About

Dr. Saba Rouhani is an Assistant Professor in the Department of Epidemiology at NYU School of Global Public Health. Her research focuses on social epidemiology, policy evaluation, and overdose prevention. Prior to her current position, she worked as a research faculty member in the Department of Health, Behavior and Society at the Johns Hopkins Bloomberg School of Public Health and completed a fellowship funded by the National Institutes of Health/National Institute on Drug Abuse. Her scholarly work has been published in prominent journals such as the International Journal of Drug Policy, Drug and Alcohol Dependence, the Journal of Urban Health, and the American Journal of Public Health and Preventive Medicine. Dr. Rouhani holds a PhD in global disease epidemiology and control from Johns Hopkins Bloomberg School of Public Health, an MSc in the control of infectious diseases from the London School of Hygiene and Tropical Medicine, and a BSc in medical microbiology from the University of Edinburgh.

Research topics

• Political Science
• Medicine
• Sociology
• Environmental health
• Psychology
• Law
• Biology
• Immunology
• Internal medicine
• Social psychology
• Pediatrics
• Psychiatry
• Criminology
• Nursing

Selected publications

• Structural Vulnerability and Police Interaction among Women Who Use Drugs amid De Facto Decriminalization in Baltimore, Maryland

  Journal of Urban Health · 2026-02-01

  articleOpen access

  Exposure to criminal-legal systems, including policing, arrest, and incarceration, has deleterious effects on access to health and social services among people who use drugs. Women who use drugs (WWUD) may be especially vulnerable to policing, due to the high prevalence of sex work among them, which is also a criminalized behavior. Recent epidemiologic events and policy reforms are thought to have reduced exposure to arrests for low-level, non-violent crimes; in Baltimore City, this decline was demonstrated following the COVID-19 pandemic and implementation of de facto decriminalization of misdemeanor offenses including drug possession and solicitation (prostitution). However, possible impacts of these changes on experiences of policing among WWUD remain unknown. This analysis explores self-reported police interactions and pandemic-related structural vulnerability among a cohort of WWUD in Baltimore City. We used multinomial and logistic regression to explore the association of ability to meet basic needs during the pandemic with the intensity and breadth of police interaction. We observed that overlapping unmet needs, such as access to medications, bathrooms, and harm reduction supplies, were associated with exposure to more intensive enforcement and greater breadth of police practices, as well as exposure to more egregious forms of policing. Despite broad changes to both policing and social service policies amid the pandemic, our results indicate that WWUD continued to experience both disproportionately high levels of material need insecurity and exposure to police. Findings have implications for tailoring policies and interventions to meet the needs of multiply marginalized women amid big events and policy volatility.

  PublisherOA PDFDOI

• Access to non-police crisis response for people who use drugs: lessons from community safety response programs in two U.S. cities

  BMC Public Health · 2026-05-12

  articleOpen access1st authorCorresponding

  INTRODUCTION: Community Safety Response (CSR) programs increasingly provide non-police alternatives to behavioral health crises, but their role in addressing substance use calls remains poorly understood. This qualitative study examined how municipal stakeholders in Denver, Colorado and San Francisco, California perceive and operationalize CSR protocols for substance use-related emergencies. METHODS: Between 2021 and 2023, we conducted 82 semi-structured interviews and 32 field observations with 911 dispatchers, law enforcement, city officials, and alternative responders from Denver and San Francisco's respective CSR programs. Transcripts and field notes were analyzed using thematic analysis to identify attitudes toward substance use, decision-making processes for call deployment, and barriers and facilitators to routing of substance use related calls to alternative response. RESULTS: Although written protocols permitted non-police response to substance use calls absent violence or weapons, findings revealed a gap between policy and practice. Dispatcher and responder discretion played a central role in determining CSR deployment: while some stakeholders regularly sent alternative responders on substance use calls, others described any mention of drugs -particularly methamphetamines-as automatically triggering police involvement. Barriers to effective CSR response included limited referral options for people who use drugs, fragmented service systems, community tensions around visible drug use, and perceived safety concerns. Facilitators included CSR teams' unique engagement capacity and potential for peer specialist involvement. CONCLUSION: To promote effectiveness of CSR as a public health intervention to reduce morbidity and mortality, programs must address discretionary decision-making, enhance training on stigma and harm reduction principles, and coordinate with broader service systems to ensure equitable access to non-police responses for people who use drugs.

