School Health Predictors of the School-to-Prison Pipeline: Substance Use and Developmental Risk and Resilience Factors
Seth J. Prins
Sandhya Kajeepeta
Mark L. Hatzenbuehler
Charles C. Branas
Lisa R. Metsch
SimpleOriginal

Summary

In a COVID-19 hospital cohort, only 1.3% had substance use disorders, mostly alcohol-related. Though 26% developed severe pneumonia, none died, suggesting possible low incidence of severe COVID-19 among treated SUD patients.

2022

School Health Predictors of the School-to-Prison Pipeline: Substance Use and Developmental Risk and Resilience Factors

Keywords School discipline; Substance use; School-to-prison pipeline

Abstract

## Purpose The purpose of the study is to establish prospective relationships among school mean levels of substance use, developmental risk and resilience factors, and school discipline.

## Methods We linked 2003–2014 data from the California Healthy Kids Survey and the Civil Rights Data Collection, from more than 4,800 schools and 4,950,000 students. With lagged multilevel linear models, we estimated relationships among standardized school average levels of six substance use measures; eight developmental risk and resilience factors; and the prevalence of total discipline, out-of-school discipline, and police-involved discipline.

## Results School mean substance use and risk/resilience factors predicted subsequent prevalence of discipline. For example, a one–standard deviation higher school mean level of smoking, binge drinking, and cannabis use was associated, respectively, with 16% (95% confidence interval [CI]: 14%, 18%), 18% (95% CI: 16%, 20%), and 21% (95% CI: 19%, 23%) higher subsequent prevalence of total discipline. A one–standard deviation higher mean level of community support and feeling safe in school was associated, respectively, with 21% (95% CI: 18%, 23%) and 9% (95% CI: 7%, 11%) lower total discipline. Higher violence/harassment was associated with 5% (95% CI: 4%, 7%) higher total discipline. Peer and home support, student resilience, and neighborhood safety were not associated with total discipline. Nearly all associations remained, attenuated, when we restricted to out-of-school and police-involved discipline.

## Conclusions Schools with students who, on average, have higher substance use, less school and community support, and feel less safe in schools have a higher prevalence of school discipline and police contact. The public health implications of mass criminalization extend beyond criminal legal system settings and into schools.

Implications and Contribution

Using a data set linking student health and discipline measures, this study provides empirical evidence that schools' average levels of student substance use and developmental risk and resilience factors longitudinally predict school discipline and school-based police contact—outcomes that characterize the school-to-prison pipeline.

Over the past decade, the intersections of public health and mass incarceration have reached the forefront of public health discourse. Researchers and practitioners now understand that social determinants of health disparities (namely racism and social class) are intertwined with exposure to mass incarceration. Less has been documented, however, about the public health implications of a closely related trend, the school-to-prison pipeline, which describes a set of policies and practices that make it more likely for some adolescents to be criminalized and ensnared in the legal system than to receive a quality education. These policies and practices include zero-tolerance disciplinary policies; airport-style security and surveillance; increased presence of police in schools; and increased use of school discipline (suspensions, expulsions, and police referrals/arrests) in response to student misbehavior. However, more broadly, the school-to-prison pipeline, understood as auxiliary to mass incarceration, is one articulation of an expanded carceral state. The purpose of this study is to demonstrate a public health implication for these trends. We establish, for the first time, longitudinal relationships among school average levels of adolescent substance use and other developmental risk and resilience factors and the prevalence of school discipline—an initiating component of the school-to-prison pipeline.

The expanding carceral state, the school-to-prison pipeline, and school discipline

As a metaphor, the school-to-prison pipeline is constitutive of the neoliberal transformation of the state in the late 20th century and the “organized abandonment” it entailed. Government withdrew from social provision and managed the consequences of that retrenchment (poverty, unemployment, civil unrest, disinvestment in public education and public health, and so forth) by investing in systems of criminalization, behavioral surveillance, and punishment. From the perspective of a critical sociology of punishment, civic institutions, like schools, transformed to internalize carceral logics. The function of schools to educate, cultivate, and meet the cognitive, behavioral, and emotional health and developmental needs of students was displaced to administer the carceral flow of a racialized, criminalized population.

As a set of policies and practices, the school-to-prison pipeline comprises direct and indirect pathways from schools to the criminal legal system. The direct pathway is through the growing presence of police in schools. A new phenomenon beginning in the 1990s, there are now at least 20,000 police officers employed in schools nationwide, a nearly 40% increase from 1997. The number of school-based arrests increased 300%–500% since the 1990s, resulting in hundreds of thousands of referrals to the legal system each year. The indirect pathway is through substantial increases in the use of suspension and expulsion to deal with misbehavior in schools. Out-of-school suspensions have more than doubled over the past 40 years, and students are more than twice as likely to be arrested in the month they are removed from school compared with months when they are not removed. These policies have been borne disproportionately by adolescents of color. Black students are more than three times likely to be suspended or expelled than white students, controlling for socioeconomic status and misbehavior. Indeed, racialized disparities in school discipline likely contribute to the overrepresentation of Black people in the criminal legal system.

