BACKGROUND: Delinquent youth are at risk for early violent death after release from detention. However, few studies have examined risk factors for mortality. Previous investigations studied only serious offenders (a fraction of the juvenile justice population) and provided little data on females. METHODS: The Northwestern Juvenile Project is a prospective longitudinal study of health needs and outcomes of a stratified random sample of 1829 youth (657 females, 1172 males; 524 Hispanic, 1005 African American, 296 non-Hispanic white, 4 other race/ethnicity) detained between 1995 and 1998. Data on risk factors were drawn from interviews; death records were obtained up to 16 years after detention. We compared all-cause mortality rates and causes of death with those of the general population. Survival analyses were used to examine risk factors for mortality after youth leave detention. RESULTS: Delinquent youth have higher mortality rates than the general population to age 29 years (P < .05), irrespective of gender or race/ethnicity. Females died at nearly 5 times the general population rate (P < .05); Hispanic males and females died at 5 and 9 times the general population rates, respectively (P < .05). Compared with the general population, significantly more delinquent youth died of homicide and its subcategory, homicide by firearm (P < .05). Among delinquent youth, racial/ethnic minorities were at increased risk of homicide compared with non-Hispanic whites (P < .05). Significant risk factors for external-cause mortality and homicide included drug dealing (up to 9 years later), alcohol use disorder, and gang membership (up to a decade later). CONCLUSIONS: Delinquent youth are an identifiable target population to reduce disparities in early violent death.

Key Points Question Are youths involved in the juvenile justice system who use, have access to, or have been injured by a firearm or threatened with a weapon during adolescence more likely to perpetrate firearm violence and own firearms in adulthood? Findings This cohort study of 1829 randomly selected youth newly detained in a temporary juvenile detention center found that 85% of males and 63% of females were involved with firearms as adolescents. Nearly all types of firearm involvement during adolescence were associated with increased odds of using and owning firearms during adulthood. Meaning These findings suggest that firearm use, access, injury, and being threatened with a weapon during adolescence may be risk factors for firearm perpetration and ownership in adulthood.

Objective To examine the relationship between psychiatric disorders and violence in delinquent youth after detention. Method The Northwestern Juvenile Project is a longitudinal study of youth from the Cook County Juvenile Temporary Detention Center (Chicago, Illinois). Violence and psychiatric disorders were assessed via self-report in 1,659 youth (56% African American, 28% Hispanic, 36% female, ages 13–25) interviewed up to 4 times between three and five years after detention. Using generalized estimating equations and logistic regression, we examined (1) the prevalence of violence three and five years after detention; (2) the contemporaneous relationships between psychiatric disorders and violence as youth age; and (3) if the presence of a psychiatric disorder predicts subsequent violence. Results Rates of any violence decreased between 3 and 5 years after detention, from 35% to 21% (males), and from 20% to 17% (females). Contemporaneous relationship between disorder and violence: Compared to the group with no disorder, males and females with any disorder had greater odds of any violence (adjusted odds ratio [AOR], 3.0 [95%CI, 1.9–4.7] and AOR, 4.4 [95%CI, 3.0–6.3], respectively). All specific disorders were associated contemporaneously with violence, except for major depressive disorder/dysthymia among males. Disorder and subsequent violence: Males with other drug use disorder and females with marijuana use disorder 3 years after detention had greater odds of any violence 2 years later (AOR, 3.4 [95%CI, 1.4–8.2] and AOR, 2.0 [95%CI, 1.1–3.8], respectively). Conclusion Aside from substance use disorders, the psychiatric disorders studied may not be useful markers of subsequent violence. Violence assessment and reduction must be key components of ongoing psychiatric services for high-risk youth.

In this sample, intrauterine co-exposure to MJ and TOB was associated with an estimated 18% reduction in birth weight not attributable to earlier delivery, exposure to ALC or OTH drugs, nor to maternal SES. We found evidence for greater susceptibility of male fetuses to any prenatal MJ exposure. Examination of dose-dependence in relationships found in this study, using continuous measures of exposure, is an important next step. Finally, we underscore the need to consider (a) the potential moderating influence of fetal sex on exposure-related neurodevelopmental risks; and (b) the importance of quantifying expressions of risk through subtle alterations, rather than dichotomous outcomes.

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