  PublisherDOI

• Business and Service Provider Attitudes Towards Police Involvement in Overdose Response: A Cross-Sectional Survey in Rhode Island Overdose Hotspots

  Journal of Community Health · 2026-03-29

  article1st authorCorresponding
  PublisherDOI

• Ghost gun recovery and firearm deaths in California, 2014–2023

  Journal of Epidemiology & Community Health · 2026-01-13 · 1 citations

  article

  BACKGROUND: We investigated whether ghost gun recovery rates are significantly associated with firearm mortality rates in the following year across California's 58 counties from 2014 to 2023. METHODS: We obtained yearly county-level data on ghost guns recovered in California from The Trace's Gun Violence Data Hub. County-level firearm death counts (total, suicide and homicide) were pulled from the Centers for Disease Control and Prevention's Restricted-Use Vital Statistics Data. Spatiotemporal models quantified the covariate-adjusted associations between ghost gun recoveries per capita and firearm death rates (total, suicide and homicide) in the following year. Secondary analyses examined suicide and homicide models stratified by sex and race/ethnicity. RESULTS : For every 20 ghost guns recovered per 100 000 population, there was an associated 6.4% increase in firearm suicide rate (adjusted incidence rate ratio (aIRR): 1.064, 95% credible interval (CrI) 1.019 to 1.111) in the following year. We found no evidence of a significant ghost gun recovery association with total firearm death rate (aIRR: 1.036, 95% CrI 0.999 to 1.075) and firearm homicide rates (aIRR: 1.002, 95% CrI 0.946 to 1.064). Stratified models for firearm suicide rates suggested variations across sex and racial/ethnic groups, with significant positive associations observed for male (6.5% increase; aIRR: 1.065, 95% CrI 1.017 to 1.115), non-Hispanic white (6.2% increase; aIRR: 1.062, 95% CrI 1.005 to 1.122) and Hispanic (12.6% increase; aIRR: 1.126, 95% CrI 1.031 to 1.230) individuals. A different pattern emerged for firearm homicide death rates, where associations across demographic groups were not statistically significant. CONCLUSIONS: Practitioners concentrating on suicide prevention efforts should be advised about the threat that ghost guns may present.

  PublisherDOI

• Legal Financial Obligations: An Understudied Public Health Exposure

  American Journal of Preventive Medicine · 2026-02-13

  articleOpen accessSenior author

  The impacts of exposure to the criminal justice system on health-related outcomes are well studied in the U.S. However, although previous studies focus on the impacts of arrest, incarceration, and re-entry on health, they neglect a critical component of the criminal justice system: legal financial obligations. Legal financial obligations, which include fines, fees, and other surcharges, are levied at nearly every stage of the criminal justice process, entrench individuals into a cycle of poverty, and exacerbate known social determinants of health such as food and housing instability and loss of health insurance. Although legal financial obligations are the most widely used form of punishment in the U.S., they are understudied as a public health exposure. This paper represents a call for researchers to address this gap in knowledge by including measures of legal financial obligations in research related to the impacts of criminal justice exposure. This article describes what is known in the literature around legal financial obligations, presents a framework outlining hypothesized pathways linking legal financial obligations to health outcomes, discusses gaps in research related to public health costs and outcomes, and highlights critical areas for future research.

