Early Violent Death Among Delinquent Youth: A Prospective Longitudinal Study

Abstract

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, nonHispanic 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 12 944 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 In their classic study of 500 white male delinquents sampled in the 1940s, Glueck and Glueck 10 found that nearly 5% had died by age 32, compared with 2.2% of nondelinquent control subjects; by age 65, 13% had died unnatural deaths, compared with 6% of the nondelinquent control subjects. 5 Another study of 118 delinquen...

Mortality of Youth Offenders Along a Continuum of Justice System Involvement

“…The findings support past research showing that youth offenders face a significantly greater risk of death than community youth. [1][2][3][4][5] A comparatively high rate of offender mortality was evident even among arrested youth whose involvement in the system is relatively common (one in three youth) 12 and minimal (i.e., no time in a secure facility). Further, consistent with the study hypothesis, the data indicate that the greater the extent of an individual's justice system involvement, the greater the risk of death.…”

“…First, although the SMRs did not vary by gender alone, SMRs among male youth varied substantially by race (1.24 among black male youth vs 2.23 among white male youth), confirming past studies showing that black male youth experience high rates of death in the community, regardless of justice system involvement. [4][5][6] Second, black youth offenders experienced the clearest increase in mortality by severity of justice system involvement. Third, in the final proportional hazards model predicting time to death among offenders, race/ethnicity was only marginally significant for black and Hispanic youth.…”

“…[1][2][3][4][5] In a longitudinal study of detained youth in Cook County, Illinois, the mortality rate of detained youth was four times that of the general adolescent population, 5 and the increased risk of early mortality persisted into young adulthood. 6 Deaths of both youth offenders and community youth are likely to be violent.…”

Suicidal Ideation and Behaviors Among Youths in Juvenile Detention

“…In our sample, African American and Hispanic males are at substantially greater risk of an early violent death than non-Hispanic whites. 56 The most common methods for recent suicide attempts -cutting and drug overdose -are also the most common in the general population. 28 A striking finding was that Hispanic males who attempted suicide were more likely to use a firearm than African American or non-Hispanic white males.…”

“…Suicidal ideation may play a different role in the risk for suicide for different groups. Further research is also needed to examine if the disproportionate violent deaths among African American and Hispanic males, 56 in part, reflects their underlying suicidal ideation. Suicidal behavior in these youth may manifest as self-destructive, reckless, or dangerous behavior, often referred to as "victim-precipitated homicide" or "suicide-by-cop".…”