Collateral consequences of the school-to-prison pipeline: Adolescent substance use and developmental risk
Seth J. Prins
Ruth T. Shefner
Sandhya Kajeepeta
Mark L. Hatzenbuehler
Charles C. Branas
SimpleOriginal

Summary

Exclusionary school discipline (e.g., suspension, expulsion, school policing) predicts higher student substance use and developmental risk the following year, identifying it as a key driver in adolescent health disparities.

2023

Collateral consequences of the school-to-prison pipeline: Adolescent substance use and developmental risk

Keywords School discipline; School-to-prison pipeline; Substance use; Mental health; Public health

Abstract

__## Objective __The adolescent health consequences of the school-to-prison pipeline remain underexplored. We test whether initiating components of the school-to-prison pipeline—suspensions, expulsions, and school policing—are associated with higher school-average levels of student substance use, depressed feelings, and developmental risk in the following year.

## Method We linked 2003–2014 data from the California Healthy Kids Survey and the Civil Rights Data Collection from over 4,800 schools and 4,950,000 students. With lagged multi-level models, we estimated relationships between the school prevalence of total discipline, out-of-school discipline, and police-involved discipline, and standardized school-average levels of 6 substance use measures and 8 measures of developmental risk, respectively.

## Results The prevalence of school discipline predicted subsequent school-mean substance use and developmental risk. A one-unit higher prevalence of total discipline predicted higher school levels (in standard deviations) of binge drinking alcohol (0.14, 95% CI: 0.11, 0.17), drinking alcohol (0.15, 95% CI: 0.12, 0.18), smoking tobacco (0.09, 95% CI: 0.06, 0.12), using cannabis (0.16, 95% CI: 0.14, 0.19), using other drugs (0.17, 95% CI: 0.14, 0.21), and violence/harassment (0.16, 95% CI: 0.12, 0.2). Total discipline predicted lower levels of reported community support (−0.07, 95% CI: −0.1, −0.05), feeling safe in school (-0.12, 95% CI: −0.16, −0.09), and school support (−0.16, 95% CI: −0.19, −0.12). Associations were greater in magnitude for more severe out-of-school discipline. Findings were inconsistent for police-involved discipline.

## Conclusion Exclusionary school discipline and school policing—core elements of the school-to-prison pipeline—are previously unidentified population predictors of adolescent substance use and developmental risk.

Highlights

  • Adolescent health consequences of exclusionary school discipline are underexplored.

  • We created an unprecedented dataset linking student health and discipline measures.

  • School prevalence of discipline predicted higher school-mean substance use.

  • School prevalence of discipline predicted lower school-mean social support.

  • Exclusionary discipline likely drives adolescent substance use/developmental risk.

1. Introduction

Despite broad recognition of the public health crisis caused by mass criminalization and mass incarceration in the United States (US, Cloud et al., 2014, Wildeman, 2011), less is known about the public health implications of an auxiliary trend: the school-to-prison pipeline. The school-to-prison pipeline describes a carceral turn in public education, in which schools criminalize and punish the behavior of some students—especially Black and Latinx students—rather than provide quality education and support for underlying social/emotional or developmental needs (Mallett, 2016). Initiating components of the school-to-prison pipeline include exclusionary discipline (suspension or expulsion) and police referrals/arrests in response to misbehavior. The pathways from school to the adult criminal legal system are empirically established (Bacher-Hicks et al., 2019, Hemez et al., 2020), as are the wide-ranging individual and community health consequences of exposure to the criminal legal system (Cloud et al., 2020, Hatzenbuehler et al., 2015, Kajeepeta et al., 2020, Kajeepeta et al., 2021), especially for substance use (e.g., Binswanger et al., 2013, Møller et al., 2010). However, the population health consequences of the school-to-prison pipeline remain underexplored. In the present study, we establish the first empirical evidence that the prevalence of exclusionary school discipline is a potential determinant of school levels of adolescent substance use and other developmental risk factors.

In a recent study of over 4,800 schools comprising 4.9 million students in California, we found that schools with students who had higher average levels of student substance use and depressed feelings, less school and community support, and lower feelings of school safety had a subsequently higher prevalence of exclusionary school discipline and school-based police contact (Authors, 2021). We theorized that exposure to high levels of suspension, expulsion, and police contact in schools likely creates or exacerbates material and psychosocial conditions conducive to adolescent substance use, mental health problems, and developmental risk. In the present study, we explore this hypothesis and establish the first empirical evidence that the prevalence of exclusionary school discipline is not only a consequence, but a potential determinant of, school levels of adolescent substance use and other developmental risk factors.

1.1. Public education in the carceral state

Economic austerity in the US has had profound effects on public education. Systematic disinvestment in social services and infrastructure, or “organized abandonment” (Gilmore, 2008, Harvey, 2018), exacerbated dramatic racial and class inequities in funding for public education and healthy child development (Chingos and Blagg, 2017, Giroux, 2013, Morgan and Amerikaner, 2018, Nguyen et al., 2020; Urban Institute, 2017). As with social policy more broadly (Scull & Wacquant, 2009), local, state, and federal government managed the consequences of austerity in education with investments in social control and punishment (Kupchik & Monahan, 2006), justified by racialized, largely manufactured crime panics (Welch, Price, & Yankey, 2002). As a result, schools have internalized carceral logics (Hirschfield, 2008, Kupchik and Monahan, 2006, Simon, 2007), as they increasingly function to manage, through criminalization, populations rendered surplus by the neoliberal transformation of the state (cf. Feeley and Simon, 1992, Wacquant, 2009).

