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不公正:在一个大型儿科医疗系统中,有个人/家庭司法相关经历的青少年的健康记录。

Unjust: the health records of youth with personal/family justice involvement in a large pediatric health system.

作者信息

Boch Samantha, Sezgin Emre, Ruch Donna, Kelleher Kelly, Chisolm Deena, Lin Simon

机构信息

College of Nursing, University of Cincinnati, Cincinnati, OH, USA.

James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

出版信息

Health Justice. 2021 Aug 1;9(1):20. doi: 10.1186/s40352-021-00147-5.

Abstract

BACKGROUND

Mass incarceration has had an undeniable toll on childhood poverty and inequality, however, little is known about the consequences on pediatric health. The purpose of this study was to identify and describe the health of pediatric patients with probable personal or family history involvement with the correctional system.

METHODS

A descriptive study was conducted using electronic health record data of 2.3 million youth (ages 0-21 years) who received care in a large Midwestern hospital-based institution from February 2006-2020. We employed a correctional-related keyword search (e.g. jail, prison, probation, parole) to locate youth with probable personal or family history involvement. Health characteristics were measured as clinician diagnostic codes.

RESULTS

Two percent of the total pediatric population had a correctional keyword in the medical chart (N = 51,855). This 2% made up 66% of all patients with cannabis-related diagnoses, 52% of all patients with trauma-related diagnoses, 48% of all stress-related diagnoses, 38% of all patients with psychotic disorder diagnoses, and 33% of all suicidal-related disorders within this institution's electronic health record database - among other highly concerning findings.

CONCLUSIONS

We captured an alarming health profile that warrants further investigation and validation methods to better address the gaps in our clinical understanding of youth with personal or family history involvement with the correctional system. We can do better in identifying, and supporting families affected by the correctional system.

摘要

背景

大规模监禁对儿童贫困和不平等产生了不可忽视的影响,然而,对于其对儿童健康的影响却知之甚少。本研究的目的是识别和描述可能有个人或家族史与惩教系统有关联的儿科患者的健康状况。

方法

采用描述性研究,使用2006年2月至2020年在中西部一家大型医院机构接受治疗的230万青少年(0至21岁)的电子健康记录数据。我们采用与惩教相关的关键词搜索(如监狱、监禁、缓刑、假释)来找出可能有个人或家族史与惩教系统有关联的青少年。健康特征通过临床医生诊断代码来衡量。

结果

在全部儿科患者中,2%的患者病历中有惩教相关关键词(N = 51,855)。在该机构的电子健康记录数据库中,这2%的患者占所有大麻相关诊断患者的66%、所有创伤相关诊断患者的52%、所有压力相关诊断患者的48%、所有精神障碍诊断患者的38%以及所有自杀相关障碍患者的33%——还有其他一些令人高度担忧的发现。

结论

我们获取到了一份令人担忧的健康状况描述,这需要进一步的调查和验证方法,以更好地填补我们在临床理解有个人或家族史与惩教系统有关联的青少年方面的空白。在识别和支持受惩教系统影响的家庭方面,我们可以做得更好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b74/8327457/4f2985678c1c/40352_2021_147_Fig1_HTML.jpg

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