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Medicaid-Enrolled Teens with Justice System Involvement are More Likely to Use Emergency Services Rather Than Preventive Care


A study in the November 2017 issue of Pediatrics, "Preventive Care Utilization among Justice-Involved and Non-Justice-Involved Youth," found that Medicaid-enrolled youth who have been arrested at least once were less likely to receive primary medical care but more likely to use the emergency department. The study, published online Oct. 2, reviewed the medical records and criminal records of 88,647 teens ages 12-18 enrolled in Medicaid in Marion County, Ind., between Jan. 1, 2004 and Dec. 31, 2011. A total of 20,668 (23 percent) were involved in the justice system, defined as having been arrested at least once. Those with an arrest record showed lower rates of well child visits and higher rates of emergency services than the youth who had never been arrested. Those involved in the justice system also had more and longer gaps in Medicaid coverage. The authors suggest that Medicaid enrollment continuity is associated with differences in well-child and emergency service use. They suggest that interventions, such as access to school-based health care and collaboration between community and state agencies, could be used to provide preventive care. School-based health centers typically offer immunizations, testing for pregnancy and sexually transmitted infections, asthma management and mental health counseling, which could result in lower use of emergency department services by justice system-involved youth, the authors state.

Editor's note: A solicited commentary, "Justice-Involved Youth: the Newest Target for Health Equity Approaches?" is also published in the November 2017 Pediatrics. Another study of interest in this issue is "Health Care Utilization of Justice-Involved Adolescents," which finds teens who have been involved in the justice system showed substantially higher rates of emergency department and hospital use.


The American Academy of Pediatrics is an organization of 66,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit and follow us on Twitter @AmerAcadPeds