U.S. Department of Justice

Office of Justice Programs

Office of Juvenile Justice and Delinquency Prevention 

Office of Juvenile Justice and Delinquency Prevention ojjdp.gov

July 2015 Melodee Hanes, Acting Administrator Robert L. Listenbee, Administrator

Beyond Detention 

Even though research indicates that 

the majority of youth in the juvenile 

justice system have been diagnosed with 

psychiatric disorders, reports issued by 

the Surgeon General and the President’s 

New Freedom Commission on Mental 

Health show that juvenile detainees 

often do not receive the treatment and 

Violent Death in Delinquent Youth 

After Detention 

Linda A. Teplin, Gary M. McClelland, Karen M. Abram, Darinka Mileusnic-Polchan, 

Nichole D. Olson, and Anna J. Harrison 

services they need. 

This bulletin series presents the results of 

the Northwestern Juvenile Project, the 

first large-scale, prospective longitudinal 

study of drug, alcohol, and psychiatric 

disorders in a diverse sample of juvenile 

detainees. Individual bulletins examine 

topics such as suicidal behaviors in 

youth in detention, posttraumatic 

stress disorder and trauma among this 

population, functional impairment in 

youth after detention, and barriers for 

youth who need to receive mental health 

services. 

Nearly all detained youth eventually 

return to their communities and the 

findings presented in this series provide 

empirical evidence that can be used 

to better understand how to meet 

youth’s mental health needs and provide 

appropriate services while in detention 

and after their release. The Office 

of Juvenile Justice and Delinquency 

Prevention hopes this knowledge will 

help guide innovative juvenile justice 

policy and create a better future for 

youth with psychiatric disorders in the 

justice system. 

Highlights 

This bulletin examines the results of the Northwestern Juvenile Project—a 

longitudinal study of youth detained at the Cook County Juvenile Temporary 

Detention Center in Chicago, IL. Among the issues under examination, the 

authors looked at mortality rates among the youth enrolled in the project. 

Some findings include the following: 

•	 The standardized mortality rate for delinquent youth is more than

four times the rate for youth in the general population.

•	 The mortality rate for delinquent female youth is nearly eight times

the rate in the general population.

•	 The vast majority of deaths among delinquent youth were homicides

from gunshot wounds.

•	 African American youth continue to experience the highest mortality

rate.
2 Juvenile Justice Bulletin 

JULY 2015

 

Violent Death in Delinquent Youth After Detention 

Linda A. Teplin, Gary M. McClelland, Karen M. Abram, Darinka Mileusnic-Polchan, Nichole D. Olson, and Anna J. Harrison 

Delinquent youth, who often are depicted as juvenile 

predators (U.S. Department of Health and Human 

Services, 2001), are also at great risk for injury (Laub 

and Vaillant, 2000; Lauritsen, Laub, and Sampson, 1992; 

Loeber, Kalb, and Huizinga, 2001; Menard, 2002) and 

early violent death (Lattimore, Linster, and MacDonald, 

1997; Yeager and Lewis, 1990). Offending increases 

exposure to life-threatening situations (Huizinga and 

Jakob-Chien, 1998; Loeber et al., 1999; Menard, 2002). 

In their classic study of 500 white male delinquents 

sampled in the 1940s, Glueck and Glueck (1950) found 

that nearly 5 percent had died by age 32, compared with 

2.2 percent of nondelinquent control subjects; by age 

65, 13 percent had died unnatural deaths, compared with 

6 percent of the nondelinquent control subjects (Laub 

and Vaillant, 2000). Another study of 118 delinquents 

found that 7 (5.9 percent) had died by age 25 (Yeager and 

Lewis, 1990). Similarly, death rates in two samples of male 

parolees were 3.6 percent (1,998 male subjects sampled in 

1981–82 and tracked for 6 years) and 5.5 percent (1,997 

male subjects sampled in 1986–87 and tracked for 11 

years) (Lattimore, Linster, and MacDonald, 1997). 

Previous studies do not reflect today’s delinquent 

youth. The Glueck and Glueck study (1950; Laub and 

Vaillant, 2000) in the 1940s did not include black or 

ABOUT THIS SERIES
 

Studies in this series describe the results of statistical 

analyses of the Northwestern Juvenile Project, a 

longitudinal study of youth detained at the Cook County 

Juvenile Temporary Detention Center in Chicago, IL, 

between 1995 and 1998. The sample included 1,829 male 

and female detainees between ages 10 and 18. The data 

come from structured interviews with the youth. 

Topics covered in the series include the prevalence of 

suicidal thoughts and behaviors among juvenile detainees, 

posttraumatic stress disorder and trauma within this 

population, functional impairment after detention (at work, 

at school, at home, or in the community), psychiatric 

disorders in youth processed in juvenile or adult court, 

barriers to mental health services, violent death among 

delinquent youth, and the prevalence of psychiatric 

disorders in youth after detention. The bulletins can 

be accessed from the Office of Juvenile Justice and 

Delinquency Prevention’s (OJJDP’s) website, ojjdp.gov. 

In addition to the funding that OJJDP provided, the 

research also was supported by the National Institute 

on Drug Abuse, the National Institute of Mental Health, 

the National Institute on Alcohol Abuse and Alcoholism, 

the Substance Abuse and Mental Health Services 

Administration (Center for Mental Health Services, Center 

for Substance Abuse Prevention, and Center for Substance 

Abuse Treatment), the Centers for Disease Control and 

Prevention (National Center for Injury Prevention and 

Control and National Center for HIV/AIDS, Viral Hepatitis, 

STD, and TB Prevention), the National Institutes of Health 

Office of Research on Women’s Health, the National 

Institute on Minority Health and Health Disparities, the 

Office of Rare Diseases, the Office of Behavioral and Social 

Sciences Research, the U.S. Departments of Labor and 

Housing and Urban Development, the William T. Grant 

Foundation, and the Robert Wood Johnson Foundation. 

The John D. and Catherine T. MacArthur Foundation, the 

Open Society Foundations, and the Chicago Community 

Trust provided additional funds. 
 

Hispanic youth (now more than two-thirds of juvenile 

detainees) (Sickmund et al., 2011) and, like the study 

by Lattimore, Linster, and MacDonald (1997), did not 

include female youth (now 30 percent of arrested youth 

(Puzzanchera, 2009) and nearly 15 percent of youth in 

residential placement (Sickmund et al., 2011)). Even 

studies that included female youth (Yeager and Lewis, 

1990) included too few to allow the study researchers 

to analyze gender differences. The Cambridge Study in 

Delinquent Development recently examined early death 

among a sample of delinquent youth in the United 

Kingdom (Piquero et al., 2014). Although an excellent 

study, generalizability is limited because the prevalence 

and correlates of death in the United Kingdom are quite 

different than those in the United States. Finally, the most 

recent U.S. study was conducted in the 1980s and early 

1990s (Lattimore, Linster, and MacDonald, 1997), when 

youth homicides were increasing to record high levels 

(Fox and Zawitz, 2002). 

