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APHA Scientific Session and Event Listing

Recorded presentation

Catherine A. Gallagher, PhD and Adam Dobrin, PhD. Justice, Law and Crime Policy, George Mason University, MSN3F4, Department of Public and International Affairs, Fairfax, VA 22030, 954-224-9776, adobrin@fau.edu

Just 48 of the approximately 3,500 juvenile justice residential facilities housing nearly 110,000 young people on a given day have received accreditation for facility health care. This low level of voluntary accreditation suggests either that juvenile justice residential facilities simply do not meet the standards of care, do meet the standards of care but do not seek accreditation, or, more reasonably, meet some of the standards of care in some areas but not others. This study describes the extent to which juvenile detention facilities in the United States adhere to the some of the suggested American Academy of Pediatrics and National Commission on Correctional Health Care standards, and to identify predictors of variation in health care provision and suggest ways in which health care services may be improved. Facility-level analyses are performed on data derived from two national censuses of all juvenile residential facilities in the United States that house young people charged with or adjudicated for a crime are merged. Juvenile detention centers, a subset of all facility types, are the focus of this study. Facility performance is described in terms of 10 types of service provision, ranging from health screening to communicable disease testing, and multivariate models are estimated to predict high levels of service provision. Most facilities provide some basic health care. Notable gaps include poor training of initial health screeners, lack of vision, dental and gynecological services, and low levels of full population testing for communicable diseases and for pregnancy. There is significant variation in service provision, with facility size, population length of stay, and percent of the population black/African American positively associated with increased services. Private ownership was linked to significantly reduced odds of high service provision. There is also significant geographic variation. This study suggests that juvenile detention centers are providing some basic services, however, characteristics of the facilities are significantly linked to whether and how services are provided, even within a very specialized and similar grouping of facilities. This suggests that the current one-size-fits-all standards offered to these facilities may be met with higher compliance if they were tailored to reflect the significant and natural variation in facility function and structure. A modular approach to national standards that prioritizes care given length of stay and other facility constraints may be a more cost-effective and efficient means better serve the health of the young people and the community from which they come.

Learning Objectives: This presentation will enable participants to

• Describe provision of basic health care within juvenile justice facilities
• Identify gaps in health care coverage in this high risk population
• Develop alternative strategies for more efficient and effective means of health care delivery within juvenile justice facilities

Keywords: Adolescent Health, Jails and Prisons

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation