Detained youth, health outcomes, and knowledge of where to access care: A cross sectional study of residents at a large juvenile detention center

Detained youth in the United States have poorer health than their peers outside of the juvenile justice system and are disproportionately at risk for poorer health compared to the general population of youth. Little is known about the preventive services they receive at visits to health care providers in the community, the impact of recidivism on their health outcomes, or youth knowledge of where to access health services in the community. This study determined the preventive services detained youth received at their most recent visit to a health care provider prior to detention, differences in immunization history, substance use, mental health symptoms, and sexual behavior between recidivist youth and first-time detainees, and what detained youth know about where to access care for these health issues. Data were collected using mixed methods from a convenience cross-sectional sample of 301 youth aged 12 – 18 years, detained at a large, urban juvenile detention center in the Southeastern United States. Information was obtained using surveys, and data abstraction from their medical records. Logistic regression analysis, Chi-squared tests and thematic analysis were used to analyze the data. Many youth did not receive recommended health screenings for sexual health, mental health symptoms and substance use at recent well-child visits. Recidivist youth had significantly higher Tdap vaccination rates compared with first-time detainees (OR – 3.4; p=0.01), and were less likely to test positive for Chlamydia than first-time detainees (OR – 0.5; p= 0.04). Many youth could not identify a resource for health care. Having a primary care provider, perceived susceptibility, and previous experiences with health care providers all influenced what youth knew about where to seek care. Few adolescents go for well-checks, therefore every contact with health providers should be an opportunity for catch-up preventive services. The use of mixed methods provided a better perspective of where detained youth would seek help for health issues. Juvenile detention centers have a unique opportunity to improve the health of a medically underserved patient population