Delinquent youth—especially girls—more likely to die violently as adults

Delinquency in youth predicts a significantly higher rate of violent death in adulthood—especially from firearms—and females are among the most vulnerable, reports a new Northwestern Medicine study.

Delinquent females died violently at nearly five times the rate of those in the general population, according to the study, while delinquent males died at three times general population rates.

Death rates in Hispanic males and females were five and nine times more than the general population rates, respectively.

This is the first large-scale study to look at in delinquent females and adds new data on Hispanics, now the largest minority group in the U.S. The paper will be published June 16 in the journal Pediatrics.

In addition, violent death up to age 34 was predicted by three risk factors in adolescence: alcohol use disorder, selling drugs and gang involvement, according to the study.

"Our findings are shocking," said lead author Linda Teplin, the Owen L. Coon Professor of Psychiatry and Behavioral Sciences at Northwestern University Feinberg School of Medicine. "Death rates in our sample of delinquent , ages 15 to 19, are nearly twice those of troops in combat in wartime Iraq and Afghanistan."

"Early violent death is a health disparity," added Teplin. "Youth who get detained are disproportionately poor and disproportionately racial and ethnic minorities. We must address early the same as any other health disparity."

The study used newly available data from the Northwestern Juvenile Project, a longitudinal study of 1,829 youth (1,172 males and 657 females, ages 10 to 18 years at baseline) who were detained at the Cook County Juvenile Temporary Detention Center in Chicago between 1995 and 1998. The authors interviewed participants and then followed them up using official death records up to 16 years after the initial interviews.

The youth in the study were randomly selected before their case was disposed, and had not yet been convicted of any crime.

Of the original participants, 111 died. Among those who died, 75 (68 percent) were victims of homicide of which 68 (91 percent) were killed with firearms. African Americans were 4.5 times more likely to die from homicide than non-Hispanic whites.

"Prevention is key," Teplin said. "We need to reduce the likelihood that youth will become delinquent. And, if they are arrested and detained, we need interventions to reduce violence. Otherwise, perpetrators often become victims."

Many delinquent youth commit crimes because of untreated psychiatric problems. For example, they may abuse drugs to self-medicate for depression, and then sell drugs to afford them, Teplin noted.

"These youth may have fallen through the cracks of the health care system into the juvenile justice net," Teplin said. "We should avoid the stereotype that delinquent youth are just bad kids. Many are not hardened criminals; but once detained, they are on a path fraught with risk."

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