Studying mortality rates among delinquent youth is 

timely. Homicide, the second leading cause of death for 

youth ages 15–24 (4,678 homicides in 2010) (Centers 

for Disease Control and Prevention, 2013b), is one of the 

only causes of death in youth to increase in incidence in 

the past 10 years (Xu et al., 2010). Data that the Centers 

for Disease Control and Prevention published show 

that, among African American youth, homicide is the 

most common cause of death (48.77 cases per 100,000) 

(Centers for Disease Control and Prevention, 2010, 

2012). The annual homicide rate among African American 

youth is 3.07 times that of Hispanic youth (15.89 per 

100,000) and 13.47 times that of non-Hispanic white 

youth (3.62 per 100,000) (Centers for Disease Control 

and Prevention, 2012). The groups that are at greatest 

risk (racial and ethnic minorities, male youth, and urban 

youth) are all overrepresented in the juvenile justice system 

(Pastore and Maguire, 2002; Snyder and Sickmund, 

2006). 

In this bulletin, the researchers compare mortality rates for 

delinquent youth with those for the general population, 

controlling for differences in gender, race/ethnicity, and age. 

Methods 

This section provides a brief overview of the authors’ 

methods. Additional, detailed information on the 

methodology can be found in Teplin et al. (2002, 2005, 

2012, 2013). 

Participants and Sampling Procedures 

Participants were part of the Northwestern Juvenile 

Project, a longitudinal study of 1,829 youth (ages 10–18) 

arrested and detained between November 20, 1995, and 

June 14, 1998, at the Cook County Juvenile Temporary 

Detention Center (CCJTDC) in Chicago, IL. The random 

sample was stratified by gender, race/ethnicity (African 

American, non-Hispanic white, Hispanic, or other), age 

(10–13 years or 14 years and older), and legal status 

(processed in juvenile or criminal court) to obtain enough 

participants to examine key subgroups (e.g., females, 

Hispanics, younger children). All detainees who were 

awaiting the adjudication or disposition of their case were 

eligible to participate in the study. Among these, 2,275 

detainees were randomly selected; 4.2 percent (34 youth 

and 62 parents or guardians) refused to participate. There 

were no significant differences in refusal rates according to 

gender, race/ethnicity, or age. Twenty-seven youth left the 

detention center before an interview could be scheduled; 

312 left CCJTDC while the authors attempted to locate 

their caretakers for consent. Eleven others were excluded 

from the sample because they were unable to complete the 

interview. Table 1 shows demographic characteristics of 

the final sample. 

Like juvenile detainees nationwide, the majority of 

CCJTDC detainees are male and most belong to racial/ 

ethnic minority groups (77.9 percent African American, 

5.6 percent non-Hispanic white, 16 percent Hispanic, 

and 0.5 percent other racial/ethnic groups). The age 

and offense distributions of the CCJTDC detainees are 

also similar to detained juveniles nationwide (Snyder and 

Sickmund, 2006). 

The authors chose the detention center in Cook County, 

which includes Chicago and surrounding suburbs, for 

three reasons: 

• Nationwide, most juvenile detainees live in and are 

detained in urban areas (Pastore and Maguire, 2000). 

• Cook County is ethnically diverse and has the thirdlargest Hispanic population in the United States (U.S. 

Census Bureau, 2001). Studying this population is 

important because Hispanics are the largest minority 

group in the United States (U.S. Census Bureau, 

2000). 

• The detention center’s size (daily census of 

approximately 650 youth and intake of 20 youth per 

day) ensured a large enough pool of participants would 

be available. 

The researchers have been tracking the participants since 

they were enrolled in the study. To ensure comparability 

with other studies of mortality rates (National Center 

for Health Statistics, 1996; Singh and Yu, 1996), the 

researchers examined deaths that occurred in participants 

who were 15–24 years old. As of March 31, 2004, 

Juvenile Justice Bulletin 3 
 

participants had been monitored for 0.5 to 8.4 years 

(mean: 7.1 years; median: 7.2 years); the aggregate 

exposure for all participants was 12,944 person-years (that 

is, the total number of years all participants were tracked). 

Deaths were identified during contacts with participants’ 

friends, family members, and other acquaintances; by 

checking death records at the Cook County Medical 

Examiner’s office; and by submitting participants’ names 

to the National Death Index (Centers for Disease Control 

and Prevention, 2013a). All deaths were verified by 

obtaining copies of death certificates. 

The comparison group included all persons in the general 

population of Cook County, IL, who were 15–24 years 

old (U.S. Census Bureau, n.d.). The researchers obtained 

counts of deaths in the comparison group using the most 

recent source available, the National Center for Health 

Statistics’ Multiple Cause-of-Death Public Use Files for 

1996–2001 (National Center for Health Statistics, 2004). 

Analyses 

To compare mortality rates for delinquents with those in 

the general population, all data were weighted according 

to the racial/ethnic, gender, and age characteristics of 

the detention center’s youth population; these weighted, 

standardized populations were used to calculate reported 

percentages and mortality ratios. Mortality ratios were 

calculated by comparing the sample’s mortality with that 

for the general population of Cook County, controlling for 

differences in gender, race/ethnicity, and age. 

The researchers used bootstrap methods for all inferential 

statistics. For a more detailed explanation, see Efron and 

Tibshirani (1993). 

Findings 

Sixty-five participants died during the followup period. 

Table 2 reports their gender, race/ethnicity, and age at 

death. Figure 1 shows that all died as a result of external 

causes (World Health Organization, 1977); 95.5 percent 

died as a result of homicide or legal intervention (90.1 

percent homicide and 5.4 percent legal intervention), 

and 1.1 percent of all deaths were suicides. Ninety-three 

percent of homicides were from gunshot wounds. 

Next, the researchers compared the mortality rate from 

external causes among delinquents with that for the 

general population, controlling for gender and race/ 

ethnicity. Table 3 and figure 2 present standardized annual 

mortality rates per 100,000 person-years for the sample 

of delinquent youth and the general population, and 

standardized mortality ratios comparing the sample with 

the general population. Figure 2 also shows the crude 

Table 1. Unweighted Sample Characteristics 

Characteristic

 Number of 

Participants 

(n = 1,829)

 Percentage of 

Participants 

Race/Ethnicity 

African American 1,005 54.9 

Non-Hispanic white 296 16.2 

Hispanic 524 28.7 

Other 4 0.2 

Gender 

Male 1,172 64.1 

Female 657 35.9 

Age (years) 

Mean 14.9 

Median 15 

Mode 16 

Specific ages (years) 

10 7 0.4 

11 20 1.1 

12 87 4.8 

13 258 14.1 

14 217 11.9 

15 498 27.2 

16 644 35.2 

17 89 4.9 

18 9 0.5 

Education 

6th grade or less 89 4.9 

7th grade 171 9.3 

8th grade 306 16.7 

9th grade 568 31.1 

10th grade 455 24.9 

11th grade 172 9.4 

12th grade 27 1.5 

Currently in GED classes 31 1.7 

Alternative or home 

schooling 

5 0.3 

Unknown 5 0.3 

Legal status 

Processed in adult court 

(automatic transfer) 

275 15.0 

Processed in juvenile 

court 

1,554 85.0 

Note: Percentages may not sum to 100 percent because of rounding. 

