About

Charley E. Willison is an assistant professor of Public Health at Cornell University and a core faculty fellow in the Cornell Health Policy Center at the Brooks School of Public Policy. She joined Cornell after completing a postdoctoral fellowship in the Harvard Department of Health Care Policy and earning her PhD in Health Policy and Political Science at the University of Michigan School of Public Health. Her research focuses on the local political economy, health politics, public policy, poverty and inequality, and the political development of social and health policy. She is the author of the book Ungoverned and Out of Sight: Public Health and the Political Crisis of Homelessness in the United States, published by Oxford University Press in 2021, which examines why municipalities may or may not use evidence-based approaches to address chronic homelessness.

Research topics

• Political Science
• Public relations
• Geography
• Medicine
• Environmental health
• Virology
• Law
• Public administration

Selected publications

• Inverse systems: national investments in homeless housing programs for veterans compared to non-veterans

  Journal of Social Distress and the Homeless · 2026-03-18

  articleSenior authorCorresponding
  PublisherDOI

• Introduction: Health Politics and Democracy

  Journal of Health Politics Policy and Law · 2026-02-12

  articleOpen accessSenior author
  PublisherOA PDFDOI

• Specialized Mental Health Crisis Response Activities Within US Law Enforcement Agencies

  Community Mental Health Journal · 2025-08-04

  articleOpen accessSenior author

  OBJECTIVE: This study examines the prevalence of specialized police responses to persons experiencing a mental health crisis across U.S. law enforcement agencies and explores whether organizational and community factors are associated with their presence. METHODS: This study used 2020 data from a nationally representative survey of over 2,500 law enforcement agencies. The primary outcomes included whether agencies implemented one of four responses: (1) designated unit, (2) designated personnel, (3) addressed mental health without designated unit or personnel, or (4) did not address. Logistic regression models assessed factors associated with each response type. RESULTS: Over half (51.0%, n = 1,349) of agencies addressed mental health but lacked designated units or personnel, while 6.9% (n = 183) did not specifically address mental health. Larger agencies, agencies located in urban areas, as well as those with external partnerships, and a higher number of use of force complaints were significantly more likely to designate a unit or personnel. CONCLUSIONS: Fewer than half of law enforcement agencies have responses for mental health crises. Further research is needed to identify barriers and facilitators to adopting specialized responses, particularly among rural and under-resourced agencies.

  PublisherOA PDFDOI

• Determinants of When Community Behavioral Health Clinics Partner With Emergency Response Systems: The Role of Capacity in 911 Referral and Co‐response Models

  Milbank Quarterly · 2025-08-15 · 1 citations

  articleOpen access

  Policy Points Certified community behavioral health clinics (CCBHCs) commonly partner with emergency response systems in mobile crisis response through 911 referral arrangements, wherein behavioral health practitioner-only teams respond to 911 calls, and co-response partnerships, wherein a CCBHC clinician joins a police or emergency medical services team. Both the internal staff capacity of the CCBHC and external police capacity are associated with when CCBHCs partner with emergency response systems in mobile crisis response, although their effects differ by partnership: Co-response is more likely when CCBHCs have greater internal capacity, whereas 911 referral is more common in communities with lower police capacity. Stakeholders seeking to increase CCBHC-emergency response system partnerships may need to apply different strategies depending on the type of arrangement they aim to expand. CONTEXT: Individuals with behavioral health disorders are more likely to experience substantial harm from a police encounter, prompting reforms to minimize encounters between police and people experiencing a behavioral health crisis. One strategy involves expanding partnerships between certified community behavioral health clinic (CCBHC) mobile crisis teams and emergency response systems, often through two models: 911 referral, wherein a CCBHC's behavioral health practitioner-only team responds to 911 calls, and co-response, wherein a CCBHC clinician joins a police or emergency medical services (EMS) team. We examine whether the internal capacity of the CCBHC and external police capacity influence when CCBHCs engage in these partnerships. METHODS: Using data from the only national survey of CCBHCs, this study applies multivariable logistic regression to assess whether CCBHC staff capacity and police capacity are associated with CCBHC-emergency response system partnerships in mobile crisis, controlling for organizational characteristics of the CCBHC and demographic and socioeconomic features of its service area. FINDINGS: One-third (33.0%, 95% confidence interval [CI], 26.0-40.0) of CCBHCs report a 911 referral partnership, and nearly half (48.5%, 95% CI 41.1-55.9) report a co-response arrangement. While police capacity is not significantly associated with co-response, a one standard deviation increase in police capacity corresponds to an 11.0-percentage-point (95% CI -19.5 to -2.5) decrease in the predicted probability of a 911 referral partnership. CCBHC capacity is not associated with 911 referral arrangements, but CCBHCs in the top tertile of CCBHC capacity are 19.2 (95% CI 4.3-34.2) percentage points more likely to report a co-response partnership. CONCLUSIONS: The internal capacity of CCBHCs and external police capacity are associated with when CCBHCs partner with emergency response systems in mobile crisis. Because a robust behavioral health crisis system likely requires multiple response models with varying police involvement, stakeholders may need different strategies depending on the type of partnership they aim to expand.