The growth and development of these direct and indirect pathways from schools to the criminal legal system was fueled by racialized, manufactured fears of “juvenile superpredators” and the introduction of “zero tolerance” policies in schools in the 1980s. Zero-tolerance policies, mirroring the U.S.'s “tough on crime” approach to politics and governance, mandate the use of exclusionary discipline (i.e., suspension, expulsion), often regardless of the severity of or context surrounding an incident. By 1997, 75%–90% of schools in the U.S. had enacted zero-tolerance policies. However, although the potential health and developmental implications of this carceral turn in public education have been theorized, they have been understudied empirically in population data.

Hypothesized adolescent health predictors of school discipline

Most empirical research on determinants of school discipline focuses on the role of economic disadvantage, racial composition of schools/communities, racially discriminatory application of school disciplinary policies, and teacher training. These studies find, for example, that schools in districts with higher levels of economic disadvantage have higher school discipline and arrest rates than those with less economic disadvantage and that poorer students are at greater risk for school discipline than wealthier students. Racialized disparities in school discipline are worse for black students in more integrated schools, and the proportion of black students in schools is positively associated (and the proportion of white students negatively associated) with school discipline rates.

Despite this substantial evidence for sociodemographic determinants, there is little epidemiological research on how public-health–related factors may pattern the distribution and determinants of school discipline. However, theory and evidence from previously unconnected bodies of research provide strong reasons to expect that the social determinants of adolescent health and well-being are intertwined with the social determinants of the school discipline component of the school-to-prison pipeline. For example, adolescent externalizing problems (e.g., disruptiveness, aggression) are highly comorbid with internalizing problems (e.g., depression and anxiety), and both are associated with substance use, which is a prototypical zero-tolerance infraction for school discipline/arrest. Externalizing problems and substance use, in turn, are associated with school truancy and arrest. Community economic disadvantage and exposure to violence are associated with childhood and adolescent behavior problems and substance use.

Moreover, there are numerous structurally distributed and socially determined developmental risk and resilience factors that likely play a role in school discipline. For example, supportive parenting practices were associated with lower likelihood of adolescent substance use and suspensions among a small sample of eighth-grade students. Peer attitudes toward substance use and peer misbehavior are predictors of adolescent substance use and suspension. School- and community-level supports such as positive school climate, student sense of belonging, and community youth programs positively influence adolescent health and may mitigate the harmful effects of school discipline [37].

However, prior research on these factors, in addition to only partially examining unconnected components of hypothesized pathways, primarily involves small or single cross-sectional samples, includes only self-reported school discipline measures, and/or permits only between-student (rather than between-school) comparisons. The latter limitation is particularly relevant because school discipline's role in the school-to-prison pipeline is theorized as an institutional mechanism of structural racism and criminalization. If, inter-relatedly, the school-to-prison pipeline is also an institutional mechanism for responding to adolescent health and developmental needs, we would expect schools with greater such needs to have higher levels of school discipline.

Because testing this hypothesis requires studying an institutional (schools) rather than an individual (students) level of analysis, we needed a unique data structure in which (1) student substance use and developmental risk and resilience factors could be aggregated to the school level, (2) these school-level aggregates could be combined with multiple sources of data on school prevalence of discipline and school district covariates, and (3) the number of schools was sufficiently large enough to ensure adequate variation in the predictors and outcomes. To our knowledge, such a data structure did not exist. We therefore created one by linking multiple data sources to establish empirical relationships between the aforementioned factors and school discipline/school police contact. We hypothesize that schools' average levels of substance use, depressed feelings, and individual, peer, family, school, and community risk and resilience factors will be associated with the prevalence of school discipline/school police contact.

Method

Data

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

The CRDC is the singular national survey of public schools in the U.S., collecting data on education and civil rights issues, including school discipline. Before 2011, the CRDC was a stratified random, representative sample of all U.S. public schools. Thereafter, the CRDC surveyed all public schools (N = 97,172 nationally). Responses come from designated school officials and official records (response rate = 98%–100%). Most research using the CRDC describes the sociodemographic variables that are associated with school discipline in a specific school year.

The CHKS is the largest survey of its kind in the U.S.: approximately 85% of public school districts in California participate. Districts administer the CHKS to all fifth-, seventh-, ninth-, and 11th-grade students, who participate anonymously. The survey asks about students' behavior, experiences, and attitudes related to their school, health, and well-being. The sampling strategy and psychometric properties of CHKS measures have been described in depth elsewhere. Average student response rates are typically >70%. We used 11 consecutive waves (2003–2005 through 2013–2014) of the CHKS.

The ACS Education Tabulation is a custom tabulation of ACS data for the National Center for Education Statistics (NCES) containing publicly available demographic data for U.S. school districts. The data files are updated annually and based on ACS five-year estimates.

