title: Health Conditions and Racial Differences Among Justice-Involved Adolescents, 2009 to 2014.
abstract: 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.
  
  
  
  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.
  
  
  
  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).
  
  
  
  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.
authors.affiliation: Robert Wood Johnson Foundation Clinical Scholars Program, University of Michigan, Ann Arbor; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor; Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor; Division of General Internal Medicine, University of Michigan, Ann Arbor; VA Ann Arbor Healthcare System. Electronic address: tywink@med.umich.edu.
authors.forename: Tyler N A
authors.initials: TNA
authors.lastname: Winkelman
authors.affiliation: VA Eastern Colorado Health Care System, Denver; Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora.
authors.forename: Joseph W
authors.initials: JW
authors.lastname: Frank
authors.affiliation: Institute for Health Research, Kaiser Permanente Colorado, Denver; Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora.
authors.forename: Ingrid A
authors.initials: IA
authors.lastname: Binswanger
authors.affiliation: Department of Psychiatry, University of Michigan, Ann Arbor.
authors.forename: Debra A
authors.initials: DA
authors.lastname: Pinals
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D002648:Child; D002908:Chronic Disease / Q000453:epidemiology* / Q000523:psychology; D003416:Criminal Law; D057237:Criminals / Q000523:psychology* / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D006304:Health Status; D006801:Humans; D007604:Juvenile Delinquency / Q000208:ethnology / Q000523:psychology / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D019964:Mood Disorders / Q000453:epidemiology; D011247:Pregnancy; D000297:Psychology, Adolescent; D019966:Substance-Related Disorders / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
keywords: behavioral health; chronic conditions; health disparities; juvenile justice