Health Conditions and Racial Differences Among Justice-Involved Adolescents, 2009 to 2014

• Published in: Academic pediatrics Vol. 17; no. 7; pp. 723 - 731
• Main Authors: Winkelman, Tyler N.A., MD, MSc, Frank, Joseph W., MD, MPH, Binswanger, Ingrid A., MD, MPH, MS, Pinals, Debra A., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2017
• Subjects: Adolescent; Adolescent Behavior - psychology; behavioral health; Child; chronic conditions; Chronic Disease - epidemiology; Chronic Disease - psychology; Criminal Law; Criminals - psychology; Criminals - statistics & numerical data; Cross-Sectional Studies; Ethnic Groups - psychology; Ethnic Groups - statistics & numerical data; Female; health disparities; Health Status; Humans; Juvenile Delinquency - ethnology; Juvenile Delinquency - psychology; Juvenile Delinquency - statistics & numerical data; juvenile justice; Logistic Models; Male; Mood Disorders - epidemiology; Neonatal and Perinatal Medicine; Pediatrics; Pregnancy; Psychology, Adolescent; Substance-Related Disorders - epidemiology; United States - epidemiology; health disparities; behavioral health; chronic conditions; juvenile justice
• ISSN: 1876-2859; 1876-2867
• DOI: 10.1016/j.acap.2017.03.003

Abstract Objective Providers can optimize care for high-risk adolescents by understanding the health risks among the 1 million US adolescents who interact with the justice system each year. We compared the prevalence of physical health, substance use, and mood disorders among adolescents with and without recent justice involvement and analyzed differences according to race/ethnicity. Methods Cross-sectional analysis using the 2009 to 2014 National Survey on Drug Use and Health. Prevalence data were adjusted for sociodemographic differences between adolescents with and without justice involvement. Justice-involved adolescents had a history of past year arrest, parole/probation, or juvenile detention. Results Our sample consisted of adolescents aged 12 to 17 years with (n = 5149) and without (n = 97,976) past year justice involvement. In adjusted analyses, adolescents involved at any level of the justice system had a significantly higher prevalence of substance use disorders ( P  < .001), mood disorders ( P  < .001), and sexually transmitted infections ( P  < .01). Adolescents on parole/probation or in juvenile detention in the past year had a higher prevalence of asthma ( P  < .05) and hypertension ( P  < .05) compared with adolescents without justice involvement. Among justice-involved adolescents, African American adolescents were significantly less likely to have a substance use disorder ( P  < .001) or mood disorder ( P  < .01) compared with white or Hispanic adolescents, but had significantly higher prevalence of physical health disorders ( P  < .01). Conclusions Adolescents involved at all levels of the justice system have high-risk health profiles compared with the general adolescent population, although these risks differ across racial/ethnic groups. Policymakers and health care providers should ensure access to coordinated, high-quality health care for adolescents involved at all levels of the justice system.