The CRDC contains unique NCES school identifiers, which we matched to CHKS unique County-District-School codes, using tables provided by the NCES. We linked school district demographic data from the ACS by the NCES school identifier.

Measures

School discipline and police contact

We constructed three measures of school discipline from the CRDC: total discipline (our primary outcome of interest) and two components of total discipline: out-of-school discipline and police-involved discipline. We chose the latter two outcomes to take full advantage of the longitudinal structure of our data linkages and determine whether school policing is a distinct outcome.

Total school discipline 2009–2014

In 2009, the CRDC began collecting detailed information on school discipline. In addition to expulsions and out-of-school suspensions, schools reported total in-school suspensions and police-involved discipline (school-based arrests and police referrals). We divided the sum of in- and out-of-school suspensions, expulsions, and police-involved discipline by total enrollment to create a total discipline prevalence proportion.

Out-of-school discipline 2003–2014

Historically, the CRDC collected limited data on school discipline. Schools reported the total number of expulsions and out-of-school suspensions that occurred in the reporting period. We divided the sum of these totals by total enrollment to create out-of-school discipline prevalence proportions.

Police-involved discipline 2009–2014

Given the direct role that police play in criminalizing students, we were interested in whether police-involved discipline alone was predicted by adolescent health and well-being. We created prevalence proportions of school-based arrests and police referrals divided by total enrollment.

Adolescent substance use and developmental risk and resilience factors

Schools are the primary unit of analysis in this study; we calculated the school mean or proportion of student responses to each measure described in the following. To facilitate comparisons across measures, we then standardized those values (i.e., calculated Z-scores) across all schools for each survey year. In the following, we describe the raw items and measures before standardization. Table A1 presents item composition, scoring, means, and standard deviations for all measures.

Substance use and depressed feelings

The CHKS asks students how many times 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, or 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 .90 to .98. Students were also asked how many times in the past 30 days they felt depressed.

Community, home, peer, and school social support and student resilience

Students were asked several questions, scored from 0 (not at all true) to 3 (very true), about their home, school, and community environments; their friends; and themselves. We took the school mean of student responses to the items from each domain to create school-level summary measures for community (8 items), home (8 items), peer (5 items), and school (9 items) social support and student resilience (12 items). Example items for community support include the following: “Outside of home and school there is an adult who really cares about me,” and “…who tells me when I do a good job.” Example items for home support include the following: “A parent or adult in my home is interested in my schoolwork” and “…talks to me about my problems.” Example items for peer support include the following: “A peer my age really cares about me” and “…helps when I'm having a hard time.” School support items include the following “At my school, there is a teacher or some adult who listens when I have something to say” and “…notices when I'm not there.” Student resilience items represent self-efficacy, self-awareness, empathy, and problem-solving. Items include “I can work out my problems” and “I feel bad when someone gets their feelings hurt.” Alpha coefficients for these items ranged from .79 to .96.

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). Finally, students were asked 18 questions about the number of times in the past 12 months they experienced violence and harassment in schools, scored from 0 (zero times) to 3 (four or more times) [47]. Example items include having been shoved, slapped, hit, or kicked; been afraid of being beaten up; been in a physical fight; and had mean rumors or lies spread about them.

Potential confounders

Given the role of racism and social class in the school-to-prison pipeline, we theorized that several school-level and school-district–level variables confound the prospective relationships among adolescent health, risk/resilience factors, and school discipline. These included the school percentage of Black students; school district median age and median income; and the percentages of school district residents who were unemployed, had a high school degree, and identified as Black.

Analysis

In a first set of unadjusted models, we fit multilevel linear models regressing each school discipline measure on each standardized health and well-being factor, lagged by one year. These models included random intercepts for school and controlled for year. In a second set of adjusted models, we added the confounding variables described previously, lagged by one year, to each model. Model coefficients for standardized predictor variables can be interpreted as the change in outcomes associated with a one–standard-deviation increase in the predictor. All analyses were conducted in R, version 3.6.

The study was approved by Institutional Review Boards of Columbia University and University of Texas at Austin.

Results

After linking to the CRDC for the years 2003–2014, the CHKS contained data from 4,840 schools and 4,950,633 students. The sample of student respondents attending these California schools was 30% White, 7.4% Black, 6.3% American Indian/Alaska Native, 10.6% Asian, 3.3% Native Hawaiian/Pacific Islander, and 43% Latinx. The mean prevalence of out-of-school discipline, total school discipline, and police-involved discipline was 19%, 32%, and 2%, respectively (Table A2). Figures A1-A4 present the means or proportions of all measures over time.

Figure 1 presents results from 18 adjusted multilevel linear models regressing the three school discipline measures on the six standardized, lagged school-level measures of substance use and depressed feelings. Table A3 presents unadjusted and adjusted coefficients and 95% confidence intervals (CIs) for each relationship. Higher school mean levels of binge drinking, drinking, and tobacco, cannabis, and other drug use were associated with higher school prevalence of discipline measures in the subsequent year, relative to schools with lower mean levels of substance use.

