The prevalence of physical health problems among youth in the juvenile justice system: A systematic review.

71 The Prevalence of Physical Health Problems among Youth in the Juvenile Justice System Udell and Mohammed Journal of Health Disparities Research and Practice Volume 12, Issue 3, Fall 2019, pp. 71-94 © 2011 Center for Health Disparities Research School of Community Health Sciences University of Nevada, Las Vegas The Prevalence of Physical Health Problems among Youth in the Juvenile Justice System: A Systematic Review Wadiya A. Udell, University of Washington Bothell Selina A. Mohammed, University of Washington Bothell Corresponding Author: Wadiya A. Udell, ABSTRACT Justice-involved youth suffer from a range of health problems. Using health and social science databases, we summarize findings from studies reporting rates of physical health problems among youth in the juvenile justice system published between 2006 and 2017. A total of 23 were identified, with the majority examining sexual health problems and focusing on youth confined to correctional facilities. Although fewer studies focused on non-sexual health problems and nondetained youth, findings suggest disparities across some physical health problems impacting youth within various levels of justice system involvement. Given the health risks faced by justiceinvolved youth and their long-term consequences, more studies examining their physical health status is needed to create targeted interventions that address disparities for this high-risk group. Keywords: Adolescents; Health; Juvenile justice; Incarceration INTRODUCTION Each year, over 45,000 youth in the United States (US) are detained or incarcerated (Office of Juvenile Justice and Delinquency Prevention [OJJDP], 2018), with even more receiving sentences of probation and community service alternatives to detention (OJJDP, 2018). Justiceinvolved youth are a high-risk group of adolescents who suffer from a range of behavioral and health challenges. Studies find that up to 70% of youth in the juvenile justice system have diagnosable mental health problems, including substance abuse disorders (Balogun, Triois, Swartz, Lloyd & Beyda, 2018; Schubert & Mulvey, 2014; Vincent, Grisso, Terry & Banks, 2008). Additionally, justice-involved youth have been found to have high rates of sexually transmitted infections (STIs). According to the Centers for Disease Control and Prevention (CDC), chlamydia rates among youth detained in correctional facilities were 6.9% for males and 15.3% for females (CDC, 2010). Similar rates have been found for non-detained adjudicated youth (Donaldson, Burns, Bradshaw, Ellen & Maehr, 2013). Journal of Health Disparities Research and Practice Volume 12, Issue 3, Fall 2019 http://digitalscholarship.unlv.edu/jhdrp/ Follow on Facebook: Health.Disparities.Journal Follow on Twitter: @jhdrp 72 The Prevalence of Physical Health Problems among Youth in the Juvenile Justice System Udell and Mohammed While the majority of studies on adjudicated youth have documented significant mental health, substance abuse, and to lesser extent sexual health problems, fewer studies have focused on health problems outside of these specific areas. However, several studies have suggested adjudicated youth have unmet health needs in the areas of oral health, trauma-related injuries and respiratory issues (Braverman & Morris, 2011; Feldmann, 2008). Additionally, researchers and health professionals have indicated that many incarcerated and detained youth lack adequate and consistent health care outside of the juvenile justice system, and receive much of their care while detained. Such studies and reports have noted various health services provided to adjudicated youth in detention and residential settings, including testing and treatment for STIs, immunizations, and treatment for asthma (Feldmann, 2008; Gallagher, Dobrin & Douds, 2007). While these reports provide a sense of the health needs of this population, much of the information has been based on providers’ experiences and anecdotes (American Academy of Pediatrics, 2011). Despite limited documentation of health problems beyond mental health issues and substance abuse experienced by adjudicated youth, few empirical studies examining the prevalence of physical health problems among this population have been conducted. The purpose of this review is to provide a systematic examination of the physical health problems faced by justice-involved youth in the United States. The review provides an overview of physical health problems and associated prevalence rates identified in previous studies, including demographic differences in rates. When possible, rates of physical health problems identified among adjudicated youth are compared to those from youth in the general population. In many cases, comparison rates for the general population were reported in the research studies reviewed. When such comparative data were not provided, we reported rates for same-aged populations provided by national health centers, such as the Centers for Disease Control and Prevention (CDC) and the Department of Health and Human Services (DHHS). Additional information regarding the comparative general population can be found in Table 1. We examined empirical studies published from 2006 - 2017 indicating prevalence rates of physical health problems among adjudicated youth. Given the extant research on adjudicated youth’s mental health and substance use, which is commonly considered a mental health problem, this review excludes these particular health areas. The following is a review of the physical health problems experienced by youth in the juvenile justice system. In addition, we outline important areas for further research and intervention. METHODS We conducted a systematic review of academic journals through a search of nine key databases covering a variety of academic disciplines studying youth in the juvenile justice system. These databases included PubMed, CINAHL, PsycINFO, Embase, Sociological Abstracts, Social Services Abstracts, Web of Science: Social Science, Criminal Justice Abstracts, and Social Work Abstracts. Search terms included keywords relating to the following three categories: 1) adolescents (i.e., ‘adolescen*’, ‘youth’, ‘juvenile’), 2) juvenile justice system (i.e., ‘incarcerated’, ‘adjudicated’, ‘detained’, ‘detention’, ‘probation’, ‘justice’, ‘offender’), 3) and physical health (i.e., ‘health’, ‘health system’, ‘health care’, ‘health services’, ‘health utilization’, ‘treatment’). Searches were restricted to English language manuscripts published in peer-reviewed journals between January 2006 – July 2017. Journal of Health Disparities Research and Practice Volume 12, Issue 3, Fall 2019 http://digitalscholarship.unlv.edu/jhdrp/ Follow on Facebook: Health.Disparities.Journal Follow on Twitter: @jhdrp 73 The Prevalence of Physical Health Problems among Youth in the Juvenile Justice System Udell and Mohammed All abstracts retrieved by searches were reviewed by the first author, and irrelevant references were discarded. St (...truncated)