This carceral turn in education increases adolescent criminalization in several ways, as school responses to student misbehavior have become more extreme and punitive (Hirschfield, 2008). “Zero tolerance” policies, or rules that require the use of exclusionary discipline regardless of the severity or context of misbehavior (American Psychological Association Zero Tolerance Task Force, 2008, Skiba and Knesting, 2001), were mandated in 75–90% of schools before the end of the 20th century (Mallett, 2016). Out-of-school suspension rates have more than doubled since the 1970s (Losen & Skiba, 2010), and students are more than twice as likely to be arrested in the month they are removed from school compared to months when they are not removed (Monahan, VanDerhei, Bechtold, & Cauffman, 2014). School securitization, including metal detectors, video surveillance, and police presence, has also increased dramatically (Mallett, 2016). Approximately 67% of high schoolers, 45% of middle schoolers, and 19% of elementary school students attended a school with at least one police officer present in the building in 2013–2014 (Lindsay, Lee, & Lloyd, 2018), and school-based arrests have increased 300–500% since the 1990s (Mallett, 2016).

Race and class disparities throughout the school-to-prison pipeline are profound. Black students, poor students, and students with disabilities are more likely to be disciplined than non-Black, wealthy, and non-disabled students (Fabelo et al., 2011, Freeman and Steidl, 2016). Black students are more than three times as likely to be suspended or expelled than white students, controlling for socioeconomic status and misbehavior (Okonofua et al., 2016, Wallace et al., 2008), and these racialized disparities likely contribute to the overrepresentation of Black people in the criminal legal system (Barnes and Motz, 2018, Rocque and Paternoster, 2011). At the school level, discipline and arrest rates are higher in districts with higher proportions of Black students and higher levels of disadvantage (Freeman and Steidl, 2016, Mendez et al., 2002).

1.2. Hypothesized adolescent substance use and mental health consequences of exclusionary school discipline

Adolescence is a critical developmental period for substance use initiation and psychiatric symptom incidence, and schools are the place that adolescents spend the majority of their time outside their homes (Ali et al., 2019, Dawson et al., 2008, Grant, 1998, Kessler et al., 2005, Kessler et al., 2007, King and Chassin, 2007, Solmi et al., 2022). By 12th grade, 40% of US adolescents have used an illegal drug in the past year (primarily cannabis), and roughly 17% of 12th graders reported binge drinking in the past two weeks (Johnston et al., 2021). However, in 2019, of the 1.1 million adolescents who needed substance use treatment, only 6% received it in a specialty facility, and fewer than 1 in 10 adolescents with a substance use disorder (SUD) reported any past-year treatment (Substance Abuse and Mental Health Services Administration. (2019), 2019).

Within this context, more than a third of US adolescents who do access any mental health treatment access it only at school; they are disproportionately Black and low-income (Ali et al., 2019). Schools are thus crucial intervention targets for substance use and mental health treatment and prevention, and health equity therein. But instead, more than 10 million students in the US attend schools with police but no counselor, nurse, psychologist, or social worker (Whitaker et al., 2019).

Theory and evidence suggest that exposure to criminalization is developmentally harmful and has adverse effects on adolescent substance use and mental health. For example, exposure to police stops increases trauma and anxiety symptoms among young men (Geller, Fagan, Tyler, & Link, 2014). Exposure to the criminal legal system can increase subsequent behavioral and substance use problems among adolescents (Huizinga, Henry, & Liberman, 2008). Students who attended schools with more severe exclusionary discipline policies had higher levels of depressive symptoms than students in schools with less severe exclusionary discipline policies (Eyllon, Salhi, Griffith, & Lincoln, 2020). And students who were subsequently suspended or expelled had nearly 50% higher odds of subsequent drug use compared with students who were not suspended or expelled (Dong & Krohn, 2020).

Finally, relationships with key supportive adults, such as teachers, are documented protective factors against adolescent substance use (Suldo, Mihalas, Powell, & French, 2008). Removing adolescents from school environments through exclusionary discipline, therefore, has the potential to exacerbate substance use risk, increase feelings of alienation and disengagement, and decrease feelings of social cohesion and physical safety in schools (Noltemeyer, Ward, & Mcloughlin, 2015).

1.3. Study hypotheses

Prior research provides some direct evidence for the individual- and institutional-level substance use and mental health consequences of exclusionary school discipline and the school-to-prison pipeline. In the present study, we add to the body of evidence about institutional relationships between adolescent criminalization and adolescent health. If school discipline and policing are conceptualized as institutional responses to organized abandonment, attendant disinvestment in adolescent health and developmental needs, and a mechanism of structural racism and criminalization (Gilmore, 2008, Hirschfield, 2008, Kupchik and Monahan, 2006), then we would expect exclusionary school discipline and policing to reproduce or exacerbate conditions harmful to adolescent health in ways apparent at the school level, not just the individual level.

To test this institutional-level hypothesis, we needed a unique data structure that contained school-level rather than student-level discipline data, as well as information on school-aggregate levels of student substance use, mental health, and developmental risk factors. We also needed school-district covariates. To ensure detectable variation in the associations between these variables, we also required a sufficiently large sample of schools. We created this data structure by linking multiple previously unconnected distinct sources, described below. Our hypothesis is that a higher prevalence of exclusionary school discipline and school-based police contact will be associated with subsequently higher school-aggregate levels of substance use, depressed feelings, and individual, peer, family, school, and community risk factors.

