Health inequalities: Is adolescent involvement in the legal system associated with reduced health care access and usage during adulthood?

OBJECTIVE

This study examined the association between being involved in the criminal legal system prior to age 18 and access to medical coverage/care in adulthood.

METHODS

Data from the National Longitudinal Survey of Youth-1997 (NLSY-97) birth cohort - a United States based sample collected from 1997 to 2021 - was analyzed to estimate differences in the probability of having health coverage or accessing medical care across four groups with varying involvement in the criminal legal system prior to age 18.

RESULTS

Arrests before 18 was associated with a 8.9 % reduction in health insurance endorsement (2003-2021), a 3 % reduction in routine check-up endorsement (2003-2021), and a 4 % increase in visiting a doctor when sick (2003-2008). Incarceration in juvenile facilities was associated with a 29 % decrease, a 16 % decrease, and a 21 % decrease in the three dependent variables (respectively). Incarceration in adult facilities before 18 was associated with a 36 % decrease, a 15 % decrease, and a 7 % increase in the three dependent variables (respectively).

CONCLUSIONS

Being arrested, incarcerated in a facility for juveniles, or incarcerated in an adult facility before 18 may be linked to reduced access to medical insurance and medical care during adulthood.