of criminalization, and ultimately a criminal record, becomes evident in disproportionate unemployment rates. The ten Chicago community areas with the highest unemployment rates are each majority Black or Latino, according to 2015 data. These community areas have an unemployment rate of 22.4% and above, compared to a 12.1% average in the city. Four of these ten community areas (Roseland, West Englewood, Auburn Gresham, North Lawndale) are the same ones in which individuals are most often released from the justice system.

Health workforce development organization that focus efforts on ensuring that individuals with criminal records have access to health careers are engaged in important work; however, this back-end advocacy will do nothing to disrupt the disproportionate number of young people of color who are removed from classrooms throughout their early education. According to findings by the U.S. Department of Education’s Office of Civil Rights, over 70% of youth involved in school-related arrests or referred to law enforcement are Black or Latino. In order to understand the lack of racial and ethnic diversity in health careers, we must first understand the criminalization of people of color as a process – beginning as early as pre-kindergarten – that systematically removes potential candidates from health career pathways.

As the state’s population diversifies and there is an expansion of health career options, more opportunities emerge for individuals from underrepresented and underserved communities to consider entering health careers. But, all too often, underrepresented populations are overrepresented within neighborhoods with the fewest resources and the greatest likelihood of contact with the criminal justice system. It is the process of criminalization along the Criminalization Pipeline, rather than the actual criminal record itself that serves as a barrier to diversifying our health workforce.

Fortunately, the state of Illinois has taken legislative steps to ensure that individuals with records are more fully included in society, but there is still a long way to go. In order to ensure a qualified health workforce that reflects the community it serves, barriers to entry for careers in health, specifically criminalization of people of color, should be a priority. This series was written to encourage cross-sectoral communication around more equitable workforce programming, policy, and advocacy efforts in education, labor, health, and in the legal system. A broader and more inclusive discussion of these issues will allow us to come together in order to truly diversify the health workforce and address social inequities.