Adverse Childhood Experiences and Justice System Contact: A Systematic Review

CONTEXT: Given the wide-ranging health impacts of justice system involvement, we examined evidence for the association between adverse childhood experiences (ACEs) and justice system contact in the United States.

OBJECTIVE: To synthesize epidemiological evidence for the association between ACEs and justice system contact.

DATA SOURCES: We searched 5 databases for studies conducted through January 2020. The search term used for each database was as follows: (“aces” OR “childhood adversities”) AND (“delinquency” OR “crime” OR “juvenile” OR criminal* OR offend*).

STUDY SELECTION: We included all observational studies assessing the association between ACEs and justice system contact conducted in the United States.

DATA EXTRACTION: Data extracted from each eligible study included information about the study design, study population, sample size, exposure and outcome measures, and key findings. Study quality was assessed by using the Newcastle-Ottawa Scale for nonrandomized trials.

RESULTS: In total, 10 of 11 studies reviewed were conducted in juvenile population groups. Elevated ACE scores were associated with increased risk of juvenile justice system contact. Estimates of the adjusted odds ratio of justice system contact per 1-point increase in ACE score ranged from 0.91 to 1.68. Results were consistent across multiple types of justice system contact and across geographic regions.

LIMITATIONS: Most studies reviewed were conducted in juvenile justice-involved populations with follow-up limited to adolescence or early adulthood.

CONCLUSIONS: ACEs are positively associated with juvenile justice system contact in a dose-response fashion. ACE prevention programs may help reduce juvenile justice system contacts and improve child and adolescent health.