PEDIATRICS Vol. 115 No. 6 June 2005, pp. 1586-1593 (doi:10.1542/peds.2004-1459)
Early Violent Death Among Delinquent Youth: A Prospective Longitudinal Study
* Psycho-legal Studies Program, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
Cook County Office of the Medical Examiner, Chicago, Illinois
Objective. Youth processed in the juvenile justice system are at great risk for early violent death. Groups at greatest risk, ie, racial/ethnic minorities, male youth, and urban youth, are overrepresented in the juvenile justice system. We compared mortality rates for delinquent youth with those for the general population, controlling for differences in gender, race/ethnicity, and age.
Methods. This prospective longitudinal study examined mortality rates among 1829 youth (1172 male and 657 female) enrolled in the Northwestern Juvenile Project, a study of health needs and outcomes of delinquent youth. Participants, 10 to 18 years of age, were sampled randomly from intake at the Cook County Juvenile Temporary Detention Center in Chicago, Illinois, between 1995 and 1998. The sample was stratified according to gender, race/ethnicity (African American, non-Hispanic white, Hispanic, or other), age (10–13 or 
14 years), and legal status (processed as a juvenile or as an adult), to obtain enough participants for examination of key subgroups. The sample included 1005 African American (54.9%), 296 non-Hispanic white (16.2%), 524 Hispanic (28.17%), and 4 other-race/ethnicity (0.2%) subjects. The mean age at enrollment was 14.9 years (median age: 15 years). The refusal rate was 4.2%. As of March 31, 2004, we had monitored participants for 0.5 to 8.4 years (mean: 7.1 years; median: 7.2 years; interquartile range: 6.5–7.8 years); the aggregate exposure for all participants was 12944 person-years. Data on deaths and causes of death were obtained from family reports or records and were then verified by the local medical examiner or the National Death Index. For comparisons of mortality rates for delinquents and the general population, all data were weighted according to the racial/ethnic, gender, and age characteristics of the detention center; these weighted standardized populations were used to calculate reported percentages and mortality ratios. We calculated mortality ratios by comparing our sample’s mortality rates with those for the general population of Cook County, controlling for differences in gender, race/ethnicity, and age.
Results. Sixty-five youth died during the follow-up period. All deaths were from external causes. As determined by using the weighted percentages to estimate causes of death, 95.5% of deaths were homicides or legal interventions (90.1% homicides and 5.4% legal interventions), 1.1% of all deaths were suicides, 1.3% were from motor vehicle accidents, 0.5% were from other accidents, and 1.6% were from other external causes. Among homicides, 93.0% were from gunshot wounds. The overall mortality rate was >4 times the general-population rate. The mortality rate among female youth was nearly 8 times the general-population rate. African American male youth had the highest mortality rate (887 deaths per 100000 person-years).
Conclusions. Early violent death among delinquent and general-population youth affects racial/ethnic minorities disproportionately and should be addressed as are other health disparities. Future studies should identify the most promising modifiable risk factors and preventive interventions, explore the causes of death among delinquent female youth, and examine whether minority youth express suicidal intent by putting themselves at risk for homicide.
Key Words: juvenile • delinquent • death • homicide • detainees • gun violence • mortality
Abbreviations: CI, confidence interval • CIBS, bootstrap confidence interval
Accepted Oct 4, 2004.
CiteULike 
Connotea 
Del.icio.us 
Digg 
Facebook 
Reddit 
Technorati 
Twitter What's this?
This article has been cited by other articles:
|
|
 |
|
  P. J. Kelly, A.-L. Cheng, E. Peralez-Dieckmann, and E. Martinez Dating Violence and Girls in the Juvenile Justice System J Interpers Violence, September 1, 2009; 24(9): 1536 - 1551. [Abstract] [PDF]
|
|
|
|
 |
|
 R. Ramchand, A. R. Morral, and K. Becker Seven-Year Life Outcomes of Adolescent Offenders in Los Angeles Am J Public Health, May 1, 2009; 99(5): 863 - 870. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. E. Ezell and E. E. Tanner-Smith Examining the Role of Lifestyle and Criminal History Variables on the Risk of Homicide Victimization Homicide Studies, May 1, 2009; 13(2): 144 - 173. [Abstract] [PDF]
|
|
|
|
 |
|
 M. A. Moreno, M. R. Parks, F. J. Zimmerman, T. E. Brito, and D. A. Christakis Display of Health Risk Behaviors on MySpace by Adolescents: Prevalence and Associations Arch Pediatr Adolesc Med, January 1, 2009; 163(1): 27 - 34. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Nieuwbeerta and A. R. Piquero Mortality Rates and Causes of Death of Convicted Dutch Criminals 25 Years Later Journal of Research in Crime and Delinquency, August 1, 2008; 45(3): 256 - 286. [Abstract] [PDF]
|
|
|
|
 |
|
 J. H. Goldberg Worldview of High-Risk Juvenile Delinquents: Relationship to Decisions to Shoot Criminal Justice and Behavior, June 1, 2007; 34(6): 846 - 861. [Abstract] [PDF]
|
|
|
|
|
|
A. R. Piquero, L. E. Daigle, C. Gibson, N. L. Piquero, and S. G. Tibbetts Research Note: Are Life-Course-Persistent Offenders At Risk for Adverse Health Outcomes? Journal of Research in Crime and Delinquency, May 1, 2007; 44(2): 185 - 207. [Abstract] [PDF]
|
|
|
|
 |
|
 D. T. Efron, A. Haider, D. Chang, E. R. Haut, B. Brooke, and E. E. Cornwell III Alarming Surge in Nonsurvivable Urban Trauma and the Case for Violence Prevention Arch Surg, August 1, 2006; 141(8): 800 - 805. [Abstract] [Full Text] [PDF]
|
|
