Transcript Why Study Detained Youth? Disproportionate Minority

Northwestern Juvenile Project
Northwestern University Feinberg School of Medicine
Health Disparities & Public Policy
Faculty
Linda A. Teplin, Ph.D. (PI)
Karen M. Abram, Ph.D.
Leah Welty, Ph.D.
Current Graduate Students
Elena De La Garza Bassett
Nichole Olson
Jennifer Hershfield
Anna Harrison
Marquita Stokes
Nicole Azores-Gococo
Lauren Potthoff
Former Graduate Students
Amy Lansing, Ph.D.
Julie Harnisher, Ph.D.
Devon King, Ph.D.
Katherine Elkington, Ph.D.
Jeanne Choe, Ph.D
Leah Paskar, Ph.D.
Erin Romero, Ph.D.
Naomi Abrams, Ph.D.
Kristin Emanuel, Ph.D.
Delinquency Cases Disposed, 1985-2009
1-Day Count of Juvenile Offenders in
Custody, 1991-2006 (in 1,000s)
count
(in 1000’s)
120
107
105
100
80
104
97
91
93
87
79
76
71
60
40
20
0
1990
1992
1994
1996
1998
2000
2002
2004
2006
2008
2010
Why Study Detained Youth?
Disproportionate Minority Confinement
% of African Americans
in US population (13%)
Proportion of Poor, Inner-City African
American Youth Arrested by Age 18
Participants
• Race/Ethnicity*
–
–
–
–
Non-Hispanic
White
African American = 1005
Hispanic: = 524
Non-Hispanic White = 296
Other = 4
African
American
Hispanic
• Gender
– Male = 1172
– Female = 657
• Age (mean = 14.9)
• Legal Status
– Adult court = 275
– Juvenile court = 1554
10
11
12
13
14
age
15
16
17
18
Methods
• Stratified Random Sample, N=1829
• Sampled from Cook County Detention Center
• Followed up in Community or Correctional
Facility
Disorders Assessed Over Time
Internalizing Disorders
Any Affective Disorder:
Externalizing Disorders
Any Behavioral Disorder:
Major Depression
Conduct a
Dysthymia
Oppositional Defiant a
Mania
Antisocial Personality b
Hypomania
Any Anxiety Disorder:
Any Substance Use Disorder:
Generalized Anxiety
Alcohol
Posttraumatic Stress
Drug
Panic
a
If < 18 years
b
If > 18 years
Prevalence of Psychiatric Disorders at the
Baseline Interview
(N=1,829)
Males
Females
%
Prevalence of Psychiatric Disorders
Among Males, Baseline
African American
Hispanic
non-Hispanic white
Prevalence of Psychiatric Disorders
Among Females, Baseline
African American
Hispanic
non-Hispanic white
Comorbid Types of Disorder Among Males
None of the
Listed Disorders
34.8%
14.6%
Substance 49.8%
1.4%
3.2%
ADHD/ Behavioral
41.7%
16.4%
6.7%
6.9%
1.1%
1.2%
2.0%
4.3%
0.7%
1.6%
Affective 17.9%
1.0%
2.1%
2.1%
Anxiety
21.1%
12
Comorbid Types of Disorder Among Females
None of the
Listed Disorders
27.2%
Substance 44.5%
2.0%
1.2%
2.2%
3.9%
2.3%
7.6%
6.7%
4.8%
ADHD/ Behavioral
46.3%
2.0%
4.9%
2.9%
Affective 26.4%
2.6%
6.0%
Anxiety
31.5%
13
Single and Multiple Substance Use
Disorders Among Males (N = 1143)
a
No Substance Use
Disorder (50.09%)
MARIJUANA
(Total = 44.95%)
23.63%
(Marijuana only)
ALCOHOL
(Total = 25.27%)
19.42%
(Alcohol + Marijuana)
4.59%
(Alcohol only)
1.23%
(Alcohol + Marijuana + Other )
0.03%
0.67%
(Alcohol + Other)
(Marijuana + Other)
0.51%
(Other only)
a
Percentages do not total to 100% due to rounding
OTHER DRUG
(Total = 2.44%)
Single and Multiple Substance Use
Disorders Among Females (N = 631)
a
No Substance Use
Disorder (55.02%)
MARIJUANA
(Total = 40.51%)
18.45%
(Marijuana only)
ALCOHOL
(Total = 24.73%)
17.25%
(Alcohol + Marijuana)
3.53%
(Alcohol + Marijuana + Other )
3.82%
(Alcohol only)
1.28%
0.13%
(Alcohol + Other)
0.53%
(Other only)
a
Percentages do not total to 100% due to rounding
OTHER DRUG
(Total = 5.47%)
(Marijuana + Other)
Proportion of Sample by IQ (KBIT)
Above Average
Average
Below Average
Well Below Average
Lower Extreme
Comorbid Types of Disorder Among Males
Baseline
Time 2
2%
6%
25%
14%
4%
5%
3%
11%
1%
11%
2%
11%
8%
1%
Substance 53.4%
Internalizing 22.2%
Behavior 25.8%
1
Percentages have been rounded up.
