About

Harold Pollack is the Helen Ross Professor of the Crown Family School of Social Work, Policy and Practice at the University of Chicago. His research focuses on public health issues, including healthcare system reform, substance use, opioid use disorder, and social determinants of health. He has contributed to understanding barriers to medication access in jails, the social and policy factors influencing substance use and mental health, and the narratives surrounding drug use on social media. His work aims to maximize health and well-being for all through policy analysis and public health research.

Research topics

• Medicine
• Psychology
• Psychiatry
• Environmental health
• Sociology
• Computer Science
• Economics
• Economic growth
• Geography
• Nursing
• Demography
• Mathematics education
• Internal medicine
• Medical education
• Criminology

Selected publications

• Public Support for Harm Reduction Strategies to Address the Opioid Pandemic in the United States: A Latent Class Analysis

  Figshare · 2026-01-01

  articleOpen access

  Harm reduction represents an approach that aims to reduce risk, promote safety, and prevent disease or disability, and has proven to be effective in preventing overdose death. However, public perceptions are mixed. Past studies have not examined public perceptions across a range of different types of harm reduction strategies. We examine public support for five different types of common harm reduction strategies, including the legalization of safe consumption sites, FDA approval of over-the-counter/nonprescription naloxone, increased number of methadone clinic locations, decriminalizing Fentanyl testing strips, and implementation of syringe service programs, in a national representative sample. Latent class analysis was applied to JCOIN Survey 10 data (<i>N</i>∼6500) to investigate whether there are distinct profiles of perceptions supporting these different types of harm reduction strategies. We also explore how demographics and past direct and indirect experiences with opioid use, overdose, and criminal legal involvement relate to these profiles. We found four distinct profiles: a group of 22.9% expressing strong support for harm reduction policies, a group with mixed support (35.4%), that is, they support some but not other harm reduction policies, a profile of individuals holding neutral opinions (22.4%), and a group holding strong opposition for harm reduction policies (19.3%). Demographics and past experiences with opioids and criminal legal involvement are differentially associated with these profiles. Information and educational programs should be designed to target different groups of individuals to increase understanding and support for harm reduction policies and programs.

  PublisherDOI

• Did the illicit fentanyl trade experience a supply shock?

  Science · 2026-01-08 · 10 citations

  article

  A synthesis of government and social media data suggests a disruption, possibly tied to events in China.

  PublisherDOI

• The Effect of Legalizing Online Sports Gambling on Population Mental Health

  medRxiv · 2026-05-07

  articleOpen access

  Abstract Importance The rapid rise of online sports gambling in the U.S. has been associated with financial harms, raising concern that it may adversely affect population mental health. Objective To estimate the causal effect of state legalization of online sports gambling on population mental health, including a range of self-reported and registry-based outcomes. Design, Setting, and Participants Repeated cross-sectional study using nationally representative Behavioral Risk Factor Surveillance System (BRFSS) data from 2014–2025 and registry-based mortality records from 2012–2024. We leveraged state-level variation in the legalization of online sports gambling and applied a stacked difference-in-differences with event study design. The analytic sample included 4,660,948 BRFSS respondents and mortality records for virtually all state-years. We estimated effects on all adults and several higher-risk subgroups, including men, young men, and men with lower educational attainment. Exposure State legalization of online sports gambling. Main Outcomes and Measures Self-reported outcomes included poor mental health days, depressive disorder diagnoses, ever binge drinking, number of binge drinking episodes, and marijuana use. Registry-based outcomes included suicide mortality and alcohol-induced mortality per 100,000. Results Among 4,660,948 BRFSS respondents, 48.7% were men, 40.2% had no more than a high school education, and the mean age was 47.6 years. Legalization of online sports gambling had no discernible effect on poor mental health days of all U.S. adults (–0.01 days; 95% CI, –0.16 to 0.14; P=0.88), depressive disorder diagnoses (0.1 percentage points; 95% CI, –0.7 to 0.9; P=0.84), binge drinking, binge drinking episodes, or marijuana use. Meanwhile, mean suicide mortality was 14.1 per 100,000 and mean alcohol-induced mortality was 12.2 per 100,000. Legalization did not affect adult suicides (0.13 deaths per 100,000; 95% CI, –0.71 to 0.97; P=0.76) or alcohol-induced mortality (1.08 deaths per 100,000; 95% CI, –0.58 to 2.73; P=0.21). Results were null among men and higher-risk subgroups of men. Conclusions and Relevance The legalization of online sports gambling has not produce detectable population-level changes in a range of mental health outcomes, including reported symptoms, diagnoses, substance use, and registry-based mortality due to suicide or alcohol, in up to 3 years of follow-up. These findings suggest that although online sports gambling may cause financial harm and severe distress for some individuals, legalization has not produced measurable average changes in population mental health over the observed follow-up period. Key points Question Has the legalization of online sports gambling affected population-level mental health, including symptoms, diagnoses, substance use, suicides, and alcohol-induced mortality? Findings In this repeated cross-sectional study that applied a difference-in-differences design to more than 4.6 million individual-level survey responses and mortality records, the legalization of online sports gambling from 2018–2024 did not affect reported poor mental health days, depressive disorders, binge drinking, marijuana use, suicide mortality, or alcohol-induced mortality. Results were similar among men and higher-risk subgroups of men. Meaning The legalization of online sports gambling has not produced detectable population-level changes in a broad range of mental health outcomes in up to 3 years of follow-up.