4 Juvenile Justice Bulletin 
Table 2. Numbers of Deaths in the Sample of 

Delinquent Youth 

 Total 

Males (n = 1,172) 51 

Race/ethnicity 

African American (n = 575) 23 

Non-Hispanic white (n = 207) 7 

Hispanic (n = 387) 21 

Other (n = 3) 0 

Age of death (years) 

15–16 8 

17–18 21 

19–20 14 

≥ 21 8 

Females (n = 657) 14 

Race/ethnicity 

African American (n = 430) 7 

Non-Hispanic white (n = 89) 2 

Hispanic (n = 137) 5 

Other (n = 1) 0 

Age of death (years) 

15–16 7 

17–18 2 

19–20 5 

≥ 21 0 

Total (n = 1,829) 65 

mortality rate for 1996 to 2001 for the same age group 

(15–24 years old) in the general population (not corrected 

for gender, race/ethnicity, and age) (Arias et al., 2003; 

Hoyert et al., 2001; Hoyert, Kochanek, and Murphy, 

1999; Minino et al., 2002; Murphy, 2000; Peters, 

Kochanek, and Murphy, 1998). 

The standardized mortality rate for delinquent youth (806 

deaths per 100,000 person-years) is approximately 4.4 

times that for general-population youth (184 deaths per 

100,000 person-years). Table 3 also shows that mortality 

ratios are substantially greater than 1 for male youth 

overall, for each racial/ethnic subgroup of male youth, 

for female youth overall, and for Hispanic female youth. 

Although the mortality ratios are greater in the detained 

population than in the community population for African 

American and non-Hispanic white females, these ratios are 

not significant. Both delinquent and general-population 

female youth had significantly lower mortality rates than 

their male counterparts. Delinquent African American 

male youth had the highest mortality rate (887 deaths per 

100,000 person-years). However, African American male 

youth had the lowest mortality ratio (3.9) because their 

mortality rate in the general population was relatively high 

(228 deaths per 100,000 person-years). Test results for 

differences in mortality rates among racial/ethnic groups 

were not significant for either male or female youth, 

possibly because there were too few participants within 

racial/ethnic subgroups for detection of differences.

Figure 1. Causes of Death in Delinquent Youth, 

Weighted Percentages 

1.6% 

1.3% 

1.1% 

0.5% 

95.5% 

Homicide (90.1%) All other external Motor vehicle 

and legal intervention causes accidents 

(5.4%) 

Suicide Accidents and adverse 

effects other than motor 

vehicle accidents 

Note: The researchers weighted the results to the racial/ethnic, gender, and age 

characteristics of the detention center. 

Source: Teplin et al. (2005). 

Table 3. Standardized Rates of Death Attributable to 

External Causes for Delinquent and Community Youth 

Deaths per 100,000 Person-Years 

Detained 

Population 

Community 

Population 

Mortality 

Ratio 

Total 806 184 4.4* 

Male 847 195 4.3* 

African American 887 228 3.9† 

Non-Hispanic white 435 60 7.3‡ 

Hispanic 807 83 9.8* 

Female 283 36 7.9* 

African American 233 42 5.5NS 

Non-Hispanic white 315 22 14.1NS 

Hispanic 501 18 28.5‡ 

* Significant at p < .001 

† Significant at p < .01 

‡ Significant at p < .05 NS Not significant at p > .05 

Juvenile Justice Bulletin 5 
 

“Deaths from firearms affect minority youth disproportionately, 

both in this sample and in the general U.S. population.” 

Figure 2. Standardized Mortality Due to External Causes (per 100,000 

Person-Years) in Delinquent and General-Population Youth 

1,000 

800 

s rson-year

600

00,000 pe

400

deaths per 1

200

nnual

Crude U.S. 

mortality, 

A

0 

ages 15–24 Total African 

American 

White Hispanic Total African 

American 

White Hispanic 

Total Male Female 

Total detained 

population Detained population General population 

Note: The crude mortality rate for 1996–2001 was computed from the National Center for Health Statistics 

reports (Arias et al., 2003; Hoyert, Kochanek, and Murphy, 1999; Hoyert et al., 2001; Minino et al., 2002; 

Murphy, 2000; and Peters, Kochanek, and Murphy, 1998). 

Discussion of Findings 

Overall, the mortality rate among delinquent youth was 

more than four times higher than that in the standardized 

general population of Cook County. Of particular concern 

was the mortality rate for delinquent female youth, which 

was nearly eight times the general-population rate. More 

than 90 percent of deaths among delinquent youth 

were homicides, and more than 90 percent were from 

gunshot wounds (homicidal, accidental, or self-inflicted). 

To put the authors’ findings (806 deaths per 100,000) 

in perspective, the leading causes of death among youth 

in the general population are accidents (37.4 deaths 

per 100,000 person-years), homicide (13.1 deaths per 

100,000 person-years), suicide (9.7 deaths per 100,000 

person-years), and malignant neoplasms (3.9 deaths per 

100,000 person years) (Xu et al., 2010). 

Mortality rates in this sample appeared 

to be as much as three times higher 

than those among 11- to 32-year-old 

delinquents and former delinquents in 

the 1940s study by Glueck and Glueck 

(1950), which examined only nonHispanic white male youth. Mortality rates 

in this sample also appeared to be higher 

than those reported by Lattimore and 

colleagues (1997), although their study 

included only male youth, all of whom 

were serious offenders, and was conducted 

when homicide rates were at an all-time 

high (Fox and Zawitz, 2002). The findings 

of Laub and Vaillant (2000) suggest that, 

as delinquent youth age, they will continue 

to have higher mortality rates than youth 

in the general population. 

The overall mortality rate in the sample 

was similar to that in an Australian study 

of young offenders (Coffey et al., 2003). 