Internalizing disorders combine any affective disorder and any anxiety disorder.
3 Overall percentages do not match percentages within Venn diagram due to weighting
2
Substance 31.2%
Internalizing 11.7%
Behavior 24.1%
Comorbid Types of Disorder Among Females
Baseline
Time 2
7%
16%
6%
9%
3%
8%
14%
2%
3%
1%
5%
10%
8%
5%
Substance 46.8%
Internalizing 32.3%
Behavior 34.2%
1
Percentages have been rounded up.
disorders combine any affective disorder and any anxiety disorder.
3 Overall percentages do not match percentages within Venn diagram due to weighting
2 Internalizing
Substance 17.3%
Internalizing 12.7%
Behavior 13.9%
Comorbid Types of Disorders Among
Males at Time 2 by Incarceration Status
Not Incarcerated Past Year
Incarcerated in Past Year
16%
8%
2%
0%
5%
1%
1%
0.4%
5%
6%
1%
11%
7%
5%
Substance 34.3%
Internalizing 11.8%
Behavior 21.1%
Substance 7.0%
Internalizing 8.8%
Behavior 9.3%
Prevalence of Specific Substance Use
Disorders in Males
50
40
30
%
20
Alcohol Use Disorder
10
Marijuana Use Disorder
Other Drug Use Disorder
0
0
Baseline
500
1000
3 Years
1500
2000
5 Years
2500
6 Years
3000
8 Years
3500
4000
4500
12 Years
Prevalence of Specific Substance Use
Disorders in Females
50
40
30
%
20
Alcohol Use Disorder
10
Marijuana Use Disorder
Other Drug Use Disorder
0
0
Baseline
500
1000
3 Years
1500
2000
5 Years
2500
6 Years
3000
8 Years
3500
4000
4500
12 Years
Other Drug Use Disorders in Males
by Race/Ethnicity
30
25
20
%
15
10
Non-Hispanic White
5
Hispanic
African American
0
0
Baseline
500
1000
3 Years
1500
2000
5 Years
2500
6 Years
3000
8 Years
3500
4000
4500
12 Years
Other Drug Use Disorders in Females by
Race/Ethnicity
30
25
20
%
15
10
Non-Hispanic White
Hispanic
5
African American
0
0
Baseline
500
1000
3 Years
1500
2000
5 Years
2500
6 Years
3000
8 Years
3500
4000
4500
12 Years
Trajectories of SUDs
• SUDs are prevalent and persistent
• BUT, not all youth follow the same course of
disorder
• Trajectory analyses examine patterns of
change within individuals over time
Aggregated Statistics
baseline
follow-up
10/50 =
20%
10/50 =
20%
10/50 =
20%
10/50 =
20%
Trajectories of SUD
1.0
probability of any SUD
n = 1382
probability
0.8
0.6
0.4
0.2
0.0
0
2
4
6
8
years since baseline
10
12
Preliminary Data
Trajectories of SUD
1.0
probability of comorbid/other SUD
n = 1382
probability
0.8
0.6
0.4
0.2
0.0
0
2
4
6
8
years since baseline
10
12
Preliminary Data
Positive Outcome Domains
•
•
•
•
•
•
Educational attainment
Employment and/or education
Desistance from criminal activity & arrests
Nonviolent personal relationships
Residential stability
Psychological well-being
How Many Participants were Subsequently
Incarcerated by the 5 Year Follow-up?
non-Hispanic white
Hispanic
African American
non-Hispanic white
Hispanic
African American
%
Preliminary Data
Youth Achieving Global Positive Outcomes
Doing very well
(5-6 positive outcomes)
9%
Doing moderately well
(3-4 positive outcomes)
Doing poorly
(0-2 positive outcomes)
50%
41%
Preliminary Data
Disproportionate Burden of HIV/AIDS
Among African Americans
100%
80%
60%
44%
57%
40%
% of African
Americans
in the U.S.