  PublisherOA PDFDOI

• The Continuing Partisan Divide in the Opioid Epidemic

  JAMA Network Open · 2026-01-16

  articleOpen access1st authorCorresponding
  PublisherDOI

• Public Support for Harm Reduction Strategies to Address the Opioid Pandemic in the United States: A Latent Class Analysis

  Figshare · 2026-01-01

  articleOpen access

  Harm reduction represents an approach that aims to reduce risk, promote safety, and prevent disease or disability, and has proven to be effective in preventing overdose death. However, public perceptions are mixed. Past studies have not examined public perceptions across a range of different types of harm reduction strategies. We examine public support for five different types of common harm reduction strategies, including the legalization of safe consumption sites, FDA approval of over-the-counter/nonprescription naloxone, increased number of methadone clinic locations, decriminalizing Fentanyl testing strips, and implementation of syringe service programs, in a national representative sample. Latent class analysis was applied to JCOIN Survey 10 data (<i>N</i>∼6500) to investigate whether there are distinct profiles of perceptions supporting these different types of harm reduction strategies. We also explore how demographics and past direct and indirect experiences with opioid use, overdose, and criminal legal involvement relate to these profiles. We found four distinct profiles: a group of 22.9% expressing strong support for harm reduction policies, a group with mixed support (35.4%), that is, they support some but not other harm reduction policies, a profile of individuals holding neutral opinions (22.4%), and a group holding strong opposition for harm reduction policies (19.3%). Demographics and past experiences with opioids and criminal legal involvement are differentially associated with these profiles. Information and educational programs should be designed to target different groups of individuals to increase understanding and support for harm reduction policies and programs.

  PublisherDOI

• Risk Perceptions of Substance Use Recovery Disclosure in Medical School Applications: A National Sample of Physicians and Dentists

  Journal of General Internal Medicine · 2026-03-09

  articleOpen access

  AIMS: Given stigmatizing attitudes held by many healthcare providers toward substance use, medical and dental school applicants in recovery from past substance use face the dilemma of whether to disclose this during the admissions process. We assessed current physicians' and dentists' perceptions of the risk that such disclosure would have on an applicant's prospects of admission and how this was influenced if the disclosure was framed as part of a professional journey to help others. DESIGN: A national probability survey of physicians and dentists using a sampling frame from the American Medical Association and American Dental Associations. SETTING: Online and paper questionnaire. PARTICIPANTS: One thousand two hundred forty emergency department physicians, primary care physicians, and dentists. MEASUREMENTS: A 125-item survey assessing provider stigma toward people with substance use disorders with two questions on the perceived risk of disclosure of substance use on medical and dental school applications. FINDINGS: A total of 82.5% of physicians and dentists reported that disclosure of a history of substance use by medical or dental school applicants would carry a "moderate" or "significant" risk for adverse admissions outcomes. When past substance use was framed as part of an applicant's professional motivation, half of the respondents (49.8%) perceived disclosure as "moderately" or "significantly" risky. Respondents who reported having a friend or patient who uses or used drugs were more likely to perceive substance use disclosure (without context) as riskier than their corresponding colleagues. CONCLUSION: Physicians and dentists overall perceive high risk for adverse admissions outcomes when applicants disclose their past substance use in their medical and dental school applications. This risk is lessened yet remains prominent when the experience is framed as part of the applicant's professional motivation. This may reflect a certain persistence of stigma among physicians and dentists toward people with a history of substance use.

  PublisherOA PDFDOI

• Beyond High Versus Low: Differentiating Levels of Stigma Toward Opioid Use Disorder and Criminal Legal Involvement

  Psychiatric Services · 2026-04-02

  articleSenior author

  OBJECTIVE: This study aimed to identify distinct profiles of the level of stigma held toward individuals with opioid use disorder and those with criminal legal involvement (CLI) and to examine the demographic characteristics, lived experience, and support for opioid-related policies associated with these profiles. METHODS: The authors analyzed cross-sectional data from a representative survey of 6,543 U.S. adults (December 2023-January 2024). A latent class analysis was performed with six stigma subscales (perceived risk, distrust, and social distance with regard to people with opioid use disorder and people with CLI). Associations between the level of stigma held and attitudes toward public health policies were examined with survey-weighted regression. RESULTS: Four classes of stigma were identified: low (8.3% of respondents [weighted]), moderate (52.5%), high (32.5%), and extreme (6.6%). The extreme group had the highest stigma scores, particularly for CLI-related perceived risk and social distance subscales, and was associated with older age and lack of personal history with opioid use disorder or the legal system. More severe stigma predicted greater support for punitive policies and lower support for harm reduction policies, with the extreme stigma group holding significantly more punitive attitudes than the high stigma group. CONCLUSIONS: The degree of stigma regarding opioid use disorder and CLI is not monolithic. The identification of an extreme stigma group, characterized by pronounced CLI-related stigma and lack of personal lived experience, suggests that one-size-fits-all public health messaging may be ineffective. Understanding this segmentation in the population is crucial for developing targeted interventions to build support for evidence-based policies.