However, nearly one-half of deaths in 

the Australian sample were attributable 

to drug overdoses, compared with only 

three drug overdose deaths in this study’s 

sample. The small number of drug 

overdoses may be because few of the study participants 

used illegal drugs other than marijuana or alcohol 

(McClelland et al., 2004; McClelland, Teplin, and Abram, 

2004). Nevertheless, many of the homicides in the sample 

might be drug related; nearly 97 percent of youth who 

die as a result of homicide have sold drugs (Howell and 

Decker, 1999). 

The findings highlight several key public health issues. 

Even in the general U.S. population, youth are vulnerable 

to homicide. Although homicide rates have decreased 

since the early 1990s, they still represent 16.3 percent of 

all deaths among youth between the ages of 15 and 24 

(Xu et al., 2010). More than one-third of homicide deaths 

in 2007 were persons younger than age 25 (Xu et al., 

2010). On an average day in 2002, four youth younger 

6 Juvenile Justice Bulletin 
Sickmund, 2006). 

than age 18 became victims of homicide (Snyder and 

Study findings highlight the role of firearms in early 

violent death, especially homicides. Among youth ages 

15–24 in the United States, nearly 20 percent of deaths 

are from firearms (Xu et al., 2010); in the sample, more 

than 90 percent of deaths were from firearms. In the 

United States, more than 80 percent of homicides among 

youth ages 15–24 are related to firearms (Centers for 

Disease Control and Prevention, 2012). Nationally, 

only the number of deaths from motor vehicle accidents 

exceeds the number of homicides from gunshot wounds 

among youth ages 15–24 (National Highway Traffic 

Safety Administration, 2001). 

Deaths from firearms affect minority youth 

disproportionately, both in this sample and in the general 

U.S. population (Minino et al., 2002). Of generalpopulation youth ages 15–24 who were killed by firearms 

in 2007, 66 percent were African American or Hispanic 

(Centers for Disease Control and Prevention, 2012), 

compared with almost 98 percent in this sample. Among 

general-population African American and Hispanic youth 

ages 15–24 who died in 2007, 35 percent of deaths 

were firearm related (Centers for Disease Control and 

Prevention, 2010, 2012), compared with more than 90 

percent in this sample. Although homicide rates have 

decreased among all racial/ethnic groups and ages since 

the mid-1990s, African Americans (regardless of gender 

or age) still have the highest mortality rate by far (Fox and 

Zawitz, 2007). 

Study Limitations 

The study has several limitations. As in previous studies 

(Lattimore, Linster, and MacDonald, 1997; Laub and 

Vaillant, 2000), the researchers sampled from a detained 

population. Generalizability, therefore, is limited to urban 

youth who are apprehended and detained. Detained youth 

may engage in more serious delinquent acts than arrestees 

or youth whose delinquency is not detected. Furthermore, 

these findings may not be generalizable to jurisdictions 

outside Chicago with different patterns of firearm 

violence. Although this study shows a higher risk of death 

among formerly incarcerated youth, readers should not 

presume a causal relationship between the experience of 

incarceration and early violent death. 

Although the mortality rate in this population is large 

compared with the death rate in the general population, 

there were still too few deaths in the sample to examine 

well-known correlates of early violent death, such as 

gang affiliation (Lattimore, Linster, and MacDonald, 

1997), substance abuse (Valois et al., 1995), family 

disorganization (Caputo, 2002; Laub and Vaillant, 2000), 

and child physical abuse (Sabotta and Davis, 1992). 

The available general-population data (1996 to 2001) 

are not precisely contemporaneous with deaths in the 

sample (June 1996 through March 2003). Bias is minimal, 

however, because homicide rates in the general population 

did not change appreciably between 2001 and 2003 (Fox 

and Zawitz, 2002; Snyder, 2003). 

The true mortality ratios may be even greater than those 

observed for the following reasons: 

• Because the researchers counted death only when they 

could obtain a death certificate, the true mortality rate 

in the sample might be underestimated. 

• The groups (i.e., the sample and the standardized 

general population of Cook County) are not 

mutually exclusive because the comparison group 

(the general population) also includes youth who 

have been detained. Because African Americans are 

incarcerated at a higher rate than non-Hispanic whites 

(Sabol, Couture, and Harrison, 2007), findings may 

underestimate the increased risk of death especially in 

African Americans. 

• Census data (the denominator with which risk is 

computed for the general population) undercount 

male subjects, minorities, youth, and persons living in 

Juvenile Justice Bulletin 7 
 

“Perhaps nothing underscores the failure to rehabilitate at-risk 

youth more than their vulnerability to an early and violent death.” 

central cities (Robinson, 2001; Schenker, 1993), which 

increases estimates of mortality rates for these groups 

and decreases the mortality ratio. 

Overall, these limitations narrow the differences between 

the sample and the comparison group and reduce the 

power to detect them. Conversely, the true mortality 

ratios may be smaller than observed because 1.2 percent 

of deaths reported to the National Death Index do 

not list the cause of death (National Center for Health 

Statistics, 2004). Despite these limitations, the study has 

implications for research and for public health policy. 

Directions for Future Research 

The authors suggest the following directions for future 

research. 

Longitudinal Studies of Violent 

Victimization 

Longitudinal descriptive studies would provide 

information about resilience to violent victimization in 

high-risk groups, the risk factors that distinguish highrisk from low-risk groups, and the modifiable risk factors 

related to youth’s behavior whose reduction holds the 

greatest promise for preventing violent death among youth 

(e.g., fighting, carrying weapons, belonging to a gang). 

Longitudinal intervention studies could inform public 

health professionals about the effectiveness and persistence 

of prevention strategies, about which programs warrant 

investment and for which risk groups, and whether 

gender-specific and culturally specific interventions warrant 

the additional effort. It is important to study youth as 

they make the transition from adolescence into young 

adulthood, the period of greatest risk. 

Studies of Delinquent Female Youth 

Despite the relatively small numbers of female youth 

in the juvenile justice system (30 percent of arrested 

youth) (Puzzanchera, 2009), research on this group is 

needed. Compared with delinquent male youth, female 

youth are more likely to have histories of physical and 

sexual abuse and certain psychiatric disorders (Abram 

et al., 2003, 2004; Teplin et al., 2002, 2003). Intimate 

partner violence and pregnancy-associated homicide are 

particularly important areas for study (Abbott et al., 1995; 

Chang et al., 2005; Silverman et al., 2001). Even in the 

general population, female youth younger than age 24 

are 10 times more likely than male youth to be killed by 

intimate partners (Greenfeld et al., 1998). 

Suicidal Ideation and Risk Among 

Minority Youth 

Suicide is now the third leading cause of death among 

African American youth ages 15–19 (Heron, 2010). The 

rate increased from 2.1 deaths per 100,000 person-years 

in 1980 (for youth ages 10–19) to 4.5 deaths per 100,000 

person-years in 1995 (Centers for Disease Control and 

Prevention, 1998), and suicide is now nearly as common 

in minority youth as in nonminority youth (Gould et al., 

2003). In the study sample, African American male youth 

had a significantly higher mortality rate than other groups; 

however, no deaths were recorded officially as suicide. 