Figure 1. Results of 36 adjusted linear multilevel models regressing three school discipline measures on six lagged measures of substance use and depressed feelings.

Figure 1. Results of 36 adjusted linear multilevel models regressing three school discipline measures on six lagged measures of substance use and depressed feelings.

Estimates for the associations between substance use and out-of-school discipline ranged from .02 (other drugs, 95% CI: .016, .03) to .05 (cannabis, 95% CI: .04, .06). That is, a one–standard-deviation higher school mean level of cannabis use was associated with a 5% higher prevalence of out-of-school discipline in the subsequent year. For total discipline, estimates ranged from .16 (smoked tobacco, 95% CI: .14, .18) to .21 (cannabis use, 95% CI: .19, .23). That is, a one–standard-deviation higher school mean level of tobacco use was associated with a 16% higher prevalence of total discipline in the subsequent year. For police-involved discipline, estimates for binge drinking and tobacco use were roughly .01 (95% CIs: .01, .02) after rounding and for cannabis, other drug, and alcohol use, approximately .02 with narrow CIs.

Figure 2 presents results from 24 adjusted multilevel linear models regressing the three measures of school discipline on the eight measures of risk and resilience factors. Table A4 presents unadjusted and adjusted coefficients and 95% CIs for each relationship. Schools with higher community and school support, and with more students reporting feeling safe in school, had lower prevalence of school discipline measures in the subsequent year. A higher school mean level of violence/harassment was associated with higher prevalence of school discipline measures in the subsequent year. Peer and home support, student resilience, and feeling safe in one's neighborhood were not associated with school discipline measures.

Figure 2. Results of 48 adjusted linear multilevel models regressing three measures of school discipline on eight lagged measures of risk and resilience.

Figure 2. Results of 48 adjusted linear multilevel models regressing three measures of school discipline on eight lagged measures of risk and resilience.

For out-of-school discipline, estimates ranged from -.02 (community support, 95% CI: -.02, -.01) to .01 (violence/harassment in school, 95% CI: .0, .01). Estimates for total discipline were stronger, ranging from -.19 (community support, 95% CI: -.22, -.16) to .06 (violence/harassment, 95% CI: .04, .08). For example, a one–standard-deviation higher school mean level of community support was associated with a 19% lower prevalence of total discipline in the subsequent year. For police-involved discipline, estimates ranged from -.02 (community support, 95% CI: -.02, -.01) to -.01 (school support, 95% CI: -.01, -.01).

Discussion

In a longitudinal data set linking school mean health and discipline measures across the most populous U.S. state, we provide the first empirical evidence that schools' average levels of student substance use and developmental risk and resilience factors are predictors of school prevalence of suspensions, expulsions, and school-based police contact—outcomes that characterize the school-to-prison pipeline. Our findings are consistent with theory and evidence from previously unconnected bodies of research that the social determinants of adolescent health and well-being are intertwined with the social determinants of the school-to-prison pipeline. Findings suggest that at an institutional level, schools with students who—on average—engage in more substance use, have less school and community support, and feel less safe in school have a higher prevalence of school discipline and school-based police contact. Future research should confirm whether this institutional pathway also reflects an individual-level pathway, by linking student-level health and discipline data.

Our main findings are as follows: (1) Schools with higher average levels of substance use had between 16% and 21% higher prevalence of total discipline in the subsequent year than schools with lower levels of substance use; (2) Schools with higher average levels of violence and harassment had 5% higher prevalence of subsequent total discipline than schools with lower levels of violence and harassment, and schools in which students reported higher average levels of feeling safe in school, school support, and community support had 9%–21% lower prevalence of total discipline. Nearly all associations remained, attenuated, when we restricted to out-of-school and police-involved discipline.

These findings are not surprising. However, the persistence and pervasiveness of the school-to-prison pipeline, and the school discipline practices that constitute it, suggest that it remains essential to provide social movements, policymakers, parents, teachers, and students with empirical evidence that challenges the assumption that these practices work as intended and without collateral consequences. These policies and practices may in fact criminalize and punish students with health and developmental needs.

It is likely that students exposed to material and psychosocial deprivations conducive to substance use and mental health problems are more likely to get into trouble at schools. It is also likely that they attend schools that rely on suspensions, expulsions, and police (rather than counselors, social-emotional learning specialists, or social workers) to manage the consequences of those very same material and psychosocial conditions. At the school and community levels, investments in school policing, school securitization, and criminalization likely come at a cost of disinvestment in school and community supports and services that could mitigate the root causes of disciplinary issues. For example, in New York City schools, there are twice as many police officers as social workers and psychologists combined and nearly twice as many police as school counselors. Indeed, in the present study, school and community support and feeling safe in school were negatively associated with school discipline and police contact, but home and peer support and student resilience were not associated with school discipline and police contact. This may suggest that the appropriate targets for intervention are community and school contexts, rather than peer or parent individual-level factors.

