Elsevier

Women's Health Issues

Volume 17, Issue 4, July–August 2007, Pages 217-226
Women's Health Issues

Article
A National Overview of Reproductive Health Care Services for Girls in Juvenile Justice Residential Facilities

https://doi.org/10.1016/j.whi.2007.02.006Get rights and content

Purpose/Research Questions

Adolescent girls involved in the juvenile justice system face a substantially higher risk for a host of reproductive health problems. This study is the first national overview of the extent to which Juvenile Justice Residential Facilities (JJRFs) are meeting their reproductive health needs. The primary focus is whether all girls/young women receive gynecologic services.

Methods

Data are from the 2004 Juvenile Residential Facility Census, an ongoing national institution-level data collection. Respondents include facility administrators and facility health care providers. Mixed-gender and girls-only facilities are included in these analyses (n = 1,255).

Main Findings

Full population testing for pregnancy and sexually transmitted diseases occurs in <18% of all facilities. Although about 25% of all JJRFs report housing ≥1 pregnant teens, an equal number offers no obstetric services. Most JJRFs (about 85%) report that only some girls receive care from a gynecologist, largely “as necessary” and based on self-reports of sexual activity or suspected pregnancy. Provision of gynecologic services to all girls/young women is significantly more likely in all-female, state-owned, large population, and longer stay facilities and less likely in short stay, mixed-gender, crowded, and locally and privately owned facilities.

Conclusions

Results indicate that most facilities can garner a few necessary services. However, contrary to recommendations of national organizations, the services tend to be provided in an ad hoc manner rather than to the full population of young women. Results of multivariate models predicting facility types most likely to provide full population services should be useful as leaders in the area retarget their recommendations to address this gap in services.

Section snippets

Data

The universe of JJRFs includes everything from short-term detention centers and group homes to residential treatment and long-term secure facilities that resemble adult prison. Other types of JJRFs include boot camps, shelters, and reception and diagnostic centers. All of the approximately 3,500 facilities in the United States house young people who have been charged with or adjudicated for an offense, and they maintain an average daily population of approximately 105,000 young people (Snyder &

Results

Of the 1,255 JJRFs meeting the inclusion criterion of housing ≥1 girl during the reference month of September, 2004, one quarter (n = 319) of these facilities housed only girls on the CJRP 2003 reference day, and the remaining facilities housed both boys and girls. On the fourth Wednesday of October, 2003, there were 14,590 girls assigned beds in a JJRF because of an offense.

As seen in Table 1, there are a number of statistically significant associations and differences between mixed-gender

Discussion

There are 3 primary results of relevance to the field and for policymakers. The first and more optimistic finding is that, on average and across a range of service areas, about 70% of all JJRFs that house girls are able to access some form of reproductive health services (exceptions include prenatal and hepatitis B vaccinations in mixed-gender facilities).

The second and more pessimistic finding shows that many JJRFs are operating contrary to the recommendations of the NCCHC, SAM, and AAP in

Catherine A. Gallagher, PhD, is an Associate Professor and Director of the Justice, Law and Crime Policy Graduate Program at George Mason University. Her research focuses on the ways in which the intersection between health care and justice agencies may be improved to better meet the needs of high-risk populations and the public health of their larger communities. Dr. Gallagher is also President and Senior Research Fellow at the Lloyd Society in Kensington, Maryland.

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      Yet, only 38.7% of JRS reported full compliance with National Commission on Correctional Health Care health screening standards and 47.7% reported full compliance with the assessment standards.24 Another 2004 juvenile facility census revealed only 15%-17% of 1255 facilities in the United States tested all youth for pregnancy on admission whereas 64.9%-69.3% of JRS provided pregnancy tests if requested by the youth.2 These data contradict national recommendations and suggest systems heavily rely on each adolescent's willingness to test for pregnancy.

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    • In Their Own Voices: The Reproductive Health Care Experiences of Detained Adolescent Girls

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    Catherine A. Gallagher, PhD, is an Associate Professor and Director of the Justice, Law and Crime Policy Graduate Program at George Mason University. Her research focuses on the ways in which the intersection between health care and justice agencies may be improved to better meet the needs of high-risk populations and the public health of their larger communities. Dr. Gallagher is also President and Senior Research Fellow at the Lloyd Society in Kensington, Maryland.

    Adam Dobrin, PhD, is an Associate Professor in the Department of Criminology and Criminal Justice at Florida Atlantic University and is an Academic Fellow at the Foundation for the Defense of Democracy. His research interests focus on violence, guns, data quality, and examining crime through a public health model. His teaching interests include research methods, police, violence, criminal and juvenile justice systems, and theory. Dr. Dobrin is also Secretary and Senior Research Fellow at the Lloyd Society in Kensington, Maryland.

    Ann S. Douds, JD, is completing her PhD in Justice, Law, and Crime Policy at George Mason University. Her academic interests include health care as a social justice issue for youth within custody of the juvenile justice system, the interface between compromised physical health and delinquency, and gender equity within the juvenile justice system. Ms. Douds is also Vice President, Treasurer, and Senior Research Fellow at the Lloyd Society in Kensington, Maryland.

    Supported in part by the Office of Juvenile Justice and Delinquency Prevention and by The Lloyd Society.

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