2. Method

2.1. Data

We connected 11 years of repeated cross-sectional California state data from three sources: adolescent health and wellbeing data from the statewide California Healthy Kids Survey (CHKS), school discipline prevalence data from the Civil Rights Data Collection (CRDC), and demographic data on California school districts from the American Community Survey (ACS).

For outcome measures, we used 11 consecutive years (2003–2005 through 2013–2014) of the CHKS, in which approximately 85% of public-school districts in California participate annually (surveys are typically conducted in 2-year cycles). The survey is the largest of its kind in the US, and asks students about their behavior, experiences, and attitudes related to their school, health, and well-being. The CHKS is administered anonymously to all 5th-, 7th-, 9th-, and 11th-grade students (Austin et al., 2011, Austin et al., 2013, Furlong et al., 2009, Hanson and Kim, 2007), and typically has a response rate greater than 70% (Austin, Hanson, & Polik, 2016). The sampling strategy and psychometric properties of CHKS measures have been described in-depth elsewhere (Austin and Duerr, 2004, Hanson and Austin, 2003, Hanson and Kim, 2007).

Exposure data come from the Civil Rights Data Collection (CRDC), a national survey of public schools in the US, which collects data on education and civil rights issues, including school discipline (Office for Civil Rights, 2018). Since 2011, the CRDC has surveyed designated school officials and official records from all public schools (N = 97,172) in the US (response rate = 98–100%)(Office for Civil Rights, 2016). Prior to 2011, the CRDC used a stratified random, representative sample of all US public schools.

Covariate data come from the American Community Survey (ACS) Education Tabulation, a custom tabulation of ACS data for the National Center for Education Statistics (NCES) (National Center for Education Statistics. (n.d.). American Community Survey – Education Tabulation (ACS-ED). Education Demographic and Geographic Estimates. Retrieved September 15 (2020)). The data files, which contain publicly available demographic data for US school districts, are based on ACS five-year estimates and are updated annually.

We linked NCES school identifiers in the CRDC with CHKS unique County-District-School (CDS) codes using a crosswalk developed by NCES. School district demographic data from the ACS were also linked using NCES school identifiers.

2.2. Measures

2.2.1. Adolescent substance use and developmental risk factors

For each measure described below, we calculated the mean or proportion of student responses within each school, since schools are the primary unit of analysis. We then standardized the measures (i.e., calculated Z-scores) across all schools by year. Table S1 presents item composition and scoring for each measure.

Substance use, depressed feelings. In the CHKS, students reported how many times, respectively, in the past 30 days they had at least one drink of alcohol, binge drank (defined as four drinks for girls and five drinks for boys per drinking occasion), used cannabis, smoked a cigarette, and used a variety of other drugs (smokeless tobacco, inhalants, cocaine, methamphetamines, or amphetamines, ecstasy, LSD, or other psychedelics, any other illegal drug). Alpha coefficients range from 0.90 to 0.98 (Hanson & Austin, 2003). Students also reported how many times in the past 30 days they felt depressed.

Community, home, peer, and school social support, and student resilience. Students reported, on a scale ranging from 0 (not at all true) to 3 (very true), whether they had support in their environments at home, in school, and in their community; support from and relationships with their friends; and their resilience, including items on self-efficacy, self-awareness, empathy, and problem-solving. We took the school mean of student responses to the items from each domain to create school-level summary measures, respectively, for community (8 items), home (8 items), peer (5 items), and school (9 items) social support, as well as student resilience (12 items). See online supplement Table S1 for the specific items in each of these domains. Alpha coefficients for these items ranged from 0.79 to 0.96 (Hanson & Austin, 2003).

Violence/harassment and school safety. Students reported how much they agreed that they felt safe in their schools and neighborhoods, scored from 1 (strongly disagree) to 5 (strongly agree). Students were also asked 18 questions about the number of times in the past 12 months they experienced violence and harassment in school, scored from 0 (zero times) to 3 (four or more times) (Russell, Sinclair, Poteat, & Koenig, 2012). See online supplement Table S1 for each of these items.

2.2.2. Exclusionary school discipline and police contact

We constructed three measures of school discipline based on item availability and our hypotheses about the health consequences of school discipline specifically, and the criminalization of students more broadly: total school discipline, out-of-school discipline only, and police-involved discipline.

The CRDC began collecting detailed school discipline data in 2009. Schools reported expulsions, out-of-school suspensions, in-school suspensions (when a student is removed from classes and activities but remains in the school building) and police-involved discipline (school-based arrests and police referrals). We divided the sum of these discipline measures by total enrollment to create a school-level total discipline prevalence proportion, covering the years 2009–2014. Before 2009, the CRDC collected data only on out-of-school-discipline, i.e., expulsions and out-of-school suspensions. To take complete advantage of all waves of available data, we created an out-of-school discipline prevalence proportion by dividing the sum of out-of-school-suspensions and expulsions by total enrollment. This measure covers the years 2003–2014. Finally, given the direct role that police play in student criminalization, we were interested in whether school policing alone predicted adolescent health outcomes. We created a school-level prevalence proportion of police-involved discipline (school-based arrests and police referrals) divided by total enrollment, covering the years 2009–2014.

