Date of Award


Document Type

Doctoral Dissertation - Restricted (NYMC/Touro only) Access

Degree Name

Doctor of Public Health


Public Health

First Advisor

Adam E. Block, PhD

Second Advisor

Patricia A. Patrick, DrPH

Third Advisor

Kenneth A. Knapp, PhD



The relationship between exclusionary discipline practices (suspension and expulsion), arrests and referrals to law enforcement in educational institutions, and increased involvement with the criminal justice system has been coined the School-to-Prison Pipeline (SPP). Exclusionary discipline and juvenile arrests are associated with negative academic and health outcomes and have negative social and economic consequences. Moreover, these discipline practices disproportionately affect Black students. This study examined associations between the adverse childhood experience of parental absence (via incarceration and death) and the SPP. This study also examined the impact of the SPP on self-reported health status and mental illness diagnoses of young adults.


This study was an observational retrospective study consisting of secondary analyses of existing longitudinal data from the National Longitudinal Study of Adolescent to Adult Health (Add Health). Multiple logistic regression analysis was used to determine associations between parental absence and the SPP, as well as associations between the SPP and future adult health status and mental illness diagnoses (PTSD, anxiety, or depression). The regression models were adjusted for gender, race, socioeconomic status (SES), and other determinants of health determined from the literature.


A total of 5114 subjects were included in the analysis. Of those, 3717 respondents had complete information about the SPP; 2091 respondents reported suspension, expulsion, or juvenile arrests and were considered to have entered the SPP; while, 1619 did not report any school discipline or juvenile arrests. It was found that entering the SPP was 7.1 times more likely if both parents were incarcerated (95% CI 1.99-25.33, p


Parental incarceration and maternal death were found to increase the likelihood of entering the School-to-Prison Pipeline — i.e. the likelihood of being suspended, expelled, or arrested in primary or secondary school. Associations were also significant for males, Black adolescents, individuals with low SES, and those who experienced childhood maltreatment. These findings are consistent with past research; and they suggest the need for policy and practice changes regarding discipline practices and law-enforcement in-schools.