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Teens who engage in delinquent behavior are at significantly higher risk of dying violently as adults, especially from guns, new research reports.

The findings show that among the most vulnerable are girls—who died violently at nearly five times the rate of those in the general population. Men who were delinquent as boys died at three times the general population rates.

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Death rates in Hispanic males and females were five and nine times more than the general population rates, respectively. Hispanics are now the largest minority group in the US.

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 that appears in Pediatrics.

“Our findings are shocking,” says lead author Linda Teplin, professor of psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine. “Death rates in our sample of delinquent youth, ages 15 to 19, are nearly twice those of troops in combat in wartime Iraq and Afghanistan.”

A health disparity

“Early violent death is a health disparity,” she says. “Youth who get detained are disproportionately poor and disproportionately racial and ethnic minorities. We must address early violent death 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

“Prevention is key,” Teplin says. “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 says.

“These youth may have fallen through the cracks of the health care system into the juvenile justice net. 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.”

The National Institutes of Health, the Ofﬁce of Juvenile Justice and Delinquency Prevention, the Substance Abuse and Mental Health Services Administration, the Centers for Disease Control and Prevention, and the Robert Wood Johnson Foundation funded the research.

Source: Northwestern University