2.2.3. Potential confounders

Since racialized group membership and class are strongly associated with school discipline and the school-to-prison pipeline (Mendez et al., 2002, Rocque and Paternoster, 2011), as well as systematic disinvestment in child health and development (García, 2015, Johnson-Staub, 2017), we hypothesized several school- and school-district-level variables would confound the relationships among school discipline/policing and adolescent health and development outcomes. These included the school percentage of Black students; school district median age and median income; as well as the percentages of school district residents that were unemployed, had a high school degree, and identified as Black. Bivariate models testing the association between these confounders and the school discipline exposure variables and substance use/developmental risk outcome variables, respectively, supported their inclusion as controls.

2.3. Analysis

We fit multi-level linear models regressing each standardized health and well-being factor on each one-year-lagged school discipline measure. Schools are the level one unit of analysis; schools were measured repeatedly over time (level 2). One-year lags were chosen to establish temporality. Models included random intercepts for school and controlled for year. In a second set of adjusted models, we added one-year-lagged confounding variables described above to each model. Models can be written as:

ytj = β00 + β10Xtj + u0j + etj

where ytj is the school-level value of a health and well-being outcome (e.g., binge drinking) for school j at time t, β00 is the average school mean outcome, Xtj is a vector of independent variables (the school discipline exposure as well as the confounding variables described above) for school j at time t, β10 is the vector of level-one fixed-effect parameters, u0j represents individual school deviations around the average school mean (allowing for each school to have its own intercept, and accounting for nonindependence of observations of the same school over time), and etj is the school j residual at time t (Bell & Jones, 2014; Diez Roux, 2002). The variance components are assumed to be normally distributed and independent (u0j N (0, σ2u) , etj N(0, σ2e ) (Bell & Jones, 2014; Diez Roux, 2002). For each of the 42 models presented below, we examined quantile-quantile and residual plots and found that model assumptions of homoscedasticity and normally distributed residuals were generally met, with some evidence of skewing due to the presence of outliers. Including the lagged outcome variable as an independent variable did not appreciable alter our findings.

Given that the outcome variables are standardized, model coefficients for the school discipline independent variables can be interpreted as the change in standard deviations of the outcome associated with a 1-unit increase in the prevalence of school discipline. All analyses were conducted in R version 3.6.

The study was approved by the Institutional Review Boards of Columbia University.

3. Results

Table 1 displays the grand average characteristics of schools in the sample. The analytic sample contained data from 4,840 schools, representing mean responses from 4,950,633 students. Students sampled were 30% white, 7.4% Black, 6.3% American Indian/Alaska Native, 10.6% Asian, 3.7% Native Hawaiian/Pacific Islander, and 43% Latinx. The mean school prevalence of total school discipline, out-of-school discipline, and police-involved discipline were 32%, 19%, and 2% respectively (Table 1). Figures S1-S4 present the means or proportions of all measures over time.

Table 1. Grand average characteristics of California schools in the sample.

Table 1 Grand average characteristics of California schools in the sample

Fig. 1 presents results from adjusted multi-level linear models regressing the six-substance use/depressed feelings measures on the three one-year-lagged school discipline measures (18 models total). Tables S3 and S4 present unadjusted and adjusted (respectively) coefficients, 95% CIs, and model fit statistics for each relationship. Adjusted estimates ranged from 0.09 (95% CI: 0.03, 0.14) for out-of-school discipline predicting subsequent school-mean-level of depressed feelings, to 0.39 (95% CI: 0.30, 0.48) for police-involved discipline predicting subsequent school-level cannabis use. In other words, a one-unit higher prevalence of police-involved discipline was associated with a 0.39 standard deviation higher school-mean level of cannabis use in the subsequent year.

Fig. 1. Results of 18 adjusted multi-level models regressing 6 standardized measures of substance use and depressed feelings on 3 lagged measures of school discipline.

Fig. 1. Results of 18 adjusted multi-level models regressing 6 standardized measures of substance use and depressed feelings on 3 lagged measures of school discipline.

After adjusting for school and school district confounders, higher total school discipline predicted subsequently higher school-mean levels of binge drinking alcohol, drinking alcohol, smoking tobacco, using cannabis, and using other drugs. Out-of-school discipline predicted subsequently higher binge drinking, depressed feelings, drinking alcohol, smoking tobacco, using cannabis, and using other drugs. Police-involved discipline predicted subsequently higher school-mean levels of drinking alcohol, using cannabis, and using other drugs.

Fig. 2 presents results from adjusted multi-level linear models regressing the eight developmental risk measures on the three one-year-lagged school discipline measures (24 models total). Tables S5 and S6 present unadjusted and adjusted (respectively) coefficients, 95% Cis, and model fit statistics for each relationship. Estimates ranged from −0.24 (95% CI: −0.39, −0.08) for out-of-school discipline and subsequent school-mean level of reported school support, to 0.28 (95% CI: 0.24, 0.33) for out-of-school discipline and subsequent school-level violence/harassment. In other words, a one-unit increase in the prevalence of out-of-school discipline was associated with a −0.24 standard deviation lower school-mean level of reported school support in the subsequent year.

Fig. 2. Results of 24 adjusted multi-level models regressing 8 measures of developmental risk on 3 lagged measures of school discipline.