(13%)
20%
0%
% of New Cases of HIV, General Population
% of New Cases of HIV, <age 25 years
33
What Proportion of Prisoners Have
HIV/AIDS?
3
2
%
1
0
HIV/AIDS 2006
Males
Females
What % of Participants Engaged in
10 or More HIV/AIDS Risk Behaviors?
40
Baseline
66
3.5 Year
Follow-up
45
56
0
20
40
60
80
100
%
Females
Males
35
Preliminary Data
Recent HIV/AIDS Risk Behaviors in
Males (%)
Living Situation, Time 2
Community (%)
Corrections (%)
Multiple partners (> 3 sexual partners)
15.9
0.3
Unprotected sex
78.8
4.2
Unprotected vaginal sex
67.7
2.9
Unprotected oral sex
53.6
1.7
Unprotected anal sexf
7.4
1.3
0.2
0.0
Shared needles or works for IDU or tattooing
Deaths: n=120
Age
Race/Ethnicity
Gender
Cause of Death
Age
Race/Ethnicity
Gender
Cause of Death
15
His p a n ic
M ale
Electrocu tion , b elieved accid en tal
22
Afric a n Am e ric a n
M ale
T rain strikin g p ed estrian
16
Afric a n Am e ric a n
M ale
Sin g le g u n sh ot wou n d , p ossib le accid en t
22
His p a n ic
M ale
Gu n sh ot wou n d an d au to accid en t
16
W h ite
M ale
Isob u tan e overd ose
22
W h ite
Fem ale
Un kn own , p ossib le overd ose
16
Afric a n Am e ric a n
M ale
Sin g le g u n sh ot wou n d
22
His p a n ic
Fem ale
Possib le d rown in g
16
Afric a n Am e ric a n
Fem ale
Sin g le g u n sh ot wou n d
22
Afric a n Am e ric a n
M ale
M u ltip le g u n sh ot wou n d s
16
His p a n ic
M ale
Sin g le g u n sh ot wou n d
22
Afric a n Am e ric a n
M ale
Un kn own
16
Afric a n Am e ric a n
M ale
Gu n sh ot wou n d to th e b ack
22
Afric a n Am e ric a n
M ale
Sem i-tractor strikin g p ed estrian
16
His p a n ic
M ale
Su icid e, Ru ssian rou lette
23
Afric a n Am e ric a n
M ale
M u ltip le g u n sh ot wou n d s
16
Afric a n Am e ric a n
M ale
M u ltip le g u n sh ot wou n d s
23
Afric a n Am e ric a n
M ale
Sin g le g u n sh ot wou n d
16
His p a n ic
M ale
Sin g le g u n sh ot wou n d
23
His p a n ic
M ale
Su icid e, g u n sh ot wou n d to th e h ead
16
W h ite
M ale
M u ltip le g u n sh ot wou n d s
23
His p a n ic
Fem ale
Dru g overd ose
17
His p a n ic
M ale
M u ltip le g u n sh ot wou n d s
23
Afric a n Am e ric a n
Fem ale
Cru sh ed b y m ob
17
His p a n ic
M ale
Sin g le g u n sh ot wou n d
23
His p a n ic
M ale
Sin g le g u n sh ot wou n d
17
Afric a n Am e ric a n
M ale
M u ltip le g u n sh ot wou n d s
23
Afric a n Am e ric a n
Fem ale
Un kn own , IDPH p roh ib its d isclosu re
17
Afric a n Am e ric a n
Fem ale
Sin g le g u n sh ot wou n d
23
Afric a n Am e ric a n
M ale
Gu n sh ot wou n d to th e ch est
17
Afric a n Am e ric a n
M ale
M u ltip le g u n sh ot wou n d s
24
His p a n ic
M ale
M u ltip le g u n sh ot wou n d s
17
Afric a n Am e ric a n
M ale
M u ltip le g u n sh ot wou n d s
24
His p a n ic
M ale
Au to accid en t
17
Afric a n Am e ric a n
Fem ale
Gu n sh ot wou n d to th e n eck
24
His p a n ic
M ale
M eth ad on e overd ose
17
Afric a n Am e ric a n
M ale
Sin g le g u n sh ot wou n d
24
His p a n ic
M ale
M u ltip le g u n sh ot wou n d s
18
W h ite
M ale
Su icid e, g u n sh ot wou n d to th e h ead
24
W h ite
M ale
Sarcoid osis an d op iate overd ose
18
His p a n ic
M ale
Au to accid en t
25
Afric a n Am e ric a n
M ale
M u ltip le g u n sh ot wou n d s
