By Nanzi Zheng , Karen M Abram , Leah J Welty , David A Aaby , Nicholas S Meyerson , and Linda A Teplin

Question What are the incidence rates of nonfatal firearm injury and firearm mortality in youths who have been involved with the juvenile justice system?

Findings This 25-year longitudinal cohort study (n = 1829) found that youths involved with the juvenile justice system had up to 23 times the rate of firearm mortality as the general population; rates varied by sex, race and ethnicity, and age. Sixteen years after detention, more than one-quarter of Black and Hispanic males had been injured or killed by firearms.

Meaning These findings suggest that reducing firearm injury and mortality in high-risk youths and young adults requires a multidisciplinary approach involving legal professionals, health care professionals, educators, street outreach workers, and public health researchers.