This dissertation applied a social determinants of health perspective to examine the relationships between health, academic, and juvenile justice-related structures, interventions, and outcomes among at-risk youths in the United States.
The first study, Relationships between Student, Staff, and Administrative Measures of School Climate and Student Health and Academic Outcomes, examined student, staff, and administrative measures of school climate to understand the extent to which they were related to each other and student outcomes. Multilevel regression analyses showed student, staff, and administrative measures of school climate to be weakly correlated. Strong associations were found between student outcomes and student-reports of engagement and safety, while staff-reports and administrative measures of school climate showed limited associations with students’ outcomes.
The second study, Understanding Racial and Ethnic Disparities in Arrest: The Role of Individual, Home, School, and Community Characteristics, identified characteristics of young adults who were more likely to become involved in justice-based punitive systems. Multilevel regression analyses showed significantly higher likelihood of having ever been arrested among Blacks, when compared to Whites, even after controlling for a range of delinquent behaviors. Notably, racial/ethnic disparities in arrest were no longer present after accounting for racial composition of the neighborhood.
The third study, The Impact of Two Los Angeles County Teen Courts on Youth Recidivism: Comparing Two Informal Probation Programs, assessed a juvenile justice system diversion program being implemented in Los Angeles County. Logistic and survival models showed Teen Court participants to have lower rates of recidivism than comparison group participants, after controlling for potential confounders.
This dissertation provides a research-grounded approach for how public health might apply its population health frame to support a more holistic vision for health and wellness within the education and juvenile justice systems. Moving forward, research and practice efforts to address the social determinants of health will require an expanded definition of what it means for youths to be “healthy,” greater willingness among researchers and practitioners to focus on multi-component/multi-system interventions, more meaningful communications and alignment between systems, and a more explicit focus on identifying factors that can facilitate successful policy and program implementation.