It is also likely that exposure to high levels of suspension, expulsion, and police contact in schools creates or exacerbates material and psychosocial conditions conducive to adolescent substance use, mental health problems, and worse developmental risk and resilience. For example, the American Psychological Association Zero Tolerance Task Force found that zero-tolerance policies, which result in school discipline/police contact, are developmentally inappropriate for adolescents and may “create, enhance, or accelerate negative mental health outcomes by increasing alienation, anxiety, rejection, and breaking of healthy adult bonds”. We plan to explore the potential for such reciprocal relationships in future research.

The purpose of the present study was to empirically establish school mean levels of adolescent substance use, depressed feelings, and developmental risk and resilience factors as independent predictors of a key component of the school-to-prison pipeline—school discipline and police contact. However, this is undoubtedly not the full story. Substantial empirical evidence and gray literature find flagrant racialized disparities in the school-to-prison pipeline, suggesting that the associations identified in the present study are also likely racialized. We plan to determine, in future research, the extent to which that is the case and whether the racialized criminalization of both substance use and the consequences of community and school disinvestment help explain these documented disparities.

Our findings should be interpreted considering several limitations. First, by aggregating to the school level, discipline prevalence proportions may reflect multiple suspensions, expulsions, or police contacts for the same student. However, we do not believe that the presence of such students in a school would systematically bias other students' responses to the CHKS. Second, the CRDC did not require data reporting on school discipline for years before 2013–2014, and roughly 15% of California schools did not participate in the CHKS, which may result in informative missingness for some schools (if their failure to report or participate was related to high rates of the outcome or predictors) and random missingness for other schools (if they chose not to report or participate due to unfamiliarity with survey procedures). Third, the CRDC does not contain information on the reasons for reported school discipline, specific discipline infractions, or the severity of the actual behaviors that triggered disciplinary measures. Fourth, the CHKS is a school-based sample and thus does not include adolescents who were not attending school; therefore, students who had already been suspended, expelled, or incarcerated are underrepresented, likely resulting in more conservative estimates for associations with substance use, depressed feelings, and risk and resilience factors reported herein. Fifth, we examined a large number of associations in this analysis, which increases the probability of finding some to be statistically significant even if the association is due to chance. However, given that we only tested strongly theorized relationships, we do not believe that the universal null hypothesis and thus adjustments for multiple comparisons were warranted. Finally, data from the CHKS are self-reported.

In conclusion, the present study demonstrates that the school-to-prison pipeline is intertwined with adolescent health and well-being. As a field now engaged in the study of mass incarceration and its collateral consequences, public health should extend its gaze beyond the walls of jails and prisons and into other institutions, particularly schools, where disinvestments in social and public health infrastructures are implicated in the processes of criminalization that contribute to an expanding carceral state.

Supplementary Data

Tables A1-A4 and Figures A1-A4.

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Abstract

## Purpose The purpose of the study is to establish prospective relationships among school mean levels of substance use, developmental risk and resilience factors, and school discipline.

## Methods We linked 2003–2014 data from the California Healthy Kids Survey and the Civil Rights Data Collection, from more than 4,800 schools and 4,950,000 students. With lagged multilevel linear models, we estimated relationships among standardized school average levels of six substance use measures; eight developmental risk and resilience factors; and the prevalence of total discipline, out-of-school discipline, and police-involved discipline.

## Results School mean substance use and risk/resilience factors predicted subsequent prevalence of discipline. For example, a one–standard deviation higher school mean level of smoking, binge drinking, and cannabis use was associated, respectively, with 16% (95% confidence interval [CI]: 14%, 18%), 18% (95% CI: 16%, 20%), and 21% (95% CI: 19%, 23%) higher subsequent prevalence of total discipline. A one–standard deviation higher mean level of community support and feeling safe in school was associated, respectively, with 21% (95% CI: 18%, 23%) and 9% (95% CI: 7%, 11%) lower total discipline. Higher violence/harassment was associated with 5% (95% CI: 4%, 7%) higher total discipline. Peer and home support, student resilience, and neighborhood safety were not associated with total discipline. Nearly all associations remained, attenuated, when we restricted to out-of-school and police-involved discipline.

## Conclusions Schools with students who, on average, have higher substance use, less school and community support, and feel less safe in schools have a higher prevalence of school discipline and police contact. The public health implications of mass criminalization extend beyond criminal legal system settings and into schools.

Summary

This study investigates the relationship between adolescent health factors and school discipline, a key component of the school-to-prison pipeline. Researchers examined longitudinal data from California, linking school discipline rates with student health and well-being data. The study's aim was to empirically demonstrate the association between school-level adolescent health indicators and the prevalence of school discipline, offering novel insights into the public health implications of the school-to-prison pipeline within the broader context of the expanding carceral state.