18
His p a n ic
M ale
M u ltip le g u n sh ot wou n d s
25
His p a n ic
M ale
M u ltip le g u n sh ot wou n d s
18
His p a n ic
M ale
Sin g le g u n sh ot wou n d
25
Afric a n Am e ric a n
M ale
Su icid e, h an g in g
18
His p a n ic
Fem ale
M u ltip le g u n sh ot wou n d s
25
W h ite
M ale
Head in ju ry f rom assau lt
18
W h ite
M ale
Heroin overd ose
25
Afric a n Am e ric a n
M ale
M u ltip le g u n sh ot wou n d s
18
Afric a n Am e ric a n
M ale
Gu n sh ot wou n d to th e b ack
25
W h ite
M ale
M eth ad on e overd ose
18
Afric a n Am e ric a n
Fem ale
Au to accid en t, alcoh ol in volved
25
Afric a n Am e ric a n
M ale
Gu n sh ot wou n d to th e b ack
18
W h ite
M ale
M otorcycle accid en t
25
Afric a n Am e ric a n
M ale
M u ltip le g u n sh ot wou n d s
18
Afric a n Am e ric a n
M ale
M u ltip le g u n sh ot wou n d s
26
Afric a n Am e ric a n
Fem ale
Au to strikin g p ed estrian
18
Afric a n Am e ric a n
M ale
Sin g le g u n sh ot wou n d
26
His p a n ic
Fem ale
Op iate overd ose
18
Afric a n Am e ric a n
M ale
M u ltip le g u n sh ot wou n d s
26
Afric a n Am e ric a n
Fem ale
Com p lication s f rom AIDS
18
Afric a n Am e ric a n
M ale
M u ltip le g u n sh ot wou n d s
26
Afric a n Am e ric a n
M ale
M u ltip le g u n sh ot wou n d s
18
His p a n ic
M ale
Sin g le g u n sh ot wou n d
27
Afric a n Am e ric a n
M ale
M u ltip le g u n sh ot wou n d s
18
Afric a n Am e ric a n
M ale
Gu n sh ot wou n d , accid en tal
27
W h ite
M ale
Au to h om icid e, ru n d own b y car
18
His p a n ic
M ale
M u ltip le g u n sh ot wou n d s
27
His p a n ic
M ale
Su icid e, g u n sh ot to th e h ead
18
His p a n ic
M ale
Sin g le g u n sh ot wou n d
27
Afric a n Am e ric a n
Fem ale
Gu n sh ot wou n d
18
His p a n ic
M ale
M u ltip le g u n sh ot wou n d s
27
W h ite
M ale
M u ltip le g u n sh ot wou n d s
19
His p a n ic
Fem ale
Heroin overd ose
27
Afric a n Am e ric a n
Fem ale
Acu te lym p h om a an d leu kem ia
19
Afric a n Am e ric a n
M ale
Sin g le g u n sh ot wou n d
27
Afric a n Am e ric a n
Fem ale
M u ltip le stab wou n d s
19
His p a n ic
M ale
M u ltip le g u n sh ot wou n d s
28
His p a n ic
M ale
Stab W ou n d to th e Ab d om en
20
W h ite
M ale
Sin g le g u n sh ot wou n d
28
W h ite
M ale
M u ltip le g u n sh ot wou n d s
20
Afric a n Am e ric a n
M ale
Sin g le g u n sh ot wou n d
28
W h ite
M ale
Op iate an d Cocain e Overd ose
20
His p a n ic
Fem ale
Gu n sh ot wou n d , p ossib le su icid e
28
Afric a n Am e ric a n
M ale
M u ltip le g u n sh ot wou n d s
20
His p a n ic
M ale
Sin g le g u n sh ot wou n d
28
Afric a n Am e ric a n
M ale
Gu n sh ot wou n d to th e ab d om en
20
Afric a n Am e ric a n
M ale
M u ltip le g u n sh ot wou n d s
28
His p a n ic
M ale
Cocain e, op iate, alcoh ol overd ose
20
W h ite
M ale
Su icid e, g u n sh ot wou n d to th e h ead
29
Afric a n Am e ric a n
M ale
Gu n sh ot wou n d to th e ab d om en
20
His p a n ic
M ale
Gu n sh ot wou n d to th e h ead
29
Afric a n Am e ric a n
Fem ale
Card iac arrh yth m ia
20
Afric a n Am e ric a n
M ale
Sin g le g u n sh ot wou n d
29
Afric a n Am e ric a n
Fem ale
M u ltip le g u n sh ot wou n d s
20
20
Afric a n Am e ric a n
Afric a n Am e ric a n
Fem ale
