(Reuters Health) - Changing the criminal penalties for drug possession could reduce racial and ethnic disparities in the criminal justice system and indirectly reduce health disparities as well, researchers say.

The impact of felony drug convictions “on immigration status and access to jobs, health benefits, housing, and financial support for higher education may exacerbate racial/ethnic disparities in health and social outcomes,” they write in the American Journal of Public Health.

“Considering the substantial evidence of the role of social and economic factors in health outcomes, reducing incarceration and felony convictions through policy reform may be a critical component of addressing racial/ ethnic disparities in health,” they add. “Our findings suggest that reclassifying drug offenses to misdemeanors is an effective approach to decreasing felony arrests across racial/ethnic groups and absolute differences between Blacks and Whites.”

After California’s Proposition 47 passed, which reclassified felony drug offenses as misdemeanors in 2014, disparities in arrests dropped, the research team reports.

“The rise in incarceration that began in the 1970s had a hugely disproportionate impact on communities of color,” said lead study author Alyssa Mooney of the University of California in San Francisco in an email to Reuters Health.

Mooney and colleagues analyzed data from the California Department of Justice’s Monthly Arrest and Citations Register from 2011-2016 and compared racial and ethnic disparities between whites, blacks and Latinos, immediately and one year after policy changes.

During the five-year period, about 1 million drug arrests were made. In the month after Proposition 47 passed, absolute black-white disparities in monthly felony drug arrests fell from 81 to 44 per 100,000 and continued to decrease over time. Felony drug arrests among whites and Latinos were equivalent before and after the proposition.

“In the very first month, police practices appeared to change,” Mooney said. “Our laws and policies are enormously important in both producing and reducing inequalities in our society.”

A limitation of the study is that the arrest register didn’t include data about prior convictions, and race/ethnicity listed in the report may be based on officers’ observations, rather than self-reported.

Mooney and colleagues are now studying what happens beyond the arrest. They want to know how case dispositions have changed, if there has been a shift in the charges that prosecutors file and if the likelihood of a felony conviction is different.

“As a case proceeds in court, the charges, plea deals and alternatives to incarceration can vary by county and judicial circuit as well,” said Ojmarrh Mitchell of the University of South Florida in Tampa. Mitchell, who wasn’t involved with this study, researches racial disparities in drug arrests in Florida.

“The racial makeup of the local courthouse could affect decision-making,” he told Reuters Health by phone. “Courts with more racial diversity are likely to be more sensitive to racial disparities and reducing those disparities.”

It’s also important to track trends in arrests and whether law enforcement discretion is changing over time, said Magnus Lofstrom of the Public Policy Institute of California in San Francisco. Lofstrom, who wasn’t involved with this study, has published several reports about the effects of Proposition 47.

In June, Lofstrom and colleagues reported on the proposition’s impact on crime and recidivism. They found that rearrest and reconviction rates had dropped. They’re now tracking similar reforms across the country.

“Other states are discussing policy reform changes and many are moving in the direction of what we see in California,” he told Reuters Health by phone.

At the same time, researchers are concerned about disparities that persist after Proposition 47, said Rebecca Fielding-Miller of the University of California, San Diego. Fielding-Miller, who wasn’t involved with this study, is studying how bias during arrests and sentencing affects later opportunities for jobs, housing, and community.

“We know arrests are symptoms of a larger systemic cause, and passing a proposition can decrease felonies but won’t address the issue of embedded racial bias in our society,” she told Reuters Health by phone. “The more work we can do to describe the different aspects of that bias and think about different policy solutions, the better.”

SOURCE: bit.ly/2Ngg2Th American Journal of Public Health, online June 21, 2018.