  PublisherDOI

• Social Determinants of Cardiovascular Disease Risk Factors Among Black Ethnic Groups: Findings From the 2013 to 2018 National Health Interview Survey

  Journal of the American Heart Association · 2026-04-09

  articleOpen accessSenior author

  BACKGROUND: Social determinants of health (SDOH) affect cardiovascular disease (CVD) risk in Black adults, but there is limited knowledge on how SDOH dimensions are linked to CVD risk factors across different Black groups. The study examined differences in SDOH dimensions and CVD risk factors among Black ethnic groups, hypothesizing stronger associations for US-born adults. METHODS: Using the National Health Interview Surveys 2013 to 2018, we categorized 24 380 non-Hispanic Black adults by birthplace into 3 groups: US born, Caribbean born, and African born. Thirteen SDOH variables were reduced to 4 indices (standard of living, neighborhood cohesion, socioeconomic advantage, and health care access) using principal component analysis. Associations between these indices and the prevalence of 3 self-reported CVD risk factors (hypertension, diabetes, and high cholesterol) were assessed using modified Poisson regression models. RESULTS: <0.05), except for low standard of living and poor neighborhood cohesion with high cholesterol. For Caribbean-born Black adults, a low standard of living was associated with a higher prevalence of hypertension (prevalence ratio, 1.10 [95% CI, 1.1-1.21]) and diabetes (prevalence ratio, 1.24 [95% CI, 1.11-1.38]). Among African-born Black adults, only socioeconomic disadvantage was significantly associated with hypertension (prevalence ratio, 1.15 [95% CI, 1.05-1.26]). CONCLUSIONS: The relationship between CVD risk factors and SDOH indices varied across different Black groups and was not consistent for all indices and risk factors. These distinct associations underscore the importance of tailored interventions to address context-specific CVD risk factors and social determinants to protect cardiovascular health.

  PublisherDOI

• Public Support for Harm Reduction Strategies to Address the Opioid Pandemic in the United States: A Latent Class Analysis

  Substance Use & Misuse · 2026-02-01

  article

  BACKGROUND AND AIMS: Harm reduction represents an approach that aims to reduce risk, promote safety, and prevent disease or disability, and has proven to be effective in preventing overdose death. However, public perceptions are mixed. Past studies have not examined public perceptions across a range of different types of harm reduction strategies. We examine public support for five different types of common harm reduction strategies, including the legalization of safe consumption sites, FDA approval of over-the-counter/nonprescription naloxone, increased number of methadone clinic locations, decriminalizing Fentanyl testing strips, and implementation of syringe service programs, in a national representative sample. METHODS: ∼6500) to investigate whether there are distinct profiles of perceptions supporting these different types of harm reduction strategies. We also explore how demographics and past direct and indirect experiences with opioid use, overdose, and criminal legal involvement relate to these profiles. RESULTS: We found four distinct profiles: a group of 22.9% expressing strong support for harm reduction policies, a group with mixed support (35.4%), that is, they support some but not other harm reduction policies, a profile of individuals holding neutral opinions (22.4%), and a group holding strong opposition for harm reduction policies (19.3%). Demographics and past experiences with opioids and criminal legal involvement are differentially associated with these profiles. CONCLUSIONS: Information and educational programs should be designed to target different groups of individuals to increase understanding and support for harm reduction policies and programs.

  PublisherDOI

• Distinct differences between COVID-19 vaccine refusers and vaccine hesitant in the United States: Results from a population-based survey and latent class analysis

  Annals of Epidemiology · 2026-05-16

  article
  PublisherDOI

Recent grants

• NIH Grant U2CDA05009801

  NIH · $20.8M · 2024

• NIH Grant P01HD076816

  NIH · $11.8M · 2021

Frequent coauthors

• Peter D. Friedmann

  Baystate Health

  116 shared

• Colleen M. Grogan

  University of Chicago

  101 shared

• Keith Humphreys

  Stanford University

  77 shared

• John A. Schneider

  University of Chicago

  61 shared

• Sunggeun Park

  54 shared

• Bruce G. Taylor

  National Opinion Research Center

  51 shared

• Christina M. Andrews

  51 shared

• Jennifer E. Mosley

  University of Chicago

  50 shared

Labs

• Harold Pollack LabPI