{"title":"Pediatric Health and System Impacts of Mass Incarceration, 2009–2020: A Matched Cohort Study","authors":"","doi":"10.1016/j.acap.2024.05.010","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>The US has the highest incarceration rate in the world; incarceration’s direct and indirect toll on the health and health care use of youth is rarely investigated. We sought to compare the health of youth with known personal or family justice involvement and a matched cohort of youth without known personal/family justice involvement.</div></div><div><h3>Methods</h3><div>A cross-sectional matched parallel cohort study was conducted. We queried electronic health records on youth (<21 years) with a visit in a large Midwestern pediatric hospital-based institution from January 2009 to December 2020. Youth were located by searching for justice-related (eg, prison, jail) keywords within all clinician notes. Health diagnostic profiles were measured using ICD 9/10 codes. Health care use included total admissions, inpatient days, emergent and urgent visits, and outpatient visits.</div></div><div><h3>Results</h3><div>Across all youth at one institution over an 11-year period, 2.2% (N = 38,263) were identified as having probable personal or family justice-involvement. Youth with personal or familial justice involvement had 1.5–16.2 times the prevalence of mental health and physical health diagnoses across all domain groupings compared to a matched sample and the total population sample. From 2009–2020, approximately two-thirds of behavioral health care and nearly a quarter of all hospital inpatient days were attributed to the 2.2% of youth with probable personal or familial justice system involvement.</div></div><div><h3>Conclusion</h3><div>The study illuminates the vast disparities between youth with indirect or direct contact with the criminal legal system and matched youth with no documented contact. Better investment in monitoring and prevention efforts are needed.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"24 8","pages":"Pages 1285-1295"},"PeriodicalIF":3.0000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Academic Pediatrics","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1876285924001645","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
Abstract
Objective
The US has the highest incarceration rate in the world; incarceration’s direct and indirect toll on the health and health care use of youth is rarely investigated. We sought to compare the health of youth with known personal or family justice involvement and a matched cohort of youth without known personal/family justice involvement.
Methods
A cross-sectional matched parallel cohort study was conducted. We queried electronic health records on youth (<21 years) with a visit in a large Midwestern pediatric hospital-based institution from January 2009 to December 2020. Youth were located by searching for justice-related (eg, prison, jail) keywords within all clinician notes. Health diagnostic profiles were measured using ICD 9/10 codes. Health care use included total admissions, inpatient days, emergent and urgent visits, and outpatient visits.
Results
Across all youth at one institution over an 11-year period, 2.2% (N = 38,263) were identified as having probable personal or family justice-involvement. Youth with personal or familial justice involvement had 1.5–16.2 times the prevalence of mental health and physical health diagnoses across all domain groupings compared to a matched sample and the total population sample. From 2009–2020, approximately two-thirds of behavioral health care and nearly a quarter of all hospital inpatient days were attributed to the 2.2% of youth with probable personal or familial justice system involvement.
Conclusion
The study illuminates the vast disparities between youth with indirect or direct contact with the criminal legal system and matched youth with no documented contact. Better investment in monitoring and prevention efforts are needed.
期刊介绍：
Academic Pediatrics, the official journal of the Academic Pediatric Association, is a peer-reviewed publication whose purpose is to strengthen the research and educational base of academic general pediatrics. The journal provides leadership in pediatric education, research, patient care and advocacy. Content areas include pediatric education, emergency medicine, injury, abuse, behavioral pediatrics, holistic medicine, child health services and health policy,and the environment. The journal provides an active forum for the presentation of pediatric educational research in diverse settings, involving medical students, residents, fellows, and practicing professionals. The journal also emphasizes important research relating to the quality of child health care, health care policy, and the organization of child health services. It also includes systematic reviews of primary care interventions and important methodologic papers to aid research in child health and education.
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