Pediatric criminal legal system involvement and functional limitations in early adulthood

Abstract

PURPOSE: Theory and research suggest that being arrested, incarcerated in a juvenile facility, or incarcerated in an adult facility before 18 could be associated with higher levels of functional limitations during adulthood when compared to non-criminal legal system (CLS) involved individuals. This pathway may exist due to limited healthcare access during early adulthood. We hypothesized that: CLS involvement before 18 could be associated with higher levels of functional limitations directly and indirectly through health care access.

METHODS: The data come from the National Longitudinal Survey of Youth 1997. CLS involvement was measured as no contact, arrested, arrested and incarcerated in a juvenile facility, and arrested and incarcerated in an adult facility before 18. Functional limitations are limitations in functioning from physical/mental impairments. Health care access captured health insurance enrollment and doctor care usage. We examined the direct and indirect effects of CLS involvement before 18 on functional limitations using Structural Equation Modeling.

RESULTS: Of the analytical sample (N=8961), 14%, 2%, and 1% reported being arrested, incarcerated in a juvenile facility, or incarcerated in an adult facility before 18 (respectively). Individuals arrested/incarcerated in juvenile facilities had lower health care access than non-CLS-involved individuals. Individuals arrested/incarcerated in an adult facility before 18 had higher functional limitations than non-CLS involved individuals. Higher health care access was associated with higher functional limitations.

MAJOR CONCLUSIONS: Being arrested/incarcerated in a juvenile facility had indirect effects on functional limitations during adulthood. Being arrested/incarcerated in an adult facility before 18 had direct effects on functional limitations during adulthood.