A new 25-year longitudinal cohort study has found that youths involved with the juvenile justice system have up to 23 times the rate of firearm mortality as the general population, with rates varying by sex, race and ethnicity, and age. The study, conducted by the Northwestern Juvenile Project, also revealed that more than one-quarter of Black and Hispanic males had been injured or killed by firearms 16 years after detention. The findings were published in JAMA Network.

The study is the first to examine the incidence rates of nonfatal firearm injury and firearm mortality in youths involved with the juvenile justice system. The findings suggest that reducing firearm injury and mortality in high-risk youths and young adults requires a multidisciplinary approach involving legal professionals, healthcare professionals, educators, street outreach workers, and public health researchers.

The US is facing a public health crisis as rates of firearm injury and death continue to escalate. Youths and young adults – especially Black and Hispanic males – are disproportionately affected. According to the study, Black males aged 20 to 24 years had higher rates of overall firearm death and firearm homicide death than any other demographic group in 2020.

The study also revealed that males had 13.6 times the rate of firearm injury or mortality than females, with 88 participants (4.8%) killed by a firearm 25 years after the study began. Compared with the Cook County general population, most demographic groups in the sample had significantly higher rates of firearm mortality, with non-Hispanic White males having the highest rate at 23.0.

These findings emphasise the importance of addressing the issue of firearm violence in high-risk youths and young adults. Youths involved with the juvenile justice system are at great risk for firearm injury and death due to exposure to numerous risk factors associated with firearm injury and death, including proximity to firearms, community violence, substance use, and gang activity.

To reduce firearm injury and mortality in high-risk youths and young adults, a multidisciplinary approach is needed. Legal professionals, health care professionals, educators, street outreach workers, and public health researchers must collaborate to advocate for resources for those who have experienced firearm violence, improve data collection on firearm injury and death, and facilitate hospital-, school-, and community-based preventive interventions.

In 2020, 39% more children and youths presented to hospitals with firearm injuries than in prior years, and firearms became the leading cause of death in children and youths for the first time since 1999. The findings of this study provide crucial insights into the incidence rates of nonfatal firearm injury and firearm mortality in youths involved with the juvenile justice system, and highlight the urgent need for a coordinated effort to address this public health crisis.