Delinquent youth far more likely to die and die violently than youth in the general population

New study of deaths of delinquent youth, the most comprehensive in 60 years, finds minorities most at risk and girls increasingly endangered.
Plagued by a high rate of homicides, youth in the juvenile justice system, a group largely composed of poor racial and ethnic minorities, are four times more likely to die, and if they are girls, eight times more likely, than youth in the general population, according to a new study that considers violent death a major public health threat for America's troubled young people. The study appears in the June edition of the journal Pediatrics.
“We need to get away from the stereotype that delinquent youth are just bad kids. They are a group of young people who are especially vulnerable to early and violent deaths,” said Linda A. Teplin, Ph.D., Owen L. Coon Professor of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, an expert on criminal justice populations, and the study's principal author. “All the young people in our study had at least one encounter with the juvenile justice system,” she added. “And that means there were opportunities to intervene.”

The study, “Early Violent Death in Delinquent Youth,” is the most comprehensive effort in more than 60 years to provide a detailed analysis of death rates among juvenile delinquents, and the first study of its kind to examine girls and Hispanic youth. Much has changed in the last six decades. Racial and ethnic minorities now represent two-thirds of juvenile detainees and females account for 28 percent of juvenile arrests.
Teplin and her colleagues followed 1,829 youth (1172 males and 657 females), some for more than eight years, who between the ages of 10 and 18 years old came through Chicago's Cook County Juvenile Temporary Detention Center. More than half of the sample were African American, almost a third were Hispanic and about 16 percent were non-Hispanic white.

As of March 2004, 65 had died, almost all in a violent manner. Homicides, murders that usually involved guns, accounted for 90 percent of the deaths, while encounters with law enforcement (technically known as death by “legal intervention”) claimed another 5 percent. Other causes of death included suicides and car accidents.

Overall, the mortality rate among delinquent youth was four times higher than youth in the general population, even after controlling for demographic differences. Moreover, it was three times higher than the rate recorded in a 1940 study that previously had been viewed as the reference point for mortality rates in delinquent youth.
Of particular concern to Teplin and her colleagues was the fact that the 14 deaths among female delinquents translated into a mortality rate that is eight times higher than the general population of young girls. Previous studies have either excluded female delinquents or not included enough to make meaningful comparisons.
The study also illuminates significant health disparities involving minority youth and firearms. According to the study, deaths from firearms affect minority youth disproportionately in both the study sample and the general population. Of youth killed by firearms in the study sample, almost 98 percent were African American or Hispanic, compared with almost 60.6 percent in the United States general population in 2000.

“We need to address early violent death as aggressively as any other health disparity,” Teplin said. “Compared to non-Hispanic whites, minorities have a much greater risk of early violent death. We also see minorities over-represented in the justice system. For example, a study published in the Journal of the American Medical Association found that more than 25 percent of low-income urban African American youth have been arrested by age 18.”
In addition, Teplin said the study is yet another warning sign that homicide is a major health risk to young people in general. Homicides have the grim distinction of being the only major cause of childhood mortality to increase in the last 30 years. But she said they have become such a common feature in the lives of inner city youth that they rarely get much attention, particularly when they involve what society considers “troubled kids.”
“Ironically, the 52 children who died in school shootings between 1990 and 2000 have received far more attention than the far greater number of homicides involving inner city youth,” she said. “In New York City alone there were 840 homicides of kids 14 to 17 during the same time period. Although urban violence may not be considered as newsworthy, the health professions must address the equally tragic, if less dramatic, daily violence that disproportionately affects urban youth in general and delinquent youth in particular.”

The study was supported by the Robert Wood Johnson Foundation, the National Institutes of Health, the Substance Abuse & Mental Health Services Administration, the Department of Justice, the Centers for Disease Control and Prevention and a consortium of other federal agencies and private foundations.

Source: June 2005 issue of Pediatrics, RWJF Press
9 June 2005

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