The true suicide rate among minority youth may be 

much higher than indicated by the findings. Some studies 

(Gould et al., 2003; Joe and Kaplan, 2001; Poussaint and 

Alexander, 2000) suggested that African American youth 

may express suicidal intent by putting themselves at risk 

for homicide. Additional research is needed to examine the 

ways in which suicidality manifests itself as violent death 

among minority youth. 

Implications for Public 

Health Policy 

Medical, public health, and juvenile justice professionals 

must take the following steps: 

First, early violent death should be addressed as 

aggressively as any other health disparity. Compared 

with non-Hispanic white youth, minority youth have 

a much greater risk of early violent death. Moreover, 

minorities are overrepresented in the justice system. One 

8 Juvenile Justice Bulletin 
 

study found that more than one-fourth of low-income, 

urban, African American youth have been arrested by the 

time they were 18 years old (Reynolds, 1998). Nearly 1 

in 9 African American males in their twenties and early 

thirties are incarcerated at any given time, compared with 

approximately 1 in 25 Hispanic and 1 in 60 non-Hispanic 

white males (West, 2010). 

Second, delinquency-prevention and violence-prevention 

programs should be implemented. Attempts to reduce 

violence can begin by addressing common modifiable 

risk factors, such as physical fighting (reported by 33 

percent of general-population youth in grades 9 through 

12) (Centers for Disease Control and Prevention, 2004), 

carrying weapons (reported by 17.1 percent of youth) 

(Centers for Disease Control and Prevention, 2004), 

and gang membership (reported by 9 percent of youth) 

(Taylor et al., 2008). Delinquency prevention programs 

could reduce the number of offenders who also become 

victims (Loeber et al., 1999; Loeber, Kalb, and Huizinga, 

2001). Interventions must be tailored to youth of widely 

varying social, economic, cultural, and ethnic backgrounds 

and should include parent training, mentoring, home 

visitation, and education (Thornton et al., 2002). 

Third, violence-prevention interventions should be 

implemented in nontraditional settings. Community-based 

programs can augment school-based interventions. Public 

health, criminal justice, and educational experts must 

collaborate to develop interventions in nontraditional 

settings for youth who do not attend school regularly. 

For example, interventions in urban detention centers 

would reach youth who are at greatest risk: male youth, 

racial/ethnic minority youth, older teens, and urban 

youth. Moreover, these interventions would be more 

likely to reach high-risk youth who cycle through the 

juvenile justice system at some time during adolescence 

(Teplin et al., 2002, 2003). Referrals from juvenile 

courts to violence-prevention programs could impact 

youth involved in the 1.2 million delinquency cases per 

year (Hockenberry and Puzzanchera, 2014; Snyder and 

Sickmund, 2006). 

Fourth, U.S. firearms policies should be evaluated in terms 

of national public health. In 2007, 31,224 persons of all 

ages died from firearms in the United States, and more 

than one-fifth of victims were 15–24 years old (Xu et al., 

2010). A World Health Organization report on violence 

and health (Krug et al., 2002) shows that the rate of death 

from firearms in the United States is more than 3 times 

higher than that in Canada, more than 6 times higher than 

that in Australia, and nearly 38 times higher than that in 

the United Kingdom. Although the consequences of gun 

violence against youth are incalculable, the financial costs 

are estimated at $15 billion per year (Kizer et al., 1995; 

Cook and Ludwig, 2002). 

Fifth, conditions correlated with early violent death should 

be improved. Many detained youth are poor (Dembo 

et al., 2000; Domalanta et al., 2003; McCabe et al., 

2002). Since the 1970s, income segregation (in addition 

to racial/ethnic segregation) has resulted in increased 

concentration of poverty in U.S. cities (Jargowsky, 1996). 

Reducing poverty, segregation, and de facto racial/ethnic 

isolation, which are known correlates of illness, violence, 

death, and homicide, could also reduce violence among 

youth (Rosenberg, O’Carroll, and Powell, 1992). 

Sixth, mental health services for high-risk youth should 

be improved. Nearly three-fourths of detained female 

youth and two-thirds of detained male youth have 

more than one psychiatric disorder (Abram et al., 2003; 

Teplin et al., 2002). The Surgeon General reports that, 

despite the need for mental health treatment, insufficient 

services are available for delinquent youth in detention 

centers and after they return to their communities (U.S. 

Public Health Service, 2000). Treating youth who have 

behavioral or substance use disorders may reduce the risk 

of victimization by curtailing high-risk lifestyles associated 

with these disorders (Loeber et al., 2004). Moreover, 

Juvenile Justice Bulletin 9 
 

treating youth who have substance use or mood disorders 

may decrease suicidal risk (Shaffer et al., 1996). 

Conclusion 

Perhaps nothing underscores the failure to address mental 

health needs and to rehabilitate at-risk youth more than 

their vulnerability to an early and violent death. Ironically, 

mass shootings (144 deaths between 2010 and 2012; 

annotated table available from the authors), which 

comprise a small fraction of gun deaths in the United 

States (Bjelopera et al., 2013), have received far more 

media attention than have homicides of inner-city youth. 

Mass shootings capture the nation’s attention because 

of their drama and potential for contagion, but in 2010 

alone, 11,078 people were murdered using firearms 

(Centers for Disease Control and Prevention, 2012). 

Health professionals must address the equally tragic, if 

less dramatic, daily violence that affects urban, delinquent 

youth. 

For More Information 

This bulletin was adapted from Teplin, L.A., McClelland, 

G.M., Abram, K.M., and Mileusnic, D. 2005. Early 

violent death among delinquent youth: A prospective 

longitudinal study. Pediatrics 115:1586–1593. 

References 

Abbott, J., Johnson, R., Koziol-McLain, J., and 

Lowenstein, S.R. 1995. Domestic violence against women: 

Incidence and prevalence in an emergency department 

population. Journal of the American Medical Association 

273:1763–1767. 

Abram, K.M., Teplin, L.A., Charles, D.R., Longworth, 

S.L., McClelland, G.M., and Dulcan, M.K. 2004. 

Posttraumatic stress disorder and trauma in youth 

in juvenile detention. Archives of General Psychiatry 

(66)1:403–410. 

Abram, K.M., Teplin, L.A., McClelland, G.M., and 

Dulcan, M.K. 2003. Comorbid psychiatric disorders in 

youth in juvenile detention. Archives of General Psychiatry 

60(11):1097–1108. 

Arias, E., Anderson, R.N., Kung, H.-C., Murphy, S.L., 

and Kochanek, K.D. 2003. Deaths: Final data for 2001. 

National Vital Statistics Report 52(3):1–116. 

