# Advancing Equity in Treatment Outcomes for Black Pregnant and Postpartum People Who Use Drugs and have Child Welfare and Criminal Legal Systems Involvement

> **NIH NIH K23** · JOHNS HOPKINS UNIVERSITY · 2021 · $107,234

## Abstract

PROEJCT SUMMARY/ABSTRACT
Providing substance use disorder treatment in pregnancy is an essential strategy to improve maternal and
newborn wellbeing, but discriminatory policies, practice, and access to necessary resources contribute to
inequities in addiction care and parenting outcomes. Many pregnant people who use drugs experience
incarceration and also have involvement from the child welfare system. Policies in both the criminal legal and
child welfare systems have trended toward criminalizing drug use in pregnancy rather than investing in robust
treatment. Significantly, due to the structural racism that underlies incarceration and historical forces that have
systematically devalued Black women’s reproduction, these policies have had a differentially negative impact
on Black pregnant and parenting people, contributing to disproportionate child removals as well as disparate
drug treatment outcomes. While policy, historical, and sociologic analyses have documented the links between
racism and criminalizing Black pregnant individuals who use drugs, one understudied aspect is how these
forces of structural and interpersonal discrimination affect the lived experiences, treatment, and recovery
outcomes among pregnant and postpartum Black people with dual involvement in these systems.
Understanding these intersecting systems is essential for targeting root causes of and eliminating racial
disparities and discrimination in substance use treatment and maternal health. The overall objective of this
NIDA Administrative Supplement on Health Equity is to examine experiences of racism and the impact on
treatment, pregnancy, and parenting outcomes among a sample of pregnant and postpartum people who use
drugs and who have dual involvement from criminal legal and child welfare systems. This study will also
evaluate the practices and perspectives of child welfare system workers who make decisions on cases
involving people who used drugs in pregnancy and who were currently or recently incarcerated. The proposal
will accomplish these aims through a series of qualitative interviews that assess validated measures of racism
in maternal health, and with methodological collaboration from community members with direct, lived
experience. This project will enhance the training goals of the parent career development award to improve
access to care for pregnant, incarcerated people with opioid use disorder by providing training opportunities in
how to study and impact racism in maternal health. Data from interviews will produce actionable insights for
future policy and training interventions for people who work in incarceration and child welfare systems. This
research is innovative because it will add to existing understandings of racialized dimensions of incarceration
and child welfare systems by examining the impact at the intersection of these systems on individuals’
treatment pathways and parenting outcomes. The work proposed for this supplement, which directly align...

## Key facts

- **NIH application ID:** 10440173
- **Project number:** 3K23DA045934-04S1
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Carolyn Sufrin
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $107,234
- **Award type:** 3
- **Project period:** 2018-08-01 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10440173

## Citation

> US National Institutes of Health, RePORTER application 10440173, Advancing Equity in Treatment Outcomes for Black Pregnant and Postpartum People Who Use Drugs and have Child Welfare and Criminal Legal Systems Involvement (3K23DA045934-04S1). Retrieved via MORVS 2026-10-25 from https://api.morvs.ai/grant/nih/10440173. Licensed CC0.

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