The Expanding Carceral State, the School-to-Prison Pipeline, and School Discipline

The school-to-prison pipeline is analyzed as a manifestation of neoliberal state transformations, characterized by reduced social provision and increased investment in criminalization and punishment. This shift has led to the adoption of carceral logics within civic institutions like schools, prioritizing discipline and control over educational and developmental needs. The pipeline operates through direct pathways (increased police presence in schools) and indirect pathways (increased suspensions and expulsions). These trends disproportionately affect adolescents of color, exacerbating existing racial disparities within the criminal legal system. Zero-tolerance policies, introduced in the 1980s, have significantly contributed to this phenomenon.

Hypothesized Adolescent Health Predictors of School Discipline

Existing research primarily focuses on sociodemographic factors influencing school discipline. This study expands upon this by investigating the role of public health-related factors. The study posits that adolescent externalizing problems, substance use, and related risk and resilience factors are intertwined with school discipline. Structurally distributed developmental factors, including parenting practices, peer influence, and school/community support, are also considered as potential predictors. Previous research limitations, such as small sample sizes and lack of longitudinal data, are addressed by the study's unique data structure and analytical approach.

Method

The study utilized a unique data set combining 11 years of repeated cross-sectional data from three sources: the Civil Rights Data Collection (CRDC), the California Healthy Kids Survey (CHKS), and the American Community Survey (ACS). These data sources were linked using unique school identifiers to create a comprehensive data structure. Measures included various school discipline indicators (total discipline, out-of-school discipline, police-involved discipline), adolescent substance use, depressed feelings, and developmental risk/resilience factors. Multilevel linear models were employed to analyze the relationships between these variables, controlling for potential confounders such as school demographics and district-level factors.

Results

The analysis encompassed 4,840 schools and over 4.9 million students. Results showed significant associations between higher school-level averages of substance use and higher subsequent school discipline rates. Conversely, higher levels of community and school support, and increased student perceptions of safety, were associated with lower discipline rates. Violence and harassment were positively associated with school discipline.

Discussion

The study provides empirical evidence supporting the interconnectedness of adolescent health, well-being, and the school-to-prison pipeline. Findings highlight the influence of school-level average substance use and risk/resilience factors on school discipline rates, suggesting that schools with higher average levels of student substance use and lower levels of support experience higher rates of discipline. The study emphasizes the need for interventions focused on community and school contexts to mitigate the root causes of disciplinary issues and underscores the potential negative consequences of current school discipline policies and practices. Limitations of the study are acknowledged, including data aggregation and potential bias due to missing data and self-reported measures. Future research will address these limitations and further investigate racial disparities within the school-to-prison pipeline.

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Abstract

## Purpose The purpose of the study is to establish prospective relationships among school mean levels of substance use, developmental risk and resilience factors, and school discipline.

## Methods We linked 2003–2014 data from the California Healthy Kids Survey and the Civil Rights Data Collection, from more than 4,800 schools and 4,950,000 students. With lagged multilevel linear models, we estimated relationships among standardized school average levels of six substance use measures; eight developmental risk and resilience factors; and the prevalence of total discipline, out-of-school discipline, and police-involved discipline.

## Results School mean substance use and risk/resilience factors predicted subsequent prevalence of discipline. For example, a one–standard deviation higher school mean level of smoking, binge drinking, and cannabis use was associated, respectively, with 16% (95% confidence interval [CI]: 14%, 18%), 18% (95% CI: 16%, 20%), and 21% (95% CI: 19%, 23%) higher subsequent prevalence of total discipline. A one–standard deviation higher mean level of community support and feeling safe in school was associated, respectively, with 21% (95% CI: 18%, 23%) and 9% (95% CI: 7%, 11%) lower total discipline. Higher violence/harassment was associated with 5% (95% CI: 4%, 7%) higher total discipline. Peer and home support, student resilience, and neighborhood safety were not associated with total discipline. Nearly all associations remained, attenuated, when we restricted to out-of-school and police-involved discipline.

## Conclusions Schools with students who, on average, have higher substance use, less school and community support, and feel less safe in schools have a higher prevalence of school discipline and police contact. The public health implications of mass criminalization extend beyond criminal legal system settings and into schools.

Summary

Over the past decade, the relationship between public health and mass incarceration has become a significant area of study. Research highlights the connection between social determinants of health (racism and social class) and exposure to incarceration. However, the public health implications of the school-to-prison pipeline—a system contributing to adolescent criminalization—remain less documented. This study investigates the longitudinal relationships between school-level adolescent substance use, developmental factors, and the prevalence of school discipline, a key component of the school-to-prison pipeline.

The Expanding Carceral State and School Discipline

The school-to-prison pipeline exemplifies the neoliberal state's shift towards criminalization and surveillance. Governmental withdrawal from social programs led to increased investment in systems of punishment, impacting civic institutions like schools. Schools, instead of prioritizing education and student well-being, increasingly adopted carceral logics.