Fig. 2. Results of 24 adjusted multi-level models regressing 8 measures of developmental risk on 3 lagged measures of school discipline.

In adjusted models, higher prevalence of total school discipline predicted lower school-mean levels of reported community support, feeling safe in school, school support, and higher school-mean levels of violence/harassment. Out-of-school discipline predicted lower subsequent school-mean levels of reported community support, feeling safe in school, school support, and higher school-mean levels of violence/harassment. Higher prevalence of police-involved discipline predicted lower subsequent school-mean levels of school support.

4. Discussion

We created an unprecedented longitudinal dataset linking statewide school discipline records and a statewide survey of student health and development from California, the state with the largest number of kindergarten-12th grade students in the US. We found that the prevalence of exclusionary school discipline (suspension and expulsion) and school-based police contact—initiating components of the school-to-prison pipeline—were associated with higher school-average levels of student substance use, depressed feelings, social support, and developmental risk factors in the following year.

Associations between total discipline and some outcomes were smaller than out-of-school discipline and confidence intervals sometimes included the null. This is likely because the total discipline measure included in-school suspensions, which are more common and less severe than out-of-school suspensions and expulsions. Findings for police-involved discipline were less consistent and warrant cautious interpretation; while the magnitudes of associations between police-involved discipline and many outcomes were often large (consistent with the hypothesized severity of this form of discipline), confidence intervals were wide and often included the null, indicating that estimates were imprecise. This is likely because police-involved discipline was rare relative to suspensions and expulsions. Findings for out-of-school discipline were more consistent and precise relative to total discipline and police-involved discipline, likely due in part because there were more waves of data available for this form of discipline.

While this institutional-level analysis does not permit inferences about individual-level pathways from suspension, expulsion, or school policing to negative adolescent health and developmental outcomes, our findings are nonetheless consistent with the view that as an educational paradigm, school discipline is not developmentally appropriate or responsive (and may be harmful) to adolescent health and developmental needs. At minimum, our findings suggest that schools that engage in more exclusionary discipline have students who, on average, subsequently engage in more substance use and have less community and school support.

Exposure to high levels of exclusionary discipline and policing in schools likely produces and reproduces material and psychosocial conditions that increase the risk of adolescent substance use and mental health problems, and erode social supports and healthy development (American Psychological Association Zero Tolerance Task Force, 2008). Meanwhile, heavy investments in school securitization and policing divert resources from school and community supports and services that might address the root causes of student disciplinary and health problems. For example 90% of students in public schools experience staffing ratios for counselor, nurse, psychologist, and social worker positions that fail to meet professional standards (Whitaker et al., 2019). Our findings support efforts to reduce schools’ reliance on exclusionary discipline and school-based policing in response to misbehavior, and instead invest in public health programs and personnel, including primary prevention and behavioral health services.

Our findings are subject to several limitations. First, the CRDC did not require data reporting on school discipline for years prior to the 2013–2014 school year. This missing data may be informative, if schools’ failure to report was related to high rates of discipline, or may be random, if some schools chose not to report due to unfamiliarity with the questions or procedures. Second, our analyses are limited by the information provided in the CRDC, which is self-reported by designated officials who may be motivated to underreport school discipline, which may make estimates conservative. Regarding school discipline, the CRDC does not include information on reasons for reported school discipline, specific disciplinary infractions, or severity of behaviors that resulted in disciplinary measures. Third, approximately 15% of schools in California are not included in the CHKS, which may contribute to either random or biased missingness. Further, CHKS is a school-based sample and therefore does not include adolescents who had already been suspended, expelled, or incarcerated. This underrepresentation may have resulted in more conservative estimates of substance use, depressed feelings, and risk and resilience factors reported in this study, as these outcomes are likely elevated among students who have experienced these forms of school discipline. Fourth, data from the CHKS are self-reported. Finally, because our data was aggregated to the school level, discipline prevalence ratios may reflect multiple suspensions, expulsions, or police contacts for the same student. However, we do not have any reason to believe that this would systematically bias other students’ responses to the CHKS. School-level aggregation also limits our ability to make conclusions about individual-level behavior or associations; at the same time, aggregation to the school level is appropriate for our research question, which seeks to examine institutional factors related to the school-to-prison pipeline. These limitations suggest that the relatively modest magnitudes of associations we found are likely conservative estimates. Nonetheless, even small effects can have a substantial impact when scaled over a large population of adolescents.

The purpose of the present study was to empirically establish school-level adolescent substance use, depressed feelings, and developmental risk factors as consequences of exclusionary school discipline and policing, known initiating components of the school-to-prison pipeline. As noted at the outset, there are strong theoretical reasons to believe, and initial evidence to suggest, that the relationships identified here are bidirectional, mutually compounding phenomena (Authors, 2021). Future research should identify the mechanisms for these bidirectional pathways and determine whether they remain consistent at the individual level. Moreover, it is likely the substance use and developmental risk outcomes mediate and modify each other with respect to school discipline. For example, it is possible that high rates of school discipline are worse for substance use outcomes in communities with less social support. Given the number of associations we tested, the distinct pathways through which these more complex relationships are likely to operate, and the limitations of our data, fully exploring these pathways was beyond the scope of the present paper, but should be tested in future research.