  PublisherOA PDFDOI

• Racial discrimination and perceptions of police among US adults

  Health & Justice · 2026-04-16

  articleOpen accessSenior authorCorresponding

  Mistrust of law enforcement across the United States has implications for public health and safety. While direct police encounters shape perceptions of law enforcement, the influence of broader experiences with racial discrimination remains understudied. This study examined associations between racial discrimination and perceptions of police among US adults. Data were from a web-based cross-sectional survey across 13 northeastern states in March–April 2023 (N = 5,048). Racial discrimination was measured in childhood, adolescence, adulthood, past year, and in the healthcare setting specifically. Perceptions of police were measured on an 8-item scale ranging from 8–40, with higher scores denoting more negative attitudes. Multivariable linear regression (1) quantified associations between racial discrimination and perceptions of police; and (2) tested whether these associations differed across racial/ethnic groups, controlling for age, gender identity, homelessness, behavioral health history, and direct positive and negative police encounters. Participants had mean age of 47 years old, and half identified as male (50%). The majority were White (48%), with 17.5% identifying as non-Hispanic Black and 21.3% as Hispanic. In adjusted models, both cumulative racial discrimination across the life course and healthcare discrimination were significantly associated with negative perceptions of police. We observed evidence of interaction between race/ethnicity cumulative racial discrimination: the association between racial discrimination and negative perceptions of police were significantly stronger in Black, relative to White respondents. Experiences of racial discrimination beyond direct policing encounters—particularly cumulative lifetime discrimination and healthcare discrimination—are independently associated with negative police perceptions. These findings suggest spillover effects across institutions, with implications for system avoidance behaviors and institutional trust that may affect both public health and public safety outcomes.

  PublisherDOI

• ‘If you've ever experienced it, you'd feel differently’: Exploring willingness and skepticism toward using higher dose naloxone products among people who use drugs in Maryland, United States

  Addiction · 2026-04-29

  article

  BACKGROUND AND AIMS: Higher dose naloxone products (HDN) have recently been approved and marketed in the United States; however, evidence on the relative advantage of these products to standard 4 mg products has not been substantiated by prior research. People who use drugs are the primary beneficiaries and consumers of naloxone products. This study aimed to characterize their willingness to use HDN products and technical understanding of these products. DESIGN AND MEASUREMENTS: We conducted in-depth interviews with syringe service program clients following an interview guide. Interviews were recorded and transcribed before being analyzed using a hybrid deductive-inductive qualitative approach. SETTING: Interviews were conducted in partnership with community-based syringe service programs in three distinct regions of the state of Maryland, USA: a rural county, Baltimore city and a surrounding suburban community. PARTICIPANTS: Twenty-two interviews were completed. All participants had used opioids and responded to an overdose using naloxone in the past 3 months. The majority of participants were men (73%), non-Hispanic white (64%) and currently experiencing housing instability (59%). FINDINGS: Participants demonstrated high willingness to use HDN, motivated by volatility in the local drug supply and perceived inefficiency of naloxone against potent synthetic opioids. Participants believed that the relative advantage of HDN was that it would reverse overdoses more quickly than existing products; however, many participants wanted increased control in overdose situations, including the ability to titrate and combine dosages to reduce the severity of precipitated withdrawal. Skepticism towards HDN products was rooted in general skepticism of pharmaceutical companies, as well as the belief that perceptions of lower dose naloxone being ineffective could be attributed to user error. CONCLUSIONS: Development of novel overdose reversal products should be informed by the experiences of primary consumers and beneficiaries of these products. A high level of transparency is needed in the marketing of these products to promote consumer trust and confidence in their safety and utility.

  PublisherDOI

• Transforming first response through non-police, community safety response programmes: a peer-reviewed and grey literature scoping review protocol

  BMJ Open · 2025-12-01

  articleOpen access

  INTRODUCTION: Police are frequently dispatched to a wide range of 911 calls, including mental and behavioural health crises, despite lacking the training, resources and time to respond effectively. In particular, people with serious mental illness are at elevated risk of experiencing excessive use of force, arrest and continued criminal legal involvement following police contact. Following the murder of George Floyd and other highly publicised police killings, Community Safety Response (CSR) programmes, staffed by unarmed peers, mental health professionals and other trained responders, have proliferated to provide non-police responses to mental and behavioural health and other quality-of-life concerns. CSR programmes have expanded rapidly, yet the evidence base remains fragmented and largely outside the peer-reviewed literature. METHODS AND ANALYSIS: This scoping review will synthesise peer-reviewed and grey literature from 2020 to present on CSR programmes operating in North America. Guided by Joanna Briggs Institute methodology and reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) standards, we will search multiple databases (Medline, PsycINFO, Embase, SocIndex, Web of Science, Policy Commons) and employ complementary grey literature search strategies, including targeted website searches, reference tracking and review of internal and external reports and evaluations. Inclusion criteria require that programmes provide non-police first response to calls traditionally served by law enforcement and include information on programme operations or outcomes. Two reviewers will independently screen and extract data on process metrics including operational characteristics, dispatch, funding, services provided and outcomes such as populations served, diversion from police, service linkage and use of force. ETHICS AND DISSEMINATION: No ethical review for this study is required as it will not include human subjects or any identifiable information. Findings will provide the first national synthesis of CSR programme models, operations and outcomes. Results will inform policy-makers, practitioners, researchers and community members. Findings will be disseminated through peer-reviewed publications and public-facing products to support implementation, scale-up and sustainability of CSR programmes.