  PublisherOA PDFDOI

• The Role of the Local Political Economy in the Opioid Settlement

  Journal of Addiction Medicine · 2025-08-04 · 1 citations

  article

  Although local governments are responsible for delivering and financing many public health services, the existing public health literature has largely overlooked how the local political economy, or how political and economic structures interact to distribute resources across and within local governments, shapes health disparities. Since local governments will control over half of opioid settlement funds, variables related to the local political economy will be crucial for understanding variation in how local governments spend these funds and their effects. This commentary pursues 3 objectives. First, we highlight 3 critical aspects of the local political economy: local government fragmentation, the privatization of public health services, and local government fiscal stability. Second, we illustrate their significance to the opioid crisis and settlement spending. Finally, we discuss the implications of these variables for both research and practice. For researchers, we offer operationalizations, and for practitioners, we propose strategies for considering fragmentation, privatization, and fiscal stability when allocating settlement funds. We aim to convince researchers to integrate these variables into future studies and empower practitioners to design more effective interventions to address the opioid crisis.

  PublisherDOI

• Draining the Swamp: The Local Governance of Mosquito Borne Diseases in Florida

  Urban Affairs Review · 2025-05-08 · 4 citations

  articleSenior author

  Public health capacity can be placed in local public health departments or alternative bureaucracies. Provision of local services through special district (SD) governments has been widely studied in local politics. What have not been examined are the implications of SD governance for the provision of public health services. Public health services are often categorically different from other types of local government services because they address problems affecting the entire local population. Siloing public health governance may influence not only agency capacity to carry out tasks, but the effectiveness and equity of public health solutions. We examine SD governance of local mosquito control in Florida, to analyze differences in policy-design and implementation between SDs and non-SDs across counties. SDs are primarily located in wealthy districts, have substantially greater resources, and provided over limited, sub-county, service-areas. Jurisdictions outside of SD service-provision often have no local mosquito control governance, relying on intergovernmental services.

  PublisherDOI

• Strategic Communication Introduction

  eCommons (Cornell University) · 2025-01-23

  otherSenior author

  N/A

  Publisher

• The Intrinsic Relationship between Local Politics and Public Health

  Urban Affairs Review · 2025-05-08 · 3 citations

  article1st authorCorresponding

  Our symposium brings to bear novel theory and rigorous empirics on a key topic: the local politics of public health. As a field, urban and local politics has made critical developments in our understanding of social inequality and its implications for democracy. Many social policy components and structures studied in local politics are known as the social or structural determinants of health—high level systems including the built environment and local policies, that have the greatest influence on individual and public health compared to any other factors ( Marmot et al. 2008 ). Yet, urban and local politics has not thought of its contribution to our knowledge of public health directly, despite studying these very systems that overwhelmingly contribute to the health and wellbeing of populations.

  PublisherDOI

• Entrenched Opportunity: Medicaid, Health Systems, and Solutions to Homelessness

  Journal of Health Politics Policy and Law · 2024-09-27 · 3 citations

  articleOpen access1st authorCorresponding

  CONTEXT: As inequality grows, politically powerful health care institutions-namely Medicaid and health systems-are increasingly assuming social policy roles, particularly related to solutions to homelessness. Medicaid and health systems regularly interact with persons experiencing homelessness who are high users of emergency health services and who experience frequent loss of or inability to access Medicaid services because of homelessness. This research examines Medicaid and health system responses to homelessness, why they may work to address homelessness, and the mechanisms by which this occurs. METHODS: The authors collected primary data from Medicaid policies and the 100 largest health systems, along with national survey data from local homelessness policy systems, to assess scope and to measure mechanisms and factors influencing decision-making. FINDINGS: Nearly one third of states have Medicaid waivers targeting homelessness, and more than half of the 100 largest health systems have homelessness mitigation programs. Most Medicaid waivers use local homelessness policy structures as implementing entities. A plurality of health systems rationalizes program existence based on the failure of existing structures. CONCLUSIONS: Entrenched health care institutions may bolster local homelessness policy governance mechanisms and policy efficacy. Reliance on health systems as alternative structures, and implementing entities in Medicaid waivers, may risk shifting homelessness policy governance and retrenchment of existing systems.

  PublisherOA PDFDOI

• SDG13, climate action: health systems as stakeholders and implementors in climate policy change

  Cambridge University Press eBooks · 2024-01-11

  book-chapterOpen accessSenior author

  Climate Action is one of the United Nation's Sustainable Development Goals. Yet, despite calls for action, global governments have broadly not taken consequential change to reduce carbon outputs and mitigate warming. Our chapter argues that a primary cause of this inaction is political conflict and policy capacity. Without strong economic incentives and facing constrained resources, governments may opt to proceed with the status quo. Here, health systems present a critical resource to engage nations in climate action. Health systems produce political leverage as major political stakeholders across nations, globally, for engaging in broader climate policy and a wealth of resources inherent to health systems – expertise, funding – to directly implement climate policy. The case study of the city of Toronto in Canada offers lessons for directly involving health systems in subnational climate action as policy stakeholders and implementors, and the co-benefits health system engagement brings to promote climate action intersectorally. Toronto provides an important case for high-latitude countries that will soon be facing climate hazards tropical nations have been grappling with for centuries. Engaging health systems in climate action policy processes may improve the likelihood of success for strengthening resilience and adaptivity to climate related hazards.

  PublisherOA PDFDOI

Frequent coauthors

• Phillip M. Singer

  16 shared

• Benjamin Lê Cook

  Cambridge Health Alliance

  10 shared

• Timothy B. Creedon

  Cambridge Health Alliance

  10 shared

• Michael Flores

  Cambridge Health Alliance

  9 shared

• Dharma E. Cortés

  Harvard University

  9 shared

• Valeria Chambers

  Cambridge Health Alliance

  9 shared

• Ana M. Progovac

  Harvard University

  9 shared

• Leslie B. Adams

  Harvard University

  9 shared

Education

• PhD, Health Management and Policy

  University of Michigan School of Public Health

Awards & honors

• Peter Katzenstein Book Prize