Health, Homelessness, and Criminal Justice (HHCJ)

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Co-Director

Dr. Kate Diaz Vickery is the Co-Director of the Health, Homelessness, and Criminal Justice Lab

Clinical Profile

PubMed

@katediazvickery

email:
Katherine.Vickery@hcmed.org

Dr. Vickery bio:

Dr. Vickery is a primary care doctor at Hennepin County Health Care for the Homeless. She holds a medical degree from the University of Rochester and Master’s of Science in Health and Health Care Research from the University of Michigan where she completed the Robert Wood Johnson Foundation Clinical Scholars fellowship.

Dr. Vickery believes research is stronger when done in partnership with multiple stakeholders, especially patients, families, and community leaders. Her work currently uses mixed methods to try to improve the health of people experiencing homelessness, especially those juggling overlapping chronic physical, mental health, and substance use conditions.

Co-Director

Dr. Tyler Winkelman is the Co-Director of the Health, Homelessness, and Criminal Justice Lab

Clinical Profile

PubMed

@tylerwinkelman

email: tyler.winkelman@hcmed.org

Dr. Winkelman bio:

Dr. Winkelman is a primary care doctor at Hennepin Healthcare and the Hennepin County Jail. He is also the Associate Director of the Hennepin Healthcare Research Institute Virtual Data Warehouse. He holds a medical degree from the University of Minnesota and a Master’s of Science in Health and Health Care Research from the University of Michigan where he completed a Robert Wood Johnson Foundation Clinical Scholars fellowship.

Dr. Winkelman studies issues at the intersection of health care and criminal justice systems, with a particular focus on substance use disorders, Medicaid, and access to care. Much of Dr. Winkelman’s work includes data integration across systems and sectors to solve problems that require a collaborative, multi-stakeholder approach.

Health, Homelessness, and Criminal Justice (HHCJ)

Addressing the complex drivers of health through research and collaboration

@HHCJ_Lab

email: HHCJLab@hhrinstitute.org

The Health, Homelessness, and Criminal Justice Lab (HHCJ), a division of the Hennepin Healthcare Research Institute, conducts research studies that address the complex drivers of health. We focus on the health impacts of homelessness and criminal justice involvement.

We study the overlap of homelessness and criminal justice involvement with chronic physical, mental and substance use conditions and with other systemic barriers to health and wellbeing, like structural racism.

Our overarching goal is to improve health inequities in our community and across the United States through research and collaboration with a broad coalition of partners.

Watch Dr. Vickery’s recent presentation

Watch recent presentation from HHCJ collaborator Dr. McPherson

Program Areas

Health:

Our lab’s research explores how the social drivers of health interact with combinations of physical, mental, and substance use conditions and the integrated solutions needed to reduce health inequities. Our research methods include clinical trials; cross-sector data linkage studies that combine health care data with social service, housing, and criminal justice data; and community-engaged research projects, in which we work closely with people with lived experience to plan, implement, and disseminate research.

Homelessness:

People experiencing unstable housing are at higher risk of many chronic and acute health conditions. Managing these conditions can be particularly difficult without stable housing. Our research strives to support people experiencing homelessness manage their chronic diseases including by helping them to find secure, safe housing.

Criminal Justice:

Individuals involved in the criminal justice system have unique health needs while incarcerated, on community supervision, and after release. Similar to people experiencing homelessness, they are at increased risk of physical, mental, and substance use conditions and premature mortality. Our research aims to improve the health of individuals and families impacted by the criminal justice system by leveraging novel methods and partnerships.

Featured Publications

Vickery KD., Shippee ND., Bodurtha P. et al. Identifying homeless Medicaid enrollees using enrollment addresses. Health Services Research. 2018;53(3). DOI: 10.1111/1475-6773.12738

Garrett N, Bikah Bi Nguema Engoang JA, Rubin J, Vickery KD, Winkelman TNA. Health system resource use among populations with complex social and behavioral needs in an urban, safety-net health system. Healthcare. 2020. In press.

Winkelman TNA, Ford BR, Shlafer RJ, McWilliams A, Admon LK, Patrick SW. Medications for opioid use disorder among pregnant women referred by criminal justice agencies before and after Medicaid expansion: A retrospective study of admissions to treatment centers in the United States. PLoS Med. 2020 May;17(5):e1003119. DOI: 10.1371/journal.pmed.1003119.

Winkelman TNA, Vickery KD, Busch AM. Tobacco use among non-elderly adults with and without criminal justice involvement in the past year – United States, 2008-2016. Addict Sci Clin Pract. 2019;14(1):2. DOI: 10.1186/s13722-019-0131-y

Winkelman TNA, Chang VW, Binswanger IA. Health, polysubstance use, and criminal justice involvement among adults with varying levels of opioid use. JAMA Netw Open. 2018;1(3):e180558. DOI: 10.1001/jamanetworkopen.2018.0558

Vickery KD, Bodurtha PJ, Winkelman TNA, et al. Cross-sector service use among health care high utilizers in Medicaid expansion. Health Affairs. 2018;37(1):62-69. DOI: 10.1377/hlthaff.2017.0991. * Editor’s “Top 10 Articles of the Year” in Health Affairs*

Winkelman TNA, Vickery KD. Defining the safety-net to improve population health in the United States. JAMA Network Open. 2019;2(8):e198562. DOI: 10.1001/jamanetworkopen.2019.8562

Featured Projects

COVID-19 Impact and Basic Needs Survey

Dr. Kate Vickery and rest of the HHCJ Lab have been working with Population Health and others at Hennepin Healthcare on the COVID-19 Impact and Basic Needs Survey. The goal of the survey was to inform Hennepin Healthcare’s response to the COVID-19 pandemic by assessing the needs of Hennepin Healthcare primary care patients, especially those at highest risk of poor outcomes. The report may be found on the Hennepin Healthcare website: http://hennepinhealthcare.org/basicneedssurvey

The survey a great example of collaboration between the researchers and quality improvement in the health system. The full report was presented at the MN State Legislature on September 9, 2020.

Stories for Change

MN COVID Consortium

Transitions Clinic Network

Post Incarceration Addiction Treatment, Healthcare and Social Support (TCN-PATHS) (Tyler Winkelman, Site-PI): In partnership with Yale University, we are testing the effectiveness of the Transitions Clinic Program Model (a primary care clinic staffed by a culturally-competent provider and a community health worker with a history of incarceration) at improving health outcomes for patients recently released from jail with an opioid use disorder. This project is funded by the National Institute on Drug Abuse.

Grand Challenges

Identifying and Addressing Disparities in the Criminal Justice and Health Care Systems (Tyler Winkelman, Co-PI): In partnership with the University of Minnesota and Hennepin County, we are exploring the impact of probation supervision on health and health utilization patterns as well as the impact of health on probation supervision outcomes. This project is funded by the University of Minnesota Grand Challenges Initiative.

Development of the Diabetes Homeless Support (D-Homes) Program

Development of the Diabetes Homeless Support (D-Homes) Program (Kate Vickery, PI): The goal of this project is to design and test a tailored intervention to support people with type 2 diabetes who are experiencing homelessness. Focus groups and interviews with people with type 2 diabetes who are experiencing homelessness as well as their healthcare, social services, and housing providers will be used to inform intervention development, which will then be tested in a pilot trial. This project is funded by the National Institute of Diabetes and Digestive and Kidney Diseases.