189 - Justice-Involved Youth and Social Determinants of Health

Poster Number: 189
Publication Number: 189.413

Christina R. Rojas, Children's National Health System, Washington, DC, United States; Gia M. Badolato, Children's National Health System, Washington, DC, United States; Alexandra Rucker, Children's National Health System, Washington, DC, United States; Monika Goyal, Children's National Medical Center, Washington, DC, United States; Meleah Boyle, Children's National Health System, Washington, DC, United States; Katie Donnelly, Children's National Health System, Washington, DC, United States

Background: Each year, approximately 690,000 youth under the age of 18 are arrested in the United States. While this number has declined over the past decade, this population is historically marginalized, often experiencing decreased educational attainment, mental health issues, and legal issues in adulthood. The majority of research in this space has been conducted by social scientists and policymakers; little work has been done in the field of pediatrics to determine how the healthcare system can best interface and support with these youth.

Objective: The aim of this study was to describe the social determinants of health for justice-involved youth presenting to a pediatric emergency department.

Design/Methods: This was a secondary analysis of a survey designed to measure self-reported social determinants of health and behavioral health risks among adolescents in a pediatric emergency department between July 2017 and August 2019. Participants were asked to indicate any personal involvement with the legal system, including encounters with law enforcement, arrests, convictions, and/or time spent in jail or juvenile detention centers. Multivariable logistic regression was used to measure the association of legal system involvement with various domains pertaining to social determinants of health, adjusting for age, sex, race/ethnicity, sexual orientation, and insurance status.

Results: Of the 384 participants meeting inclusion criteria, 58 adolescents (15.1%) reported prior or current involvement in the legal system (Table 1). Adolescents with legal system contact had higher odds of housing insecurity (aOR 3.7; 95% CI 2.0-6.8), food insecurity (aOR 3.5; 95% CI 1.7-7.2), sex trafficking (aOR 32.4; 95% CI 9.8-106.7), STI concerns (aOR 2.0; 95% CI 1.1-3.8), safety concerns (aOR 3.0; 95% CI 1.6-5.5), mental health concerns (aOR 3.8; 95% CI 1.7-8.3), substance abuse concerns (aOR 7.3; 95% CI 3.8-13.9), and intimate partner violence concerns (aOR 3.1; 95% CI 1.3-7.1) (Table 2).Conclusion(s): Justice-involved youth presenting to our pediatric emergency department experience various psychosocial stressors that can negatively affect their health. Pediatricians and healthcare systems should aim to recognize the needs of this population and implement screening and support tools to better serve these youth. Additional studies are warranted to better understand both the unique healthcare needs of justice-involved youth and how medical providers can best advocate for this population.
Table 1: Adolescents with Juvenile Justice System Involvement
Table 2: Understanding Social Determinants of Health for Adolescents with Juvenile Justice System Involvement