Further, existing empirical evidence and gray literature has documented the extent to which the school-to-prison-pipeline is an institutional mechanism of structural racism, given the profound racial disparities in the students it targets (Freeman & Steidl, 2016; Wallace, Jr. et al., 2008). In future research, we plan to determine the extent to which the associations identified in the present study are also racialized, and to what degree both the racialized criminalization of substance use and the consequences of community and school disinvestment help explain disparities in the school-to-prison pipeline.

This study found evidence that exclusionary school discipline and policing in schools—core elements of the school-to-prison pipeline—are a previously unidentified population predictors of adolescent substance use and developmental risk. As the social and health sciences continue to conduct research on the collateral consequences of mass criminalization and incarceration, they must also recognize schools as institutions that are implicated in the development and maintenance of carceral systems of control and the social production of poor health.

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Abstract

__## Objective __The adolescent health consequences of the school-to-prison pipeline remain underexplored. We test whether initiating components of the school-to-prison pipeline—suspensions, expulsions, and school policing—are associated with higher school-average levels of student substance use, depressed feelings, and developmental risk in the following year.

## Method We linked 2003–2014 data from the California Healthy Kids Survey and the Civil Rights Data Collection from over 4,800 schools and 4,950,000 students. With lagged multi-level models, we estimated relationships between the school prevalence of total discipline, out-of-school discipline, and police-involved discipline, and standardized school-average levels of 6 substance use measures and 8 measures of developmental risk, respectively.

## Results The prevalence of school discipline predicted subsequent school-mean substance use and developmental risk. A one-unit higher prevalence of total discipline predicted higher school levels (in standard deviations) of binge drinking alcohol (0.14, 95% CI: 0.11, 0.17), drinking alcohol (0.15, 95% CI: 0.12, 0.18), smoking tobacco (0.09, 95% CI: 0.06, 0.12), using cannabis (0.16, 95% CI: 0.14, 0.19), using other drugs (0.17, 95% CI: 0.14, 0.21), and violence/harassment (0.16, 95% CI: 0.12, 0.2). Total discipline predicted lower levels of reported community support (−0.07, 95% CI: −0.1, −0.05), feeling safe in school (-0.12, 95% CI: −0.16, −0.09), and school support (−0.16, 95% CI: −0.19, −0.12). Associations were greater in magnitude for more severe out-of-school discipline. Findings were inconsistent for police-involved discipline.

## Conclusion Exclusionary school discipline and school policing—core elements of the school-to-prison pipeline—are previously unidentified population predictors of adolescent substance use and developmental risk.

Summary

This study investigates the under-researched correlation between exclusionary school discipline and adolescent health outcomes. Utilizing a novel dataset linking student health and discipline data, the researchers analyzed the impact of school discipline prevalence on adolescent substance use and developmental risk factors.

Adolescent Health and Exclusionary School Discipline

The study highlights the public health implications of the school-to-prison pipeline, a phenomenon where schools utilize punitive measures instead of providing adequate support for students. While the individual and community health consequences of involvement with the criminal justice system are well-documented, the population health effects of the school-to-prison pipeline remain understudied. This research aimed to provide empirical evidence linking exclusionary school discipline to adolescent substance use and other developmental risk factors.

Public Education within a Carceral Framework

The researchers posit that economic austerity and disinvestment in public education have led to a "carceral turn," where schools increasingly employ criminalizing and punitive approaches. Zero-tolerance policies and increased school policing are identified as contributing factors. Significant racial and class disparities in disciplinary actions are also highlighted, with Black students disproportionately affected.

Hypothesized Consequences of Exclusionary Discipline

The study proposes that exposure to criminalization negatively impacts adolescent development, contributing to substance use and mental health issues. The crucial role of schools in adolescent development and access to mental health services is emphasized, noting the significant disparity in resources.

Methodology and Data Analysis

The researchers used a longitudinal dataset combining California Healthy Kids Survey (CHKS) data on adolescent health, Civil Rights Data Collection (CRDC) data on school discipline, and American Community Survey (ACS) data on school demographics. Multi-level linear models were employed to analyze the relationships between school discipline and various health and developmental outcome measures, controlling for potential confounders.

Results and Discussion

Analysis of data from nearly 5 million students in 4,840 California schools revealed significant associations between higher levels of school discipline (total discipline, out-of-school discipline, and police-involved discipline) and increased substance use, depressed feelings, decreased social support, and heightened developmental risks. While some associations showed larger effects than others, the overall findings suggest a detrimental impact of exclusionary school discipline on adolescent well-being.

Limitations and Future Research

The researchers acknowledge several limitations, including missing data in CRDC reporting and potential biases in self-reported data. Further, the school-level aggregation of data limits conclusions about individual-level causal relationships. Despite these limitations, the study emphasizes the importance of reducing reliance on exclusionary discipline and advocating for increased investment in public health programs and support services within schools. Future research should explore the mechanisms underlying these relationships, investigate racial disparities, and delve into more complex bidirectional pathways.

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Abstract

__## Objective __The adolescent health consequences of the school-to-prison pipeline remain underexplored. We test whether initiating components of the school-to-prison pipeline—suspensions, expulsions, and school policing—are associated with higher school-average levels of student substance use, depressed feelings, and developmental risk in the following year.

## Method We linked 2003–2014 data from the California Healthy Kids Survey and the Civil Rights Data Collection from over 4,800 schools and 4,950,000 students. With lagged multi-level models, we estimated relationships between the school prevalence of total discipline, out-of-school discipline, and police-involved discipline, and standardized school-average levels of 6 substance use measures and 8 measures of developmental risk, respectively.

