Black Girls And Referrals: Racial and Gender Disparities in Referral to Substance Use Disorder Screening in The Juvenile Justice System

Abstract Background: Justice-involved children (JIC) have a high risk for illicit substance use (SU) and substance use disorders (SUD). Females are particularly vulnerable. It is critical that JIC who report current SU are referred for SUD screening to be provided with potentially life-saving treatment services. Florida law and Florida Department of Juvenile Justice (FLDJJ) policy mandate that JIC who report current SU be referred for SUD screening. Evidence suggests a racial referral gap among JIC who require SUD screening, and research on intersectionality suggests that these disparities may be exacerbated for minority females. Therefore, we hypothesize that Black and Latinx females will be less likely to be referred for SUD screening than White children despite reporting current substance use to FLDJJ. Methods: Multivariate logistic regression was employed to analyze cross-sectional data from FLDJJ on 35,884 JIC who reported SU in the past six months. The main and interaction effects of race and gender on the likelihood of referral for SUD screening were tested. The control variables included substance type, age, household income, current SU problems, history of mental health problems, number of misdemeanors, and risk to recidivate. Results: There were no significant differences in the likelihood of being referred for SUD screening between White females and White males. However, Black females (AOR= 0.48), Latinx females (AOR= 0.77), and Black males (AOR= 0.76) were significantly less likely to be referred than White males. Black females were half as likely to be referred as White males and females. Conclusion: This study finds evidence that Black females in the juvenile justice system are significantly underserved. The justice community must leverage these findings to implement protocols that ensure equal services for all children and eliminate gender and racial disparities in SUD screening.