Pathways to the Criminal Legal System

The school-to-prison pipeline operates through direct and indirect pathways. Directly, increased police presence in schools and higher arrest rates contribute to legal system involvement. Indirectly, increased suspensions and expulsions push students towards the legal system, disproportionately affecting students of color. These trends were fueled by anxieties surrounding "juvenile superpredators" and the adoption of zero-tolerance policies.

Adolescent Health and School Discipline

Existing research focuses on socioeconomic factors and racial disparities in school discipline. This study explores the role of public health-related factors, proposing that adolescent health and well-being are linked to school discipline. Factors such as externalizing and internalizing problems, substance use, and community conditions influence the likelihood of school discipline. Supportive environments, conversely, may mitigate these risks.

Methods and Data

This study utilized longitudinal data from California, linking school discipline data (Civil Rights Data Collection), adolescent health data (California Healthy Kids Survey), and demographic data (American Community Survey). The analysis involved multilevel linear models examining the relationship between school-level aggregates of adolescent health factors and school discipline measures, controlling for confounding variables.

Results

Analysis of data from nearly 5 million students across 4840 schools revealed significant associations. Higher school-level substance use correlated with increased school discipline. Conversely, greater school and community support and higher feelings of safety were associated with lower discipline rates. These findings held across different discipline measures (out-of-school, total, and police-involved).

Discussion

This study provides empirical evidence linking adolescent health and well-being to the school-to-prison pipeline. Schools with higher rates of substance use and lower levels of support experienced increased discipline. The findings highlight the need to address the underlying social determinants contributing to both adolescent health problems and the school-to-prison pipeline. Future research should explore individual-level pathways and racial disparities. Limitations include data aggregation, missing data, and reliance on self-reported data. The study concludes by emphasizing the need for public health to address the school-to-prison pipeline, advocating for investment in supportive services over punitive measures.

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Abstract

## Purpose The purpose of the study is to establish prospective relationships among school mean levels of substance use, developmental risk and resilience factors, and school discipline.

## Methods We linked 2003–2014 data from the California Healthy Kids Survey and the Civil Rights Data Collection, from more than 4,800 schools and 4,950,000 students. With lagged multilevel linear models, we estimated relationships among standardized school average levels of six substance use measures; eight developmental risk and resilience factors; and the prevalence of total discipline, out-of-school discipline, and police-involved discipline.

## Results School mean substance use and risk/resilience factors predicted subsequent prevalence of discipline. For example, a one–standard deviation higher school mean level of smoking, binge drinking, and cannabis use was associated, respectively, with 16% (95% confidence interval [CI]: 14%, 18%), 18% (95% CI: 16%, 20%), and 21% (95% CI: 19%, 23%) higher subsequent prevalence of total discipline. A one–standard deviation higher mean level of community support and feeling safe in school was associated, respectively, with 21% (95% CI: 18%, 23%) and 9% (95% CI: 7%, 11%) lower total discipline. Higher violence/harassment was associated with 5% (95% CI: 4%, 7%) higher total discipline. Peer and home support, student resilience, and neighborhood safety were not associated with total discipline. Nearly all associations remained, attenuated, when we restricted to out-of-school and police-involved discipline.

## Conclusions Schools with students who, on average, have higher substance use, less school and community support, and feel less safe in schools have a higher prevalence of school discipline and police contact. The public health implications of mass criminalization extend beyond criminal legal system settings and into schools.

Summary

Over the past decade, the link between public health and mass incarceration has become a major focus. Researchers now understand that social factors like racism and poverty contribute to both health disparities and incarceration rates. However, the school-to-prison pipeline—policies and practices pushing adolescents toward the legal system instead of education—needs more attention. This includes zero-tolerance policies, increased security, more police in schools, and harsher discipline for misbehavior. This study aims to show the public health consequences of these trends by examining the relationship between school disciplinary actions and adolescent substance use and other developmental factors.

The Expanding Carceral State and School Discipline

The school-to-prison pipeline reflects a shift towards a more punitive society. Governments reduced social services, leading to increased investment in criminal justice systems and surveillance. Schools adapted, prioritizing discipline and control over education and student well-being. This created direct (police in schools) and indirect (increased suspensions and expulsions) pathways from schools to the legal system. These pathways disproportionately affect minority students, particularly Black students, who are far more likely to face suspension or expulsion than white students.

Adolescent Health and School Discipline

Most research on school discipline focuses on poverty and racial bias. However, this study examines how public health factors influence school discipline. Adolescent behavioral problems, substance use, and mental health issues are connected. Economic disadvantage and exposure to violence also contribute to these issues, influencing a student's likelihood of facing school discipline. Supportive environments (family, peers, school, and community) help mitigate these risks. Previous research often uses small samples and doesn't fully consider the school as an institution. This study addresses these limitations by using a unique data set.

