Adolescent Violent Delinquency Associated With Increased Emergency Department Usage in Young Adulthood

• Author: Jill Portnoy,Joseph A. Schwartz
• DOI: http://doi.org/10.1177/0306624X211066835
• Published date: 01 June 2023
• Date: 01 June 2023
• Subject Matter: Articles

https://doi.org/10.1177/0306624X211066835

International Journal of

Offender Therapy and

Comparative Criminology

2023, Vol. 67(8) 739 –756

© The Author(s) 2021

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DOI: 10.1177/0306624X211066835

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Article

Adolescent Violent

Delinquency Associated

With Increased Emergency

Department Usage in Young

Adulthood

Jill Portnoy1 and Joseph A. Schwartz2,3

Abstract

Limited research has examined the extent to which adolescent delinquency predicts

healthcare usage in young adulthood, including emergency department (ED) visits.

This study used data from 3,310 adolescents (52.05% female; mean age at Wave

I = 16.04 years) from the sibling subsample of the National Longitudinal Study of

Adolescent to Adult Health (Add Health). We examined whether adolescent

delinquency at Wave I predicted ED visits at Wave III using sibling fixed effects

models to adjust estimates for within-family unobserved heterogeneity. Increased

violent, but not nonviolent, delinquency predicted a higher number of ED visits in

early adulthood in the sibling fixed effects models. To our knowledge, this is the first

study to examine the relationship between delinquency and ED usage using a sibling

fixed effects design. Findings demonstrate that violent adolescent delinquency may

increase healthcare usage and suggest the potential role of healthcare providers in

improving outcomes for delinquent youth.

Keywords

delinquency, emergency department, sibling fixed effects, violence, adolescence

1University of Massachusetts Lowell, Lowell, MA, USA

2Florida State University, Tallahassee, FL, USA

3King Abdulaziz University, Jeddah, Saudi Arabia

Corresponding Author:

Jill Portnoy, School of Criminology and Justice Studies, University of Massachusetts Lowell, 113 Wilder

Street, Lowell, MA 01854, USA.

Email: jill_portnoy@uml.edu

1066835IJOXXX10.1177/0306624X211066835International Journal of Offender Therapy and Comparative CriminologyPortnoy and Schwartz

research-article2021

740 International Journal of Offender Therapy and Comparative Criminology 67(8)

Background

Offending has repeatedly been shown to increase dramatically during adolescence

(Farrington, 1986; Moffitt, 2018; Piquero et al., 2003; Rocque et al., 2015). Although

offending decreases in adulthood, adolescent delinquency is nonetheless associated

with a host of negative adult outcomes, including unemployment (Carter, 2019;

Jennings et al., 2016), economic problems (Jennings et al., 2016; Moffitt et al., 2002),

alcohol and substance use problems (Farrington et al., 2006; Jennings et al., 2016;

Moffitt et al., 2002), aggression (Farrington et al., 2006; Jennings et al., 2016;

Pulkkinen et al., 2009), and mental health disorders (Moffitt et al., 2002). Evidence

has increasingly accumulated that adolescent delinquency is also associated with poor

health (Baćak & Karim, 2019; Borowsky & Ireland, 2004; Junger et al., 2001; Kim

et al., 2020; Reingle et al., 2014; Stogner et al., 2014; Testa & Semenza, 2020). Despite

this, research examining the extent to which delinquency facilitates increased health-

care usage, including increased emergency department (ED) usage, is limited. This is

an important limitation given the potential implications of this research for both devel-

oping prevention programs that address delinquency and health-related outcomes, as

well as reducing healthcare costs. The goal of the current study was to examine the

relationship between adolescent violent and nonviolent delinquency and ED usage in

early adulthood.

The link between healthcare usage and delinquency is relevant given the relation-

ship between delinquency and health. Adult offending is associated with later poor

physical health (Semenza et al., 2020) and high rate chronic offending is linked to

disability in adulthood (Piquero et al., 2011). During adolescence and young adult-

hood, participation in violence and delinquency has also been shown to have adverse

health effects. Among adolescents participating in the National Longitudinal Study of

Adolescent to Adult Health (Add Health), physical fighting and violence predicted

increased fight-related injuries and poor self-reported health 1 year later (Borowsky &

Ireland, 2004; Stogner et al., 2014). Chronic delinquency, serious offending, and

delinquency during adolescence also predicted poor self-reported health in this sample

(Baćak & Karim, 2019; Testa & Semenza, 2020), as well as poor cardiovascular health

and cardiometabolic risk in adulthood (Kim et al., 2020; Schwartz et al., 2020).

Adolescent-limited and persistent violence were also associated with chronic disease

(Reingle et al., 2014). In a sample of Dutch adolescents and young adults, delinquency

was associated with concurrent poor health status, somatic complaints, and chronic

health conditions (Junger et al., 2001).

The relationship between health and crime and delinquency is suggestive that ado-

lescent delinquent behavior may facilitate increased healthcare usage, though research

examining this is limited. Among participants in the Dunedin Multidisciplinary Health

and Development Study, children with serious long-term conduct problems had an

increased number of hospitalizations, ED visits, and primary care visits in adulthood

(Odgers et al., 2007; Rivenbark et al., 2018). Findings using data from the Cambridge

Study in Delinquent Development, a longitudinal study of London males born in

the 1950s, have been mixed. Concurrent self-reported delinquency was inversely