Association of Childhood History of Parental Incarceration and Juvenile Justice Involvement With Mental Health in Early Adulthood | Adolescent Medicine | JAMA Network Open | JAMA Network
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    1 Comment for this article
    Adverse exposures during childhood
    Frederick Rivara, MD, MPH | University of Washington
    This study highlights another serious health disparity to children in the US. Youth of color are both much more likely to have a parent who has been incarcerated as well as have juvenile justice involvement than children of other races and ethnicities. The long term health effects can contribute to the perpetuation of this cycle. One partial solution is to decrease the rate of incarceration among black males.
    CONFLICT OF INTEREST: Editor in Chief, JAMA Network Open
    Original Investigation
    Public Health
    September 4, 2019

    Association of Childhood History of Parental Incarceration and Juvenile Justice Involvement With Mental Health in Early Adulthood

    Author Affiliations
    • 1Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
    • 2Division of Academic General Pediatrics, Department of Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
    • 3Mary Ann & J. Milburn Smith Child Health Research, Outreach, and Advocacy Center, Stanley Manne Children’s Research Institute, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
    • 4Division of General Internal Medicine, Department of Medicine, Hennepin Healthcare, Minneapolis, Minnesota
    • 5Hennepin Healthcare Research Institute, Minneapolis, Minnesota
    • 6Department of Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
    • 7Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, California
    • 8Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
    • 9Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
    • 10Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
    JAMA Netw Open. 2019;2(9):e1910465. doi:10.1001/jamanetworkopen.2019.10465
    Key Points español 中文 (chinese)

    Question  Is a childhood history of parental incarceration and juvenile justice involvement associated with mental health conditions in early adulthood?

    Findings  In this nationally representative cross-sectional study, young adults with a history of both parental incarceration and juvenile justice involvement reported more mental health conditions compared with peers with no justice system exposure during childhood.

    Meaning  Parental incarceration and juvenile justice involvement may be associated with mental illness in young adult populations.

    Abstract

    Importance  Young adults with a childhood history of parental incarceration (PI) or juvenile justice involvement (JJI) are more likely to have worse mental health outcomes than their peers. However, the association between mental health and exposure to both PI and JJI (PI plus JJI) is unclear.

    Objective  To determine the association of PI plus JJI exposure with mental health outcomes in young adulthood.

    Design, Setting, and Participants  A cross-sectional study of the US National Longitudinal Survey of Adolescent to Adult Health was conducted to examine the associations between PI, JJI, and PI plus JJI and mental health outcomes (ie, depression, anxiety, posttraumatic stress disorder, suicidal ideation, and mental health counseling). In-home interviews were conducted of 13 083 participants; 704 participants with PI after age 18 years were excluded, and 12 379 participants formed the analysis sample. Participants were in grades 7 to 12 in 1994 to 1995 and were ages 24 to 32 years at follow-up in 2008. Data analysis was completed in 2019.

    Exposures  Parental incarceration, JJI, or PI plus JJI before age 18 years.

    Main Outcomes and Measures  Mental health outcomes in early adulthood (ages 24-32 years). The analysis included multivariable logistic regression models; accounted for individual, family, and geographic-level factors; and generated adjusted odds ratios.

    Results  Among 13 083 participants (6962 female; weighted proportion, 49.6%) with a mean age at wave 1 of 15.4 years (95% CI, 15.2-15.7 years), 10 499 (80.2%) did not have a history of PI or JJI, 1247 (9.1%) had childhood PI, 704 (5.2%) had PI after age 18 years, 492 (4.5%) had JJI only, and 141 (1.2%) had PI plus JJI. Sociodemographic characteristics varied by exposure. Exposure to both PI and JJI was associated with a greater risk of depression (adjusted odds ratio, 2.80; 95% CI, 1.60-4.90), anxiety (adjusted odds ratio, 1.89; 95% CI, 1.08-3.31), and posttraumatic stress disorder (adjusted odds ratio, 2.92; 95% CI, 1.09-7.82) compared with peers with neither exposure. Exposure to both PI and JJI did not have an additive association with mental health beyond PI or JJI alone.

    Conclusions and Relevance  This study suggests that exposure to the criminal justice system during childhood places individuals at risk for poor mental health outcomes in early adulthood. Clinical, advocacy, and policy efforts that prioritize reducing the impact of the US criminal justice system on children may yield substantive improvements in the mental well-being of those individuals as adults.

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