Journal of Correctional Health Care - April 2023 - 115

Journal of Correctional Health Care
Volume 29, Number 2, 2023
ª The Author(s) 2023
DOI: 10.1089/jchc.21.10.0112
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BEST PRACTICES
Juvenile Detention and Primary Care Utilization:
Are They Related?
Shelley Aggarwal, MD1* and John Will, MPA2
Abstract
There is little information on the health care utilization habits of juvenile justice-involved youth. We evaluated
whether health care utilization trends after discharge from a juvenile detention facility are associated
with a decreased risk of future detention. A retrospective chart review was conducted for youth admitted to
a juvenile detention facility from November 1, 2017, to October 31, 2018. Youth who accessed primary care
(PC) appeared less likely to be readmitted to juvenile detention compared to those who did not access PC,
with the greatest increase in readmissions occurring between days 30 and 60 and slowing after day 90. PC
access and health care utilization may be associated with a decreased risk of future detention; however,
additional research is needed to further explore this potential linkage.
Keywords: juvenile justice, primary care, juvenile detention, health care utilization, youth reentry
Introduction
Admission to the correctional environment is a unique
medical opportunity to expand knowledge about the
health care needs of justice-involved adolescents and
young adults. In 2019, there were 696,620 arrests of individuals
under the age of 18 years in the United States.
This is 58% fewer than the number of arrests in 2010
and a notable decrease from the peak of 2.7 million in
1996 (Office of Juvenile Justice and Delinquency Prevention
[OJJDP], 2020; Owen et al., 2020). In data from
2019, male and female youth under the age of 15 years
(32%) and female youth (31%) accounted for nearly
one-third of total arrests, with minority youth disproportionately
represented within this population (OJJDP,
2020).
Youth in the juvenile justice ( JJ) system have health
care needs that go beyond those of their nonjusticeinvolved
peers, are at greater risk for worse health outcomes,
and are known to have higher rates of chronic
medical conditions and mental health diagnoses (Aalsma
et al., 2017; Anthony et al., 2010; Barnert et al., 2017,
2020). Despite the linkage between incarceration and
higher morbidity and mortality in this population, there
is limited information on how juvenile detention influences
health care utilization and whether there are aspects
of health care utilization that can function as protective
factors against JJ involvement.
The United States has the highest prison population of
any country and detains more people than anywhere else
in the world (World Prison Brief, 2022). The American
Academy of Pediatrics has advocated for juvenile justice
reform and urged pediatricians to function as advocates
for justice-involved populations (Aalsma et al., 2017;
Barnert, 2020).
1Department of Pediatrics, Santa Clara County Valley Medical Center, San Jose, California, USA.
2Technology and Services Solutions-Health Systems, Santa Clara County Valley Medical Center, San Jose, California, USA.
*Address correspondence to: Shelley Aggarwal, MD, Department of Pediatrics, Santa Clara County Valley Medical Center, 751 S. Bascom Avenue, San Jose, CA 95128, USA,
Email: shelley.aggarwal@hhs.sccgov.org
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Journal of Correctional Health Care - April 2023

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