Methods

This study linked eleven years of California data from three sources: school discipline data (Civil Rights Data Collection or CRDC), adolescent health data (California Healthy Kids Survey or CHKS), and school district demographics (American Community Survey or ACS). The CRDC provides school discipline information. The CHKS surveys students on behavior, experiences, and well-being. The ACS offers demographic data on school districts. These datasets were linked using school identifiers.

Measures

The study used several measures of school discipline: total discipline, out-of-school discipline, and police-involved discipline. Adolescent health factors included substance use (alcohol, cannabis, tobacco, other drugs), depressed feelings, and various risk and resilience factors (community, home, peer, and school support; violence/harassment; school safety). Confounding variables included racial demographics and socioeconomic status of schools and districts. Multilevel linear models analyzed the data, accounting for school-level variations.

Results

The study analyzed data from nearly 5 million students in 4,840 California schools. Higher average student substance use in a school was linked to a higher prevalence of school discipline the following year. Schools with more violence and harassment also had increased discipline rates. Conversely, stronger community and school support, along with students feeling safer, were linked to lower discipline rates. These relationships held even after accounting for factors like race and socioeconomic status.

Discussion

This study provides evidence linking school discipline rates to average student substance use and other developmental factors. Schools with students who, on average, had more substance use issues, less support, and felt less safe experienced higher discipline rates. Future research needs to confirm if these institutional-level findings also apply at the individual student level. The school-to-prison pipeline potentially criminalizes students with unmet health and developmental needs. This highlights the need for increased community and school support services. There are limitations such as the aggregation of data to the school level and potential biases in data collection.

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Abstract

## Purpose The purpose of the study is to establish prospective relationships among school mean levels of substance use, developmental risk and resilience factors, and school discipline.

## Methods We linked 2003–2014 data from the California Healthy Kids Survey and the Civil Rights Data Collection, from more than 4,800 schools and 4,950,000 students. With lagged multilevel linear models, we estimated relationships among standardized school average levels of six substance use measures; eight developmental risk and resilience factors; and the prevalence of total discipline, out-of-school discipline, and police-involved discipline.

## Results School mean substance use and risk/resilience factors predicted subsequent prevalence of discipline. For example, a one–standard deviation higher school mean level of smoking, binge drinking, and cannabis use was associated, respectively, with 16% (95% confidence interval [CI]: 14%, 18%), 18% (95% CI: 16%, 20%), and 21% (95% CI: 19%, 23%) higher subsequent prevalence of total discipline. A one–standard deviation higher mean level of community support and feeling safe in school was associated, respectively, with 21% (95% CI: 18%, 23%) and 9% (95% CI: 7%, 11%) lower total discipline. Higher violence/harassment was associated with 5% (95% CI: 4%, 7%) higher total discipline. Peer and home support, student resilience, and neighborhood safety were not associated with total discipline. Nearly all associations remained, attenuated, when we restricted to out-of-school and police-involved discipline.

## Conclusions Schools with students who, on average, have higher substance use, less school and community support, and feel less safe in schools have a higher prevalence of school discipline and police contact. The public health implications of mass criminalization extend beyond criminal legal system settings and into schools.

Summary

Many kids end up in trouble with the law because of the way schools handle problems. This is called the school-to-prison pipeline. Things like strict rules and lots of police in schools can lead kids to get suspended, expelled, or even arrested instead of getting help. This study looked at how things like drug use, feeling sad, and lack of support at school and home affect how often kids get in trouble at school.

The School-to-Prison Pipeline

The school-to-prison pipeline is like a path that leads some kids from school to jail. Schools are supposed to teach and help kids, but sometimes they focus too much on punishment. Having police in schools and strict rules means more kids get in trouble and end up in the legal system.

What Makes Kids Get in Trouble at School?

Lots of things can affect whether a kid gets in trouble at school. Studies show that kids from poor families or from certain racial groups are more likely to face school discipline. This study also looked at how a kid's health and well-being, such as drug use and how much support they get at home and school, might play a role.

The Study

Researchers studied lots of California schools and kids to see if there was a link between kids' behavior and the number of students who got in trouble at school. They looked at things like how often kids used drugs and alcohol, how often kids felt sad or down, and how much support kids got from their families, friends, and schools.

Results

The study showed that schools with more kids who used drugs or alcohol had more kids getting in trouble. Also, schools where kids felt unsafe or didn't have much support tended to have more kids getting suspended or arrested.

What it Means

This study shows that how schools handle things is connected to kids' health and well-being. Schools need to focus on helping kids, not just punishing them. Supporting kids and their families is important to prevent problems before they lead to trouble with the law.

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Footnotes and Citation

Cite

Prins, S. J., Kajeepeta, S., Hatzenbuehler, M. L., Branas, C. C., Metsch, L. R., & Russell, S. T. (2022). School health predictors of the school-to-prison pipeline: substance use and developmental risk and resilience factors. Journal of Adolescent Health, 70(3), 463-469.

    Highlights