Bjelopera, J., Bagalman, E., Caldwell, S.W., Finklea, 

K.M., and McCallion, G. 2013. Public Mass Shootings in 

the United States: Selected Implications for Federal Public 

Health and Safety Policy. Washington, DC: Congressional 

Research Service. Available online: www.fas.org/sgp/crs/ 

misc/R43004.pdf. 

Caputo, R.K. 2002. Correlates of mortality in a U.S. 

cohort of youth, 1980–98: Implications for social justice. 

Social Justice Research 15(3):271–293. 

Centers for Disease Control and Prevention. 1998. 

Suicide among black youths—United States, 1980–1995. 

Morbidity & Mortality Weekly Report 47(10):193–196. 

Centers for Disease Control and Prevention. 2004. 

Violence-Related Behaviors Among High School Students— 

United States, 1991–2003. Atlanta, GA: Centers for 

Disease Control and Prevention. 

Centers for Disease Control and Prevention. 2010. 

WISQARS 10 Leading Causes of Death, United States, 

2007. Available online: http://webappa.cdc.gov/sasweb/ 

ncipc/leadcaus10.html. 

Centers for Disease Control and Prevention. 2012. Injury 

Prevention & Control: Data & Statistics (WISQARS)— 

Fatal Injury Reports 1999–2010. Available online: www. 

cdc.gov/injury/wisqars/fatal_injury_reports.html. 

Centers for Disease Control and Prevention. 2013a. 

National Death Index. Available online: www.cdc.gov/ 

nchs/ndi.htm. 

Centers for Disease Control and Prevention. 2013b. Ten 

Leading Causes of Death and Injury. Available online: 

www.cdc.gov/injury/wisqars/LeadingCauses.html. 

Chang, J., Berg, C.J., Saltzman, L.E., and Herndon, 

J. 2005. Homicide: A leading cause of injury deaths 

among pregnant and postpartum women in the United 

States, 1991–1999. American Journal of Public Health 

95(11):471–477. 

Coffey, C., Veit, F., Wolfe, R., Cini, E., and Patton, G.C.
 

2003. Mortality in young offenders: Retrospective cohort
 

study. British Medical Journal 326(7398):1064–1067.
 

Cook, P.J., and Ludwig, J. 2002. The costs of gun
 

violence against children. The Future of Children
 

12(1):87–99.
 

Dembo, R., Wothke, W., Seeberger, W., Shemwell,
 

M., Pacheco, K., Rollie, M., Schmeidler, J., Klein, L.,
 

Hartsfield, A., and Livingston, S. 2000. Testing a model
 

of the influence of family problem factors on high-risk
 

youths’ troubled behavior: A three-wave longitudinal
 

study. Journal of Psychoactive Drugs 32(1):55–65.
 

10 Juvenile Justice Bulletin 
Domalanta, D.D., Risser, W.L., Roberts, R.E., and Risser, 

J.M. 2003. Prevalence of depression and other psychiatric 

disorders among incarcerated youths. Journal of the 

American Academy of Child and Adolescent Psychiatry 

42(4):477–484. 

Efron, B., and Tibshirani, R. 1993. An Introduction to the 

Bootstrap. New York, NY: Chapman & Hall. 

Fox, J.A., and Zawitz, M.W. 2002. Homicide Trends in 

the United States. Washington, DC: U.S. Department 

of Justice, Office of Justice Programs, Bureau of Justice 

Statistics. 

Fox, J.A., and Zawitz, M.W. 2007. Homicide Trends in 

the United States. Washington, DC: U.S. Department 

of Justice, Office of Justice Programs, Bureau of Justice 

Statistics. 

Glueck, S., and Glueck, E. 1950. Unravelling Juvenile 

Delinquency. New York, NY: Commonwealth Fund. 

Gould, M.S., Greenberg, T., Velting, D.M., and 

Shaffer, D. 2003. Youth suicide risk and preventive 

interventions: A review of the past 10 years. Journal of 

the American Academy of Child and Adolescent Psychiatry 

42(4):386–405. 

Greenfeld, L.A., Rand, M.R., Craven, D., Klaus, P.A., 

Perkins, C.A., Ringel, C., Warchol, G., Matson, C., and 

Fox, J. 1998. Violence by Intimates: Analysis of Data on 

Crimes by Current or Former Spouses, Boyfriends, and 

Girlfriends. Washington, DC: U.S. Department of Justice, 

Office of Justice Programs, Bureau of Justice Statistics. 

Heron, M. 2010. Deaths: Leading Causes for 2006. 

Hyattsville, MD: Centers for Disease Control and 

Prevention, National Center for Health Statistics. 

Hockenberry, S., and Puzzanchera, C. 2014. Juvenile 

Court Statistics 2011. Pittsburgh, PA: National Center for 

Juvenile Justice. 

Howell, J.C., and Decker, S.H. 1999. The Youth Gangs, 

Drugs, and Violence Connection. Bulletin. Washington, 

DC: U.S. Department of Justice, Office of Justice 

Programs, Office of Juvenile Justice and Delinquency 

Prevention. 

Hoyert, D.L., Arias, E., Smith, B.L., Murphy, S.L., and 

Kochanek, K.D. 2001. Deaths: Final data for 1999. 

National Vital Statistics Report 49(8):1–114. 

Hoyert, D.L., Kochanek, K.D., and Murphy, S.L. 1999. 

Deaths: Final data for 1997. National Vital Statistics 

Report 47(19):1–105. 

Huizinga, D., and Jakob-Chien, C. 1998. The 

contemporaneous co-occurrence of serious and violent 

juvenile offending and other problem behaviors. In Serious 

and Violent Juvenile Offenders: Risk Factors and Successful 

Interventions, edited by R. Loeber and D.P. Farrington. 

Thousand Oaks, CA: Sage Publications, pp. 47–67. 

Jargowsky, P.A. 1996. Take the money and run: Economic 

segregation in U.S. metropolitan areas. American 

Sociological Review 61:984–998. 

Joe, S., and Kaplan, M.S. 2001. Suicide among African 

American men. Suicide and Life-Threatening Behavior 

31:106–121. 

Kizer, K.W., Vassar, M.J., Harry, R.L., and Layton, 

K.D. 1995. Hospitalization charges, costs, and income 

for firearm-related injuries at a university trauma 

center. Journal of the American Medical Association 

273(22):1768–1773. 

Krug, E.G., Dahlberg, L.L., Mercy, J.A., Zwi, A.B., and 

Lozano, R. 2002. World Report on Violence and Health. 

Geneva, Switzerland: World Health Organization. 

Lattimore, P.K., Linster, R.L., and MacDonald, J.M. 

1997. Risk of death among serious young offenders. 

Journal of Research in Crime and Delinquency 

34(2):187–209. 

