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Why Juvenile Prisoners Become Unhealthy Adults

Research shows that, the more time people spend behind bars as kids, the unhealthier they will be as adults.

By Kate Wheeling


(Photo: Darrell Ingham/Getty Images)

The United States’ juvenile incarceration woes are well-documented: More than 1.3 million adolescents and children are arrested every year, and roughly 80 percent of juveniles who spend time incarcerated wind up back behind bars as adults. There are major public-health implications from this high juvenile incarceration rate, and academics and policymakers alike are both scrambling to understand how, exactly, juvenile incarceration affects young people’s health.

Though previous studies have shown that adolescents and adults with a history of incarceration tend to have poorer health, researchers have not been able to deduce whether incarceration actually causes those health declines. (That’s because many of the same factors that lead to poor health outcomes — poverty, minority status, mental illness — also increase the risk of incarceration.) And, in the U.S., where a greater proportion of American adolescents and children are behind bars than any other developed nation, that’s an important question.

To find out if incarceration plays a causal role in health outcomes, researchers from the University of California–Los Angeles turned to data from 14,344 participants in the National Longitudinal Study of Adolescent to Adult Health. The researchers looked into whether the duration of incarceration influenced participants’ self-reported accounts of general health status, depressive symptoms, suicidal thoughts, and functional limitations (in other words, problems climbing stairs). The authors accounted for variables associated with both incarceration and health in their analysis of the data, including baseline health, gender, race, and parents’ income and education.

“The juvenile justice system, initially created to rehabilitate youthful offenders, has become increasingly harsh and punitive.”

Fourteen percent of the participants reported having been incarcerated: half for less than a month, roughly a third for between one and 12 months, and 15 percent for more than a year. The more time offenders spent behind bars, the worse off they were health-wise later on. Those who had spent any more than one month behind bars experienced worse overall physicalhealth outcomes; those who spent more than a year locked up saw, in addition to poor physical health, worsened mental health and a greater likelihood to suffer from functional limitations.

The authors outline several possible explanations for the correlation between incarceration and health: exposure to communicable diseases in detention facilities, physical or sexual assaults, the fracture of social networks and supports, and stigma that leaves former inmates socially and economically disadvantaged even after they get out.

“For the 1.3 million children and adolescents arrested in the United States each year, incarceration may systemically degrade their healthy development,” the study authors write. “The juvenile justice system, initially created to rehabilitate youthful offenders, has become increasingly harsh and punitive.”

The findings are particularly concerning in light of Donald Trump’s “tough on crime” stance, a position that ignores decades of evidence that shows harsher punishments and mass incarceration do little to ensure public safety. And, as this study shows, America’s penchant for incarceration may even threaten public health.