In the Journals

Physicians have 'critical opportunity' to prevent youth incarceration, improve patients' adult health

Youth and adults who have spent time in prison have distinctly worse health statuses than those who did not, according to research recently published in Pediatrics.

One of the study’s authors explained the dual role physicians can play to keep their young patients out of prison.

Elizabeth Barnert
Elizabeth Barnert

“The AAP 2011 policy statement on youth involved in the juvenile justice system called for pediatricians to improve the health of justice-involved youth, including to advocate to reduce the number of youth confined in the juvenile justice systems,” Elizabeth Barnert, MD, MPH, MS, assistant professor, department of pediatrics, University of California, Los Angeles, told Healio Family Medicine. “Acting both in the public health sphere and as clinicians, it is becoming increasingly clear that incarceration is an important social determinant of health and physicians need to respond accordingly.” 

Barnert and colleagues studied data from 14,344 adults in the National Longitudinal Study of Adolescent to Adult Health. Weighted multivariate logistic regressions were used to study the connection between cumulative incarceration duration (none, less than 1 month, 1 to 12 months, and more than 1 year) before Wave IV (aged 24 to 34 years) and subsequent suicidal thoughts, depressive symptoms, functional limitations and health outcomes as adults. Models controlled for Wave I (grades 7–12) sociodemographics, baseline health, and covariates associated with health and incarceration.

The researchers reported that compared with no incarceration, prison time of less than 1 month foretold subsequent adult depressive symptoms (OR = 1.41; 95% CI, 1.11-1.8). A period of 1 to 12 months in prison foretold worse subsequent adult general health (OR = 1.48; 95% CI, 1.12–1.96). A period of more than a year in prison foretold subsequent adult functional limitations (OR = 2.92; 95% CI, 1.51-5.64), adult depressive symptoms (OR = 4.18; 95% CI, 2.48–7.06), and adult suicidal thoughts (OR = 2.34; 95% CI, 1.09–5.01). 

Barnert said conversations between physicians, patients and parents about the connection between incarceration and health must take place early and often.

“Pediatricians and family physicians have a critical opportunity to improve youths’ long-term adult health outcomes by helping youth and their families to prevent youth incarceration in the first place and, for those exposed, to actively screen for potential downstream negative health effects, such as higher rates of depression and suicidal thoughts,” she said. “Our demonstration of a long-term relationship between youth incarceration and subsequent adult health suggests that these conversations need to extend into adulthood.”

According to researchers, the United States imprisons a “far greater proportion” of its youth than all other developed countries and of the 1.3 million people arrested at age 18 years or younger, about 80% will return to prison as adults.  by Janel Miller

Disclosure: The researchers report no relevant financial disclosures.

Youth and adults who have spent time in prison have distinctly worse health statuses than those who did not, according to research recently published in Pediatrics.

One of the study’s authors explained the dual role physicians can play to keep their young patients out of prison.

Elizabeth Barnert
Elizabeth Barnert

“The AAP 2011 policy statement on youth involved in the juvenile justice system called for pediatricians to improve the health of justice-involved youth, including to advocate to reduce the number of youth confined in the juvenile justice systems,” Elizabeth Barnert, MD, MPH, MS, assistant professor, department of pediatrics, University of California, Los Angeles, told Healio Family Medicine. “Acting both in the public health sphere and as clinicians, it is becoming increasingly clear that incarceration is an important social determinant of health and physicians need to respond accordingly.” 

Barnert and colleagues studied data from 14,344 adults in the National Longitudinal Study of Adolescent to Adult Health. Weighted multivariate logistic regressions were used to study the connection between cumulative incarceration duration (none, less than 1 month, 1 to 12 months, and more than 1 year) before Wave IV (aged 24 to 34 years) and subsequent suicidal thoughts, depressive symptoms, functional limitations and health outcomes as adults. Models controlled for Wave I (grades 7–12) sociodemographics, baseline health, and covariates associated with health and incarceration.

The researchers reported that compared with no incarceration, prison time of less than 1 month foretold subsequent adult depressive symptoms (OR = 1.41; 95% CI, 1.11-1.8). A period of 1 to 12 months in prison foretold worse subsequent adult general health (OR = 1.48; 95% CI, 1.12–1.96). A period of more than a year in prison foretold subsequent adult functional limitations (OR = 2.92; 95% CI, 1.51-5.64), adult depressive symptoms (OR = 4.18; 95% CI, 2.48–7.06), and adult suicidal thoughts (OR = 2.34; 95% CI, 1.09–5.01). 

Barnert said conversations between physicians, patients and parents about the connection between incarceration and health must take place early and often.

“Pediatricians and family physicians have a critical opportunity to improve youths’ long-term adult health outcomes by helping youth and their families to prevent youth incarceration in the first place and, for those exposed, to actively screen for potential downstream negative health effects, such as higher rates of depression and suicidal thoughts,” she said. “Our demonstration of a long-term relationship between youth incarceration and subsequent adult health suggests that these conversations need to extend into adulthood.”

According to researchers, the United States imprisons a “far greater proportion” of its youth than all other developed countries and of the 1.3 million people arrested at age 18 years or younger, about 80% will return to prison as adults.  by Janel Miller

Disclosure: The researchers report no relevant financial disclosures.