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Justice system involvement significantly increases risk of early, violent death in youth offenders

Compared with community youth, youth involved in the justice system are more likely to face early mortality, according to data published in the American Journal of Preventive Medicine.

Matthew C. Aalsma , PhD, a researcher in the section of adolescent medicine at Indiana University School of Medicine, and colleagues conducted a retrospective cohort study of youth involved in the justice system between Jan. 1, 1999 and Dec. 31, 2011. Their research focused on youth in Marion County, Indiana.

The researchers used electronic criminal records from the Marion County Juvenile Superior Court and the Marion County Sheriff's Office as well as electronic death records from the Regenstreif Medical Record System. They also obtained cause of death for 77.2% of deceased offenders from the Marion County Coroner's Office.

Matthew C. Aalsma

Youth offenders were divided into four groups based on their involvement in the justice system: arrested, detained, incarcerated or transferred to adult court. The researchers noted that black youth were disproportionately represented across all groups.

Aalsma and colleagues reported a sample of 49,479 youth offenders for which data were collected from 0.1 to 12.9 years after the first arrest. Among this sample, there were 518 deaths.

Results showed that the majority of deceased offenders were male (83.8%) and black (56%). Youth offenders were 1.48 times more likely to die when compared with community youth. The most common causes of death were homicide (48.2%) and overdose (14.7%).

Survival analysis results demonstrated that increased mortality risk was associated with older age and male offenders were more likely to die than female offenders (HR = 2.7; 95% CI, 2.1-3.4).

In the first 5 years following an arrest, Aalsma and colleagues found that only detained youth faced an increased mortality risk compared with arrested youth (HR = 1.6; 95% CI, 1.2-2.1). After that period of time, the other three groups of offenders were all at increased risk of death when compared with arrested youth: detained youth (HR = 1.7; 95% CI, 1.2-2.2), incarcerated youth (HR = 2.5; 95% CI, 1.8-3.6) and youth transferred to adult court (HR = 3.3; 95% CI, 2.3-4.9).

The researchers stated that findings indicate the need for interventions targeted to severity of involvement in the justice system, evidence-based violence prevention programs and race.

"The results highlight the need to address the interaction between race and justice system involvement in order to reduce high rates of death among youth offenders," Aalsma and colleagues wrote. "It is well established that black youth, compared with white youth, are over-represented in the justice system and bear a disproportionate burden of death by homicide. For all youth, regardless of race, involvement in the justice system beyond arrest significantly increases risk of early, violent death. Continued intervention is necessary to redress these grim findings." – by Chelsea Frajerman Pardes

Disclosures: The authors report no relevant financial disclosures.