Skip to main content
Open Access Publications from the University of California


UC San Francisco Electronic Theses and Dissertations bannerUCSF

Proposition 47: Effects of a California Drug Law Reform on Hospital Visits and Racial and Geographic Disparities in Criminal Justice Involvement


Disparate rates of felony drug arrests and convictions across race and geography have implications for inequalities in health and social outcomes linked to criminal justice exposure. California Proposition 47 (Prop 47), passed in 2014, reduced drug possession offenses classified as felonies or wobblers (with prosecutorial discretion to file felony or misdemeanor charges) to misdemeanors. This dissertation examines three effects of Prop 47: 1) whether racial/ethnic disparities in drug arrests declined; 2) whether eliminating prosecutorial discretion for charging drug possession as a felony or misdemeanor reduced geographic disparities in felony convictions; and 3) unintended consequences with regards to drug-related hospital visits. For objective 1: using data on all drug arrests made in California from 2011-2016, we compared the immediate and one year post-policy changes in racial disparities in drug arrests between Whites, Blacks, and Latinos, controlling for secular and seasonal trends. For objective 2: after propensity score matching arrests made in the year after the implementation of Prop 47 to similar arrests in the year prior to Prop 47, we used mixed models to estimate the change in county variance in the probability of felony conviction. For objective 3: Incorporating data on all drug-related hospital visits in California from 2011-2015 with drug arrests data, we use county fixed effects models to estimate expected rates in the 10-months post-policy, and calculate the difference compared to observed rates. We use linear regression to test whether county-level changes in drug arrest rates were associated with changes in drug-related hospital visit rates. In the month following passage, absolute Black-White disparities in monthly felony drug arrests decreased from 81 to 44 per 100,000 and continued to decrease over time. The probability of a felony conviction among those arrested for Prop 47 drug offenses declined by 14 percentage points (95% CI: -0.16, -0.12), from 0.21 (95% CI: 0.19, 0.24) to 0.07 (95% CI: 0.06, 0.08). Counties with higher felony conviction probabilities pre-Prop 47 declined most, reducing cross-county variance, with no evidence of increases in felony convictions for concurrent offenses. Declines in arrests were not associated with increases in drug-related hospital visits.

Main Content
For improved accessibility of PDF content, download the file to your device.
Current View