## Results The prevalence of school discipline predicted subsequent school-mean substance use and developmental risk. A one-unit higher prevalence of total discipline predicted higher school levels (in standard deviations) of binge drinking alcohol (0.14, 95% CI: 0.11, 0.17), drinking alcohol (0.15, 95% CI: 0.12, 0.18), smoking tobacco (0.09, 95% CI: 0.06, 0.12), using cannabis (0.16, 95% CI: 0.14, 0.19), using other drugs (0.17, 95% CI: 0.14, 0.21), and violence/harassment (0.16, 95% CI: 0.12, 0.2). Total discipline predicted lower levels of reported community support (−0.07, 95% CI: −0.1, −0.05), feeling safe in school (-0.12, 95% CI: −0.16, −0.09), and school support (−0.16, 95% CI: −0.19, −0.12). Associations were greater in magnitude for more severe out-of-school discipline. Findings were inconsistent for police-involved discipline.

## Conclusion Exclusionary school discipline and school policing—core elements of the school-to-prison pipeline—are previously unidentified population predictors of adolescent substance use and developmental risk.

Summary

This study investigates the under-researched link between exclusionary school discipline and adolescent health outcomes. Researchers analyzed a large dataset linking student health and discipline data from California public schools. The findings reveal a significant correlation between the prevalence of exclusionary discipline (suspensions and expulsions) and increased substance use, depressed feelings, and reduced social support among students. The study suggests that exclusionary discipline contributes to, and may exacerbate, adolescent developmental risks.

Public Education within a Carceral System

The increasing criminalization of students within the US public education system, often referred to as the "school-to-prison pipeline," is examined. This trend, marked by punitive disciplinary measures and increased police presence in schools, disproportionately affects minority and low-income students. The study argues that this carceral approach to education stems from broader societal factors, including economic austerity and a shift towards social control mechanisms. This shift has led to increased rates of suspension, expulsion, and arrests within schools, exacerbating existing racial and socioeconomic inequities.

Hypothesized Consequences of Exclusionary Discipline

The study hypothesizes that exposure to exclusionary discipline negatively impacts adolescent mental and physical health. Given the crucial role schools play in adolescent development, the researchers posit that removing students from school through suspension or expulsion negatively affects their well-being and increases their risk for substance abuse and mental health issues. The loss of supportive adult relationships and the increased sense of alienation are highlighted as significant contributing factors.

Methodology

The study utilizes a unique dataset created by linking multiple sources of information, including the California Healthy Kids Survey (CHKS), the Civil Rights Data Collection (CRDC), and the American Community Survey (ACS). The CHKS provides data on student health and well-being, the CRDC offers school discipline data, and the ACS contributes demographic information. The researchers employed multi-level linear models to analyze the data, controlling for various confounding variables.

Results

Analysis of the data revealed significant associations between higher rates of school discipline (total discipline, out-of-school discipline, and police-involved discipline) and elevated levels of substance use, depressed feelings, decreased social support, and increased violence/harassment among students. While some associations were stronger than others, the overall findings pointed toward a consistent negative impact of exclusionary school discipline on adolescent well-being.

Discussion and Limitations

The study's findings reinforce the notion that exclusionary school discipline is not conducive to healthy adolescent development. The high rates of suspension and expulsion, coupled with increased police presence, create a negative environment that contributes to heightened substance use and mental health problems. Limitations of the study include data limitations (missing data, self-reported data), and the inability to draw individual-level conclusions. Despite these limitations, the study emphasizes the importance of reducing reliance on punitive disciplinary measures and investing in preventative and supportive services within schools. Future research needs to explore the racialized nature of these disparities and the bidirectional nature of the relationship between school discipline and student outcomes.

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Abstract

__## Objective __The adolescent health consequences of the school-to-prison pipeline remain underexplored. We test whether initiating components of the school-to-prison pipeline—suspensions, expulsions, and school policing—are associated with higher school-average levels of student substance use, depressed feelings, and developmental risk in the following year.

## Method We linked 2003–2014 data from the California Healthy Kids Survey and the Civil Rights Data Collection from over 4,800 schools and 4,950,000 students. With lagged multi-level models, we estimated relationships between the school prevalence of total discipline, out-of-school discipline, and police-involved discipline, and standardized school-average levels of 6 substance use measures and 8 measures of developmental risk, respectively.

## Results The prevalence of school discipline predicted subsequent school-mean substance use and developmental risk. A one-unit higher prevalence of total discipline predicted higher school levels (in standard deviations) of binge drinking alcohol (0.14, 95% CI: 0.11, 0.17), drinking alcohol (0.15, 95% CI: 0.12, 0.18), smoking tobacco (0.09, 95% CI: 0.06, 0.12), using cannabis (0.16, 95% CI: 0.14, 0.19), using other drugs (0.17, 95% CI: 0.14, 0.21), and violence/harassment (0.16, 95% CI: 0.12, 0.2). Total discipline predicted lower levels of reported community support (−0.07, 95% CI: −0.1, −0.05), feeling safe in school (-0.12, 95% CI: −0.16, −0.09), and school support (−0.16, 95% CI: −0.19, −0.12). Associations were greater in magnitude for more severe out-of-school discipline. Findings were inconsistent for police-involved discipline.

