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 "A lot of people think there are potentially harmful effects of
being in the justice system, but the long-term effects really
haven’t been quantified," said lead author Dr. Elizabeth Barnert, of
the David Geffen School of Medicine at the University of California,
Los Angeles.
The magnitude of the increased health risks was tied to the time
people spent incarcerated, researchers found.
About 1.3 million children under age 18 years are arrested each
year, write the researchers in Pediatrics. Of those, 46 percent
require some type of immediate medical attention. Additionally 70
percent of incarcerated children have at least one psychiatric
disorder.
For the new study, the researchers analyzed data collected from
14,344 participants in the National Longitudinal Study of Adolescent
to Adult Health. The researchers aimed to see if their duration of
incarceration was linked to general health, functional limitations,
depressive symptoms and suicidal thoughts as adults.
Overall, 14 percent reported being incarcerated as children. About
half were incarcerated for less than a month, about one-third were
incarcerated for one to 12 months and about 15 percent were
incarcerated for more than a year.
Compared to participants who were never incarcerated, those who were
in the juvenile justice system for less than a month were 41 percent
more likely to have symptoms of depression as adults.
Being incarcerated for one to 12 months was tied to a 48 percent
increased risk of worse general health as an adult than those who
weren't involved with the juvenile justice system.
Compared to those not incarcerated, those in the system for more
than a year were nearly three times more likely to have functional
limitation, over four times more likely to have symptoms of
depression and over two times more likely to have suicidal thoughts
as adults.
Similarly, a second study published in the same journal found
factors that put people at risk for HIV and AIDS were more common
among adults who spent time in the juvenile justice system than the
general population.
Like the general population, Karen Abram and colleagues at the
Northwestern University Feinberg School of Medicine in Chicago write
that the prevalence of those risk factors declined over time.
"Like most things in life, the experiences they have as a young
person seem to carry over into their adult years," said Ralph
DiClemente, of Emory University's Rollins School of Public Health in
Atlanta.
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DiClemente, who co-authored an editorial accompanying the new
studies, told Reuters Health that juvenile detention can be very
traumatic even though children are typically not incarcerated for
years at a time.
For example, he said, children may not have a lot of worldly
experiences and may have never left their communities, but they're
being put into a facility with a lot of other people.
"They’re fearful and traumatized from being away," he said.
Instead of incarceration, DiClemente said one possible alternative
is diversion programs like community service or treatment. Also,
introducing programs to promote healthy behaviors and decrease risk
are important.
While implementing programs cost money, he said prevention and risk
reduction programs may pay off later when people are not needing to
be treated for more severe health conditions.
"It becomes an issue of do you pay me now or pay me later,"
DiClemente said.
Barnert told Reuters Health that juvenile incarceration should be
seen as a factor that influences future health.
Some states have age limits that dictate how old a person has to be
before they're involved with the justice system, she said.
Incarceration is something that should be discussed in doctors'
offices, but there are obstacles.
"It’s not something professional associations as a whole are
addressing well or individual clinicians feel comfortable
discussing," she said.
Barnert said future research should trace people's pathways once
they leave the juvenile justice system to pinpoint where health
becomes worse.
SOURCE: http://bit.ly/2jqg4th, http://bit.ly/2jqu8mT and http://bit.ly/2jqpIfK
Pediatrics, online January 23, 2017.
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