title: Overcoming Challenges to Care in the Juvenile Justice System: A Case Study and Commentary.
abstract: Youth in the criminal justice system commonly suffer from multiple medical and psychological health problems. Because they likely live in lower socioeconomic environments, the medical care they receive through the justice system might be their only recent medical care and can result in the discovery of health problems or chronic illnesses that must be managed while in the system and beyond. We describe the case of an adolescent diagnosed with a serious chronic disease during his time in an urban detention center to illustrate how health workers and justice staff must use a team approach in caring for this vulnerable population of children. Barriers to appropriate care, including social and systems-level challenges, are discussed. The lessons learned in this case can be applied more broadly to other vulnerable youth populations, including those in foster care and impoverished communities where the primary care pediatrician (or other assigned pediatric specialist) is both the leader of the medical team and an advocate for quality care.
authors.affiliation: Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine.|Department of Family and Community Medicine, Division of Student Affairs.
authors.forename: Rebekah J
authors.initials: RJ
authors.lastname: Savage
authors.affiliation: Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine.|Physicians' Primary Care of Southwest Florida, Fort Myers, FL.
authors.forename: Jasmine M
authors.initials: JM
authors.lastname: Reese
authors.affiliation: Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine.
authors.forename: Stephenie
authors.initials: S
authors.lastname: Wallace
authors.affiliation: Department of Pediatrics.
authors.forename: Timothy
authors.initials: T
authors.lastname: Wang
authors.affiliation: Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition.
authors.forename: Traci
authors.initials: T
authors.lastname: Jester
authors.affiliation: Department of Pediatrics, Division of Pediatric Rheumatology, University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Robert
authors.initials: R
authors.lastname: Lowe
authors.affiliation: University of Alabama at Birmingham School of Medicine, Birmingham, AL.
authors.forename: LaKeshia
authors.initials: L
authors.lastname: Hyndman
authors.affiliation: Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine.
authors.forename: Nefertiti
authors.initials: N
authors.lastname: Durant
mesh_terms: D000068879:Adalimumab / Q000627:therapeutic use; D000293:Adolescent; D003416:Criminal Law / Q000592:standards*; D003424:Crohn Disease / Q000175:diagnosis / Q000628:therapy*; D003695:Delivery of Health Care; D006301:Health Services Needs and Demand; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D010372:Pediatrics; D012935:Social Justice; D035862:Vulnerable Populations
chemical_list: D007166:Immunosuppressive Agents; D000068879:Adalimumab; D008727:Methotrexate