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Originally published by 2 Minute Medicine® (view original article). Reused on AccessMedicine with permission.

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1. Adolescents with any justice system involvement in the past year were more likely to have also been to the emergency department (ED) or been hospitalized during that time period.

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2. Adolescents involved with the justice system who reported fair or poor health, asthma, an illicit drug use problem, or a mood disorder had the highest rates of hospital encounters.

Study Rundown:

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Literature shows juvenile justice system involvement is associated with high risk of various mental and physical health disorders among teenagers, with mortality rates of 4 times those of adolescents who have not been involved with the system. This population represents a potentially large burden on health care services as estimates suggest 1 in 5 adolescents under age 18 are arrested for charges other than minor traffic violations. Researchers in this study aimed to determine if ED and hospital visits were higher among adolescents with recent justice system involvement. They also stratified care facility use rates by health condition to see if adolescents with specific diseases were more likely to present to the hospital. Results showed adolescents with any level of justice system involvement in the past year were more likely to have visited the ED or been hospitalized than adolescents without juvenile justice contact. Among those with recent justice system involvement, adolescents with substance use disorders or asthma had the highest rates of ED encounters. This study relied on self-reporting for data collection and thus may be subject to underreporting of justice system involvement, mental health disorders, and substance abuse. Data from adolescents who were institutionalized during the study period were not included, which may have resulted in underestimation of care facility use. This study highlights the need for support systems connecting adolescents with justice system involvement to timely, appropriate primary care, behavioral health and social service resources to reduce rates of acute care use.

In-depth [cross-sectional]:

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Researchers reviewed information regarding adolescents aged 12 to 17 from the National Survey on Drug Use and Health during 2009 to 2014. Data including ED visit frequency, hospitalizations, illicit drug use, mental health disorders, and other health conditions were analyzed for 5149 adolescents with justice system involvement within the past year and compared with data from 97 976 adolescents without involvement. Adolescents were group by level of justice system involvement (none, arrest, probation/parole, detention). Results showed adolescents with any level of system involvement were more likely to report ED visits in the past year than their peers with no justice system involvement (no involvement, 31.0% [95%CI 30.6–31.5]; past year arrest: 38.5% [95%CI 34.7–42.2]; past year probation or parole: 38.8% [95%CI 35.7–41.9]; past year juvenile detention: 39.5% [95%CI 35.2–43.7]). Similar trends were seen for hospitalizations rates over the past 12 months (no past year justice involvement: 4.8% [95%CI 4.6–5.0]; past year arrest: 7.2% [95%CI 5.4–8.9]; past year probation or parole: 7.1% [95%CI 5.8–8.4]; past year juvenile detention: 8.8% [95%CI 6.9–10.7]). Among those with justice system involvement, ED visit rates were highest among adolescents with substance abuse disorders and asthma (p < .05 for both comparisons). Both ED visits and hospitalization rates in adolescents with justice system involvement were higher among individuals who reported poor or fair health, illicit drug use, or a mood disorder than those who did not (p < .05 for all comparisons).

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