## Conclusion Exclusionary school discipline and school policing—core elements of the school-to-prison pipeline—are previously unidentified population predictors of adolescent substance use and developmental risk.

Summary

This study examines the connection between school discipline and adolescent health in California. Researchers linked student health survey data with school discipline records to analyze this relationship at the school level. The study found a correlation between higher rates of school discipline (especially out-of-school suspension and expulsion) and increased substance use, depression, and other developmental risks among students.

Public Education and the Carceral System

High rates of exclusionary discipline in schools may worsen existing societal inequalities in access to resources and support. The study suggests that punitive school policies, often disproportionately affecting minority students, create a negative cycle leading to further health and developmental problems. This is linked to broader trends of increased criminalization in education, driven partly by resource constraints and a focus on punishment rather than support.

Adolescent Substance Use and Mental Health

Adolescence is a crucial period for substance use initiation and mental health challenges. Schools play a significant role in adolescents' lives, making them important settings for intervention and prevention. However, the study highlights the negative impact of exclusionary discipline on adolescent well-being, potentially exacerbating existing risks and diminishing access to crucial support systems.

Study Hypotheses and Methods

The study hypothesized that high rates of exclusionary discipline would correlate with negative adolescent health outcomes at the school level. Researchers created a unique dataset by linking multiple data sources, including student health surveys, school discipline records, and school district demographics. Multi-level models were used to analyze the data, controlling for various factors like school demographics and socioeconomic status.

Results

The analysis revealed a significant association between higher rates of exclusionary discipline and increased substance use, depression, and other risk factors among students in the following year. While associations with total discipline were less pronounced, out-of-school discipline showed the strongest and most consistent relationship with negative outcomes. Police involvement in school discipline also showed a correlation with increased substance use, though with less precision due to its lower prevalence.

Discussion

The study’s findings suggest a need to shift away from punitive school discipline and towards increased investment in student support services. While the study focuses on school-level associations, the results indicate that high rates of exclusionary discipline create a detrimental environment that negatively impacts student well-being. The limitations of the study are acknowledged, including data limitations and potential biases in self-reported data. Further research is recommended to investigate the complex interplay between individual and institutional factors, including the role of race and socioeconomic status.

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Abstract

__## Objective __The adolescent health consequences of the school-to-prison pipeline remain underexplored. We test whether initiating components of the school-to-prison pipeline—suspensions, expulsions, and school policing—are associated with higher school-average levels of student substance use, depressed feelings, and developmental risk in the following year.

## Method We linked 2003–2014 data from the California Healthy Kids Survey and the Civil Rights Data Collection from over 4,800 schools and 4,950,000 students. With lagged multi-level models, we estimated relationships between the school prevalence of total discipline, out-of-school discipline, and police-involved discipline, and standardized school-average levels of 6 substance use measures and 8 measures of developmental risk, respectively.

## Results The prevalence of school discipline predicted subsequent school-mean substance use and developmental risk. A one-unit higher prevalence of total discipline predicted higher school levels (in standard deviations) of binge drinking alcohol (0.14, 95% CI: 0.11, 0.17), drinking alcohol (0.15, 95% CI: 0.12, 0.18), smoking tobacco (0.09, 95% CI: 0.06, 0.12), using cannabis (0.16, 95% CI: 0.14, 0.19), using other drugs (0.17, 95% CI: 0.14, 0.21), and violence/harassment (0.16, 95% CI: 0.12, 0.2). Total discipline predicted lower levels of reported community support (−0.07, 95% CI: −0.1, −0.05), feeling safe in school (-0.12, 95% CI: −0.16, −0.09), and school support (−0.16, 95% CI: −0.19, −0.12). Associations were greater in magnitude for more severe out-of-school discipline. Findings were inconsistent for police-involved discipline.

## Conclusion Exclusionary school discipline and school policing—core elements of the school-to-prison pipeline—are previously unidentified population predictors of adolescent substance use and developmental risk.

Summary

This study looked at how school rules and punishments affect kids' health and behavior. It used information from lots of California schools and students.

School Rules and Punishments

Researchers found that schools with more harsh punishments had kids who used more drugs and alcohol, felt sadder, and had less support from friends, family, and school. This suggests that strict rules might actually make things worse for kids.

The Study

The researchers collected information from a huge number of California schools over many years. They looked at how many kids got suspended or expelled and how many had police involvement. They also looked at how often kids used drugs and alcohol, felt depressed, and how much support they had.

Results

They found a connection: Schools with more punishments had kids who, on average, had more problems. For example, more suspensions meant more kids using drugs and feeling unsafe at school.

What This Means

This shows that harsh punishments in school might not be the best way to help kids. Instead, schools should focus on helping kids feel safe and supported. More help from counselors, nurses, and social workers could be better than just suspensions and expulsions.

Things to Keep in Mind

The study had some limitations. For example, not all schools provided information, and some information was based on what students said themselves. Despite these limitations, the results are still important because they show a big problem: how school rules can negatively affect student health and well-being.

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Footnotes and Citation

Cite

Prins, S. J., Shefner, R. T., Kajeepeta, S., Hatzenbuehler, M. L., Branas, C. C., Metsch, L. R., & Russell, S. T. (2023). Collateral consequences of the school-to-prison pipeline: Adolescent substance use and developmental risk. Addictive behaviors, 137, 107524.

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