Research over the last decade has shown that young people who have been incarcerated can have poorer physical and mental health outcomes than persons who have not been incarcerated, and that youth who have experienced a family member’s incarceration also may experience negative effects.

A new study conducted at Nationwide Children’s Hospital’s Abigail Wexner Research Institute and published in the journal Health & Justice, appears to be the first to use electronic medical records and link children’s personal or family involvement in the correctional system to diagnoses—and the authors say the findings are so alarming they should be a call to action for pediatric providers.

The study looked at the electronic medical records of 2.3 million youth (up to 21 years old) who had received care at Nationwide Children’s between 2006 and 2020. No standard screening for exposure to the justice system was typically employed at Nationwide Children’s during those years. Nevertheless, approximately 2% had a correctional “keyword” in their record indicating probable personal or parental involvement in the correctional system as recorded by a health professional.

That 2% accounted for 66% of all patients with cannabis-related diagnosis over the time period of the study. They also accounted for:

• 9% of all patients with substance use-related disorders
• 8% of all patients with trauma-related disorders
• 8% of all patients with stress-related disorders
• 6% of all patients with psychotic-related disorders
• 5% of all patients with anemia-related disorders
• 8% of all patients with suicidal-related disorders
• 0% of all developmental-related disorders of speech and language

“We anticipated that the results would show that children with any involvement in the correctional system would have some concerning diagnoses, but the magnitude was a bit shocking,” said Samantha Boch, Ph.D., RN, a former prison nurse and lead author of the study.

The authors note that many factors other than involvement in the justice system likely contribute to these diagnoses, and those factors may also have led to their parents’ or their own incarceration. But personal or family involvement in the justice system appears to be a signal that the potential for other worrying diagnoses is high.

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