Laub, J.H., and Vaillant, G.E. 2000. Delinquency and 

mortality: A 50-year follow-up study of 1,000 delinquent 

and nondelinquent boys. American Journal of Psychiatry 

157(1):96–102. 

Lauritsen, J.L., Laub, J.H., and Sampson, R.J. 1992. 

Conventional and delinquent activities: Implications for 

the prevention of violent victimization among adolescents. 

Violence and Victims 7(2):91–108. 

Loeber, R., Burke, J., Mutchka, J., and Lahey, B.B. 2004. 

Gun carrying and conduct disorder: A highly combustible 

combination? Archives of Pediatrics and Adolescent 

Medicine 158(2):138–145. 

Loeber, R., DeLamatre, M., Tita, G., Cohen, J., 

Stouthamer-Loeber, M., and Farrington, D.P. 1999. Gun 

injury and mortality: The delinquent backgrounds of 

juvenile victims. Violence and Victims 14(4):339–352. 

Loeber, R., Kalb, L., and Huizinga, D. 2001. Juvenile 

Delinquency and Serious Injury Victimization. Bulletin. 

Washington, DC: U.S. Department of Justice, Office 

of Justice Programs, Office of Juvenile Justice and 

Delinquency Prevention. 

McCabe, K.M., Lansing, A.E., Garland, A., and Hough, 

R. 2002. Gender differences in psychopathology, 

Juvenile Justice Bulletin 11 
 

functional impairment, and familial risk factors among 

adjudicated delinquents. Journal of the American Academy 

of Child and Adolescent Psychiatry 41(7):860–867. 

McClelland, G.M., Elkington, K.S., Teplin, L.A., and 

Abram, K.M. 2004. Multiple substance use disorders in 

juvenile detainees. Journal of the American Academy of 

Child and Adolescent Psychiatry 43(10):1215–1224. 

McClelland, G.M., Teplin, L.A., and Abram, K.M. 2004. 

Detection and Prevalence of Substance Use Among Juvenile 

Detainees. Bulletin. Washington, DC: U.S. Department 

of Justice, Office of Justice Programs, Office of Juvenile 

Justice and Delinquency Prevention. 

Menard, S. 2002. Short- and Long-Term Consequences of 

Adolescent Victimization. Bulletin. Washington, DC: U.S. 

Department of Justice, Office of Justice Programs, Office 

of Juvenile Justice and Delinquency Prevention. 

Minino, A.M., Arias, E., Kochanek, K.D., Murphy, S.L., 

and Smith, B.L. 2002. Deaths: Final data for 2000. 

National Vital Statistics Report 50(15):1–120. 

Murphy, S.L. 2000. Deaths: Final data for 1998. National 

Vital Statistics Report 48(11):1–106. 

National Center for Health Statistics. 1996. Vital Statistics 

of the United States, 1992, Vol. II, Mortality, Part A. 

Washington, DC: U.S. Public Health Service. 

National Center for Health Statistics. 2004. Data file 

documentations, multiple cause-of-death, 1998 (machinereadable data file and documentation). Hyattsville, MD: 

National Center for Health Statistics. 

National Highway Traffic Safety Administration. 

2001. Traffic Safety Facts 2000. Washington, DC: U.S. 

Department of Transportation, National Highway Traffic 

Safety Administration, National Center for Statistics and 

Analysis. 

Pastore, A.L., and Maguire, K. 2000. Sourcebook of 

Criminal Justice Statistics, 1999. Washington, DC: U.S. 

Department of Justice, Office of Justice Programs, Bureau 

of Justice Statistics. 

Pastore, A.L., and Maguire, K. 2002. Sourcebook of 

Criminal Justice Statistics, 2001. Washington, DC: U.S. 

Department of Justice, Office of Justice Programs, Bureau 

of Justice Statistics. 

Peters, K.D., Kochanek, K.D., and Murphy, S.L. 1998. 

Deaths: Final data for 1996. National Vital Statistics 

Report 47(9):1–99. 

Piquero, A.R., Farrington, D.P., Shepherd, J.P., and Auty, 

K.L. 2014. Offending and early death in the Cambridge 

Study in Delinquent Development. Justice Quarterly 

31(3):445–472. 

Poussaint, A.F., and Alexander, A. 2000. Lay My Burden 

Down: Unraveling Suicide and the Mental Health Crisis 

among African Americans. Boston, MA: Beacon Press. 

Puzzanchera, C. 2009. Juvenile Arrests 2008. Bulletin. 

Washington, DC: U.S. Department of Justice, Office 

of Justice Programs, Office of Juvenile Justice and 

Delinquency Prevention. 

Reynolds, A.J. 1998. Resilience among black urban 

youth: Prevalence, intervention effects, and mechanisms 

of influence. American Journal of Orthopsychiatry 

68(1):84–100. 

Robinson, J.G. 2001. ESCAP II: Demographic Analysis 

Results. Washington, DC: U.S. Department of Commerce, 

Census Bureau. 

Rosenberg, M.L., O’Carroll, P.W., and Powell, K.E. 1992. 

Let’s be clear: Violence is a public health problem. Journal 

of the American Medical Association 267(22):3071–3072. 

Sabotta, E.E., and Davis, R.L. 1992. Fatality after report 

to a child abuse registry in Washington state 1973–1986. 

Child Abuse and Neglect 16:627–635. 

Schenker, N. 1993. Undercount in the 1990 Census: 

Special Section. Journal of the American Statistical 

Association 88(423):1044–1046. 

Shaffer, D., Gould, M.S., Fisher, P., Trautman, P., 

Moreau, D., Kleinman, M., and Flory, M. 1996. 

Psychiatric diagnosis in child and adolescent suicide. 

Archives of General Psychiatry 53(4):339–348. 

Sickmund, M., Sladky, T.J., Kang, W., and Puzzanchera, 

C. 2011. Easy Access to the Census of Juveniles in 

Residential Placement. Available online: www.ojjdp.gov/ 

ojstatbb/ezacjrp. 

Silverman, J.G., Raj, A., Mucci, L.A., and Hathaway, 

J.E. 2001. Dating violence against adolescent girls and 

associated substance use, unhealthy weight control, sexual 

risk behavior, pregnancy, and suicidality. Journal of the 

American Medical Association 286(5):572–579. 

Singh, G.K., and Yu, S.M. 1996. Trends and differentials 

in adolescent and young adult mortality in the United 

States, 1950 through 1993. American Journal of Public 

Health 86(4):560–564. 

Snyder, H.N. 2003. Juvenile Arrests 2001. Bulletin. 

Washington, DC: U.S. Department of Justice, Office 

of Justice Programs, Office of Juvenile Justice and 

Delinquency Prevention. 

