Youth involved in justice system less likely to use preventive care

Youth involved in the juvenile justice system — or those who have been arrested — are less likely to use preventive care measures, including well-child visits, and are more likely to use emergency services when compared with youth who had not been involved in the justice system, according to a study published in Pediatrics.

“Increasing use of preventive primary care services is one approach offered to improve the health of vulnerable populations, including justice-involved youth,” Matthew C. Aalsma, PhD, from the department of pediatrics and the section of adolescent medicine at the Indiana University School of Medicine, and colleagues wrote. “Well-child visits provide an opportunity for primary care physicians to screen for common causes of preventable morbidity among adolescents, such as substance use, risky sexual behavior and episodes of violence.”

Youth who were enrolled in Medicaid and had been arrested at least once were less likely to receive primary care services but more inclined to use emergency services.

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“However, the actual rate at which justice-involved youth use preventive primary care services has rarely been studied, much less in direct comparison with an equivalent group of non-justice-involved youth,” the researchers continued.

To verify how rates of well-child visits and ED use compare between justice-involved and non-justice-involved youth, as well as the prevalence of public insurance enrollment, the researchers conducted retrospective cohort study that included all adolescents between the ages of 12 and 18 years enrolled in Medicaid between Jan. 1, 2004, and Dec. 31, 2011, within Marion County, Indiana. Data collected were from administrative medical records and criminal records.

Of the 88,647 adolescents included in the study, 23% were involved in the justice system. When compared with youth who had not been a part of the justice system, those involved were less likely to have well-child visits and used emergency services more frequently. Those involved with the justice system also had longer gaps in Medicaid coverage. Regarding the continuity of coverage, variations were observed in both non-involved and involved youth in the use of well-child visits and emergency services.

“That justice-involved youth have more and longer periods without health insurance coverage is particularly problematic for this vulnerable group, because uninsured youth are less likely to use recommended preventive primary care services,” Aalsma and colleagues wrote. “Indeed, findings from the current study follow expected patterns of preventive primary care use when comparing justice-involved youth and non-justice-involved youth.” – by Katherine Bortz

Disclosure: The authors report no financial disclosures.

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Source: Aalsma MC, et al. Pediatrics. 2017. doi:10.1542/peds.2017-1107.