Fem ale
M u ltip le stab wou n d s
Stab W ou n d to th e Neck
29
29
Afric a n Am e ric a n
Afric a n Am e ric a n
M ale
M ale
M u ltip le g u n sh ot wou n d s
M u ltip le Stab W ou n d s
20
His p a n ic
M ale
M u ltip le g u n sh ot wou n d s
30
Afric a n Am e ric a n
M ale
Gu n sh ot wou n d to th e ch est
21
W h ite
Fem ale
PM A overd ose
30
Afric a n Am e ric a n
Fem ale
Su icid e b y h an g in g
21
His p a n ic
M ale
M u ltip le g u n sh ot wou n d s
31
W h ite
M ale
M otor Veh icle Accid en t
21
Afric a n Am e ric a n
M ale
M u ltip le g u n sh ot wou n d s
31
Afric a n Am e ric a n
M ale
M u ltip le g u n sh ot wou n d s
21
Afric a n Am e ric a n
M ale
M u ltip le g u n sh ot wou n d s
31
Afric a n Am e ric a n
Fem ale
Com p lication s f rom ch ild b irth
21
His p a n ic
M ale
Gu n sh ot wou n d to th e f ace
32
Afric a n Am e ric a n
M ale
M u ltip le g u n sh ot wou n d s
*
Afric a n Am e ric a n
M ale
Heart Con d ition & Asth m a
*
W h ite
M ale
Sh ovellin g Sn ow
*
Afric a n Am e ric a n
Fem ale
Hit & Ru n
*
His p a n ic
M ale
Su icid e
*
Afric a n Am e ric a n
Fem ale
Can cer
*
Afric a n Am e ric a n
Fem ale
Com p lication s f rom Ch ild b irth
*
W h ite
M ale
Can cer
*
His p a n ic
M ale
Can cer
*Un con f irm ed
NJP Sample: Cause of Death,
Ages 15-29 by Gender*
100%
Other, 5%
}
Homicide: Other, 6%
Motor Vehicle, 1%
Drug Overdose, 1%
Suicide, 2%
Other, 24%
Motor Vehicle, 10%
Drug Overdose, 18%
50%
Homicide: Firearm,
84%
Homicide: Other, 20%
Homicide: Firearm,
28%
0%
NJP Males
NJP Females
*Standardized on Cook County Juvenile Temporary Detention Center population
Preliminary data
Cause of Death: Males Ages 15-29*
100%
Other, 5%
Homicide: Other, 5%
}
Motor Vehicle, 1%
Drug Overdose, 1%
Suicide, 2%
Other, 25%
Motor Vehicle, 13%
50%
Drug Overdose, 5%
Suicide, 4%
Homicide: Other, 4%
Homicide: Firearm,
85%
Homicide: Firearm,
49%
0%
Delinquent Males
General Population Males
*Standardized on Cook County Juvenile Temporary Detention Center population
Mortality AmongMales
Males Ages 15-29:
Delinquent Sample vs. General Population*
Risk Ratios and Associated 95% CIs
1.9
African
American
4.9
Hispanic
4.0
Non-Hispanic
White
00
11
22
3
44
*Standardized on Cook County Juvenile Temporary Detention Center population
5
66
7
88
Cause of Death: Females Ages 15-29*
100%
Other, 26%
Other, 60%
Motor Vehicle, 9%
Drug Overdose, 16%
50%
Suicide, 5%
Homicide: Other, 14%
Motor Vehicle, 10%
Drug Overdose, 5%
Suicide, 6%
Homicide: Firearm,
30%
Homicide: Other, 8%
Delinquent Females
General Population Females
Homicide: Firearm,
11%
0%
*Standardized on Cook County Juvenile Temporary Detention Center population
Mortality AmongFemales
Females Ages 15-29:
Delinquent Sample vs. General Population*
Risk Ratios and Associated 95% CIs
2.8
African
American
12.0
Hispanic
Non-Hispanic
White
(Unable to estimate)
00 11
2
3
4
55
6
7
8
9
1010
11
12
13
*Standardized on Cook County Juvenile Temporary Detention Center population
14
15
16
17
18
19
2020
21
22
23
24
25
26
27
28
29
30 30
1.00
Survival
by Drug Dealing at Year 3
No
0.90
0.95
Yes
15
20
25
Ag e
Preliminary data
1.00
Survival
by Alcohol Use Disorder at Year 3
0.95
No
p<.05
0.90
Yes
15
20
25
Ag e
Preliminary data