12 Juvenile Justice Bulletin 
Snyder, H.N., and Sickmund, M. 2006. Juvenile Offenders 

and Victims: 2006 National Report. Report. Washington, 

DC: U.S. Department of Justice, Office of Justice 

Programs, Office of Juvenile Justice and Delinquency 

Prevention. 

Sabol, W.J., Couture, H., and Harrison, P.M. 2007. 

Prisoners in 2006. Washington, DC: U.S. Department 

of Justice, Office of Justice Programs, Bureau of Justice 

Statistics. 

Taylor, T.J., Freng, A., Esbensen, F.-A., and Peterson, 

D. 2008. Youth gang membership and serious 

violent victimization: The importance of lifestyles and 

routine activities. Journal of Interpersonal Violence 

23(10):1441–1464. 

Teplin, L.A., Abram, K.M., McClelland, G.M., Dulcan,
 

M.K., and Mericle, A.A. 2002. Psychiatric disorders in
 

youth in juvenile detention. Archives of General Psychiatry
 

59(12):1133–1143.
 

Teplin, L.A., Abram, K.M., Washburn, J.J., Welty,
 

L.J., Hershfield, J.A., and Dulcan, M.K. 2013. The
 

Northwestern Juvenile Project: Overview. Washington, DC:
 

U.S. Department of Justice, Office of Justice Programs, 

Office of Juvenile Justice and Delinquency Prevention. 

Teplin, L.A., McClelland, G.M., Abram, K.M., and 

Mileusnic, D. 2005. Early violent death among delinquent 

youth: A prospective longitudinal study. Pediatrics 

115:1586–1593. 

Teplin, L.A., Mericle, A.A., Abram, K.M., and 

McClelland, G.M. 2003. HIV and AIDS risk behaviors in 

juvenile detainees: Implications for public health policy. 

American Journal of Public Health 93(6):906–912. 

Teplin, L.A., Welty, L.J., Abram, K.M., Dulcan, M.K., 

and Washburn, J.J. 2012. Prevalence and persistence 

of psychiatric disorders in youth after detention: A 

prospective longitudinal study. Archives of General 

Psychiatry 69(10):1031–1043. 

Thornton, T.N., Craft, C.A., Dahlberg, L.L., Lynch, 

B.S., and Baer, K. 2002. Best Practices of Youth Violence 

Prevention: A Sourcebook for Community Action (Revised). 

Atlanta, GA: Centers for Disease Control and Prevention, 

National Center for Injury Prevention and Control. 

U.S. Census Bureau. n.d. Special Tabulations Program.
 

Available online: www.census.gov/population/www/
 

cen2000/sptabs/main.html.
 

U.S. Census Bureau. 2000. Census 2000 Profiles of General
 

Demographic Characteristics: National Summary &
 

Special Packages. Washington, DC: U.S. Department of
 

Commerce. Available online: http://factfinder.census.gov.
 

U.S. Census Bureau. 2001. The Hispanic Population.
 

Washington, DC: U.S. Department of Commerce.
 

U.S. Department of Health and Human Services.
 

2001. Youth Violence: A Report of the Surgeon General.
 

Washington, DC: U.S. Department of Health and Human
 

Services.
 

U.S. Public Health Service. 2000. Report of the Surgeon
 

General’s Conference on Children’s Mental Health:
 

A National Action Agenda. Washington, DC: U.S.
 

Department of Health and Human Services.
 

Valois, R.F., McKeown, R.E., Garrison, C.Z., and 

Vincent, M.L. 1995. Correlates of aggressive and violent 

behavior among public high school adolescents. Journal of 

Adolescent Health 16:26–34. 

West, H.C. 2010. Prison Inmates at Midyear 2009— 

Statistical Tables. Washington, DC: U.S. Department 

of Justice, Office of Justice Programs, Bureau of Justice 

Statistics. 

World Health Organization. 1977. International 

Classification of Diseases (9th revision). Geneva, 

Switzerland: World Health Organization. 

Xu, J., Kochanek, K.D., Murphy, S.L., and Tejada-Vera, B. 

2010. Deaths: Final Data for 2007. Atlanta, GA: Centers 

for Disease Control and Prevention. 

Yeager, C.A., and Lewis, D.O. 1990. Mortality in a group 

of formerly incarcerated juvenile delinquents. American 

Journal of Psychiatry 147:612–614. 

Juvenile Justice Bulletin 13 
The research described in this bulletin was 

supported in part by grants 1999–JE–FX–1001, 

2005–JL–FX–0288, and 2008–JF–FX–0068 from 

the Office of Juvenile Justice and Delinquency 

Prevention (OJJDP), U.S. Department of Justice.

Points of view or opinions expressed in this 

document are those of the authors and do not 

necessarily represent the official position or policie

of OJJDP or the U.S. Department of Justice.

s 

NCJ 248408

The Office of Juvenile Justice and Delinquency 

Prevention is a component of the Office of 

Justice Programs, which also includes the 

Bureau of Justice Assistance; the Bureau of 

Justice Statistics; the National Institute of 

Justice; the Office for Victims of Crime; and the 

Office of Sex Offender Sentencing, Monitoring, 

Apprehending, Registering, and Tracking.

Acknowledgments

Linda A. Teplin, Ph.D., is the Owen L. Coon Professor and Vice Chair for Research in the 

Department of Psychiatry and Behavioral Sciences at the Feinberg School of Medicine, 

Northwestern University, Chicago, IL, as well as Director of the Department’s Program in 

Health Disparities and Public Policy. 

Gary M. McClelland, Ph.D., is a Research Assistant Professor and Director of Data Operations 

in the Mental Health Services and Public Policy Program, Department of Psychiatry and 

Behavioral Sciences at the Feinberg School of Medicine. 

Karen M. Abram, Ph.D., is Associate Professor and Associate Director, Health Disparities and 

Public Policy, in the Department of Psychiatry and Behavioral Sciences at the Feinberg School 

of Medicine. 

Darinka Mileusnic-Polchan, M.D., Ph.D., was formerly Assistant Medical Examiner at the 

Cook County Office of the Medical Examiner, Chicago, IL, and is currently Medical Examiner 

at the Knox County Office of the Medical Examiner, Knoxville, TN. 

Nichole D. Olson, Ph.D., is a postdoctoral fellow at the Stanford University School of 

Medicine, Department of Psychiatry and Behavioral Sciences.

Anna J. Harrison, M.S., is a doctoral candidate in the Division of Psychology, Department of 

Psychiatry and Behavioral Sciences at the Feinberg School of Medicine.

The authors thank all of their agencies for their collaborative spirit and steadfast support. 

They also thank the research participants for their time and willingness to participate as well 

as the Cook County Juvenile Temporary Detention Center, Cook County Department of 

Corrections, and Illinois Department of Corrections for their cooperation.

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