The Consequences of Ending Cash Bail for Community Health Equity

Project Summary

Nearly 500,000 legally innocent people in the U.S. are currently in pretrial detention. The inability to afford bail prevents many from being released from jail pretrial, disproportionately impacting Black Americans and people living in poverty. Recent cash bail policies have been aimed at eliminating financial barriers to bail and reducing jail incarceration. This includes policies in New Jersey, which in 2017 implemented one of the most comprehensive pieces of bail reform legislation to date. The goal of the project is to provide advocates, practitioners, and policy makers across the U.S. with evidence about the community health effects of eliminating cash bail in order to equitably reduce pretrial detention in New Jersey and beyond.

Research Question(s)

  1. Did community health improve, worsen, or remain unchanged after New Jersey’s 2017 bail reform policy, compared to control states? Were improvements equal for Black and white residents?
  2. Does structural racism or the existing social service environment moderate the health effects of bail reform?


Provide policymakers and decarceration advocates across the U.S with evidence about the effect of New Jersey’s cash bail reform on community health.

Racial Equity Implications

Structural racism shapes every facet of the U.S. criminal legal system, including criminal law, policing, court processing, and incarceration. In 2017, New Jersey implemented one of the most comprehensive bail reforms to date (P.L. 2014, c.31). The law shifted the state away from a “resource-based” approach, in which 38% of the state’s jail population was held pretrial because they could not afford bail, to a “risk-based” approach that uses an empirical risk assessment tool to help determine whether someone is detained pretrial. The team’s proposed evaluation will support racial equity by shaping evidence-based policy and advocacy on cash bail policies, which, if designed and implemented equitably, have the potential to substantially reduce the footprint of the criminal legal system that disproportionately impacts Black Americans.


Health and wellbeing: drug and alcohol-related deaths, firearm violence and deaths, intimate partner violence, prenatal care utilization and birth outcomes (preterm birth and low birth weight).

Other: jail incarceration, socioeconomic stability (unemployment and evictions)


The team will use synthetic control methods to compare observed changes in health outcomes in New Jersey to a closely matched control group. To assess whether post-policy racial inequities in health outcomes are larger in or limited to counties where the policy differentially reduced white but not Black jail incarceration rates, the team will use a race-stratified interrupted time series approach to examine county-level changes in health outcomes before versus after the policy. To measure historical structural racism, the team will construct a measure of county-level structural racism to assess whether post-policy declines in race-specific jail incarceration rates and adverse health outcomes were larger in counties with higher levels of historical structural racism. Using data from the U.S. County Business Patterns administered by the Census Bureau, the team will also examine whether negative or null effects on racial health and jail incarceration inequities were more pronounced in counties with less robust social service and healthcare environments.

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Grantee and Partner organizations

Drexel University 
Boston University 
The Bail Project
District Attorney’s Transparency Analytics (DATA) Lab
Project Advisory Board

Grant status
In Progress
Principal investigators
Jaquelyn L. Jahn, MPH, PhD
Jessica T. Simes, MA, PhD
Start date
Award amount
24 months

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