  PublisherOA PDFDOI

• Cumulative Racism and Substance use: Results from the 2023 Racism and Public Health Study

  Drug and Alcohol Dependence · 2025-02-01

  article1st authorCorresponding
  PublisherDOI

• Ghost Gun Recovery and Firearm Deaths in California, 2014-2023

  medRxiv · 2025-09-09

  preprintOpen access

  Abstract Background Ghost guns are untraceable firearms assembled from online parts kits without background checks or waiting periods. Police nationally recovered 17 times more ghost guns in 2023 than 2017, yet the relationship between ghost gun recovery and firearm mortality is understudied. We investigated whether ghost gun recovery rates are significantly associated with subsequent firearm mortality rates across California’s 58 counties from 2014 to 2023. Methods We obtained yearly county-level data on ghost guns recovered in California from The Trace’s Gun Violence Data Hub, which aggregated data from the California Department of Justice’s October 2024 report California’s Fight Against the Ghost Gun Crisis: Progress and New Challenges. County-level firearm death counts (total, suicide, homicide) were pulled from the Centers for Disease Control and Prevention’s Restricted-Use Vital Statistics Data. Covariates included (1) urbanicity measured using the Rural-Urban Continuum Codes from the U.S. Department of Agriculture and (2) economic/racial segregation assessed by the Index of Concentration at the Extremes for income and race/ethnicity. We employed a hierarchical Bayesian approach to quantify the associations between ghost gun recoveries per capita and total firearm death rates in the following year. Exploratory analyses examined whether urbanicity and economic/racial segregation were significantly related to ghost gun recovery rates from 2014 to 2023. Results Controlling for urbanicity and economic/racial segregation, spatiotemporal models indicated that for every 20 ghost guns recovered per 100,000 population, there was an associated 5% increase in total firearm death rate (IRR: 1.05, 95% CrI: 1.02-1.08) and a 5% increase in firearm suicide rate (IRR: 1.05, 95% CrI: 1.02-1.09) in the following year. Ghost gun recovery rates were 298% higher in urban versus rural counties (IRR: 3.98, 95% CrI: 2.37-6.94) and increased 113% per 0.25-unit increase in economic/racial segregation score (IRR: 2.13, 95% CrI: 1.11-4.19). Conclusions This study provides the first empirical evidence examining the relationship between ghost gun recovery rates and subsequent increases in firearm mortality, particularly firearm suicides, across California counties from 2014 to 2023. Practitioners concentrating on suicide prevention efforts should be advised about the threat that ghost guns may present.

  PublisherOA PDFDOI

Frequent coauthors

• Susan G. Sherman

  Johns Hopkins University

  99 shared

• Ju Nyeong Park

  Brown University

  78 shared

• Miles Morris

  Johns Hopkins University

  66 shared

• Glenna J. Urquhart

  Johns Hopkins University

  62 shared

• M. H. Clark

  Florida College

  52 shared

• Brandon del Pozo

  52 shared

• Rejwi Dahal

  Indiana University

  49 shared

• Kristin E. Schneider

  Johns Hopkins University

  24 shared

Awards & honors

• Drug Dependency Epidemiology Training (T32) Fellowship, Nati…
• The R. Bradley Sack Family Scholarship Award, Johns Hopkins…
• Global Health Established Field Placement Scholarship, Johns…
• Save the Children Program Management Award, Save the Childre…
• Royal Society of Tropical Medicine and Hygiene Award for Bes…