The association between criminal legal attitudes and healthcare utilization among adolescents: differences by gender and race

System avoidance is a concept that individual contact with the criminal legal system causes avoidance of other social institutions. Negative attitudes about the criminal legal system and subsequent mistrust in healthcare systems or providers have only been studied in adults. Therefore, the aim of this study is to explore the association between healthcare utilization and youth-reported negative criminal legal attitudes stratified by gender and race in adolescents. Adolescents from the Future of Families and Child Wellbeing Study self-reported attitudes involving legal cynicism, police legitimacy, and healthcare utilization. Logistic regressions were estimated to examine the associations between youth-reported criminal legal attitudes involving legal cynicism and police legitimacy, healthcare utilization, and sociodemographics. Only among non-white girls were negative criminal legal attitudes significantly associated with reduced likelihood of healthcare utilization during the previous 12 months (aOR = 0.55, p ≤ 0.01). Negative criminal legal attitudes in non-white girls reduced the odds of healthcare utilization, which supports the concept of system avoidance of institutions. This has implications for policymakers as they enact laws on crime and surveillance, especially in minority communities, as views on the criminal legal institution can impact other facets of life. More research is needed to directly explore this relationship beyond cross-sectional studies.