The impact of a health equity and criminal justice public health concentration among clinical students at Touro University California

Most healthcare professionals encounter patients with a history of incarceration while practicing medicine; yet there is limited research on provider attitudes towards this population. In 2019, Touro University California’s (TUC) Masters in Public Health (MPH) Program launched a concentration in Health Equity and Criminal Justice (HECJ) that examines the health impacts of incarceration on individuals, families, and communities. Our mixed-method study examined perspectives on stigmatizing attitudes among 329 clinical students in TUC’s Physician Assistant, Pharmacy, and Osteopathic Medicine programs in the context of MPH and HECJ instruction. We created an online survey with an adapted stigma scale, performed exploratory factor analysis and bivariate and multivariate regression analyses, and coded responses to open-ended survey questions for themes. We found three distinct factors in the stigma scale and marked differences in reported stigmatizing attitudes when students were asked about professional versus private relationships. We observed lower stigma scores among clinical students also completing an MPH degree, with the lowest scores among those in the HECJ concentration. Our findings suggest that educating clinical students about the criminal justice system may help reduce stigma, which could contribute to improvements in care quality and public health.