A Comparative Examination of Adult Health After Youth Exposure to Juvenile and Adult Systems

To examine young-adult and mid-adult physical and mental health outcomes among persons exposed to juvenile system processing, juvenile legal facility confinement, or adult legal facility confinement before the age of 18.

Using Pathways to Desistance (n = 1131) and the National Longitudinal Survey of Youth 1997 cohort (n = 8961), we use multigroup average treatment effect inverse probability weights to balance system-involved youth who were not exposed to legal facilities, youth exposed to adult facilities, and youth exposed to juvenile facilities in adolescence. We estimate the average treatment effect of exposure to adult facilities on self-reported health, depressive symptoms, and anxious symptoms in early- and mid-adulthood using weighted Poisson regression models.

Generally, respondents who experience deeper system penetration (ie, no facility exposure vs facility confinement, juvenile facility confinement vs adult facility confinement) report worse overall health and greater depressive and anxious symptoms in adulthood. Several contrary findings suggest that exposure to facilities and exposure to adult facilities are associated with better lower anxiety in adulthood.

While exposure to legal-system confinement in adolescence displays negative trends for adult health, community health care systems and juvenile systems disadvantage some youth with regard to long-term physical and mental health. A re-evaluation of health care practices among marginalized populations and juvenile legal systems is needed to produce quality screening, preventative care, and long-term healthful outcomes.