Pathways to Early Violent Death: The Voices of Serious Violent Youth Offenders

Abstract

Quantitative studies have uncovered factors associated with early violent death among youth offenders detained in the juvenile justice system, but little is known about the contextual factors associated with pathways to early violent death among youths detained in adult jails.

We interviewed young Black male serious violent youth offenders detained in an adult jail to understand their experience of violence. Their narratives reveal how the code of the street, informal rules that govern interpersonal violence among poor inner-city Black male youths, increases the likelihood of violent victimization.

Youth offenders detained in adult jails have the lowest rate of service provision among all jail populations. We have addressed how services for youth offenders can be improved to reduce the pathways to early violent death.

“I carry my gun anywhere I go, I mean if I got to crush [kill or injure] someone, then I will. I don’t care. It’s either him or me.”

—Ice, aged 17 years

On any given day in the United States 7600 youths younger than 18 years are detained in adult jails.^1,2 Youths of color are overrepresented among this group.³ Although they represent only 17% of the total youth population, 62% of youths prosecuted in the adult criminal justice system are Black, and they are 9 times more likely than are White youths to receive an adult prison sentence.⁴ Serious minority male offenders are more likely to be transferred to adult court and confined to more restrictive settings.⁵ Research on serious violent youth offenders who were adjudicated in an adult criminal court suggests that they are at greater risk for violent injury and early violent death than are youths processed in juvenile court.^6–11 Youths placed in adult jails and prisons are also at greater risk to be sexually and physically assaulted. They are the easiest prey for violent victimization and sexual abuse and so are the hardest hit,^12,13 and according to the Centers for Disease Control and Prevention, they are approximately 34% more likely than are youths adjudicated in the juvenile justice system to be rearrested for a violent crime.¹⁴

Although studies have documented early violent death among youth offenders detained in adult jail,⁶ a critical omission in this research is contextual information on why the rate of violence and homicide is so high among this population.^{6,10,11,15–18} Their “voices” are missing.¹⁸ Although there is a wealth of quantitative data on risk factors for early violent death among youth offenders,⁶ we know little about the meaning of violence in their lives and how violence shapes their social worlds. We have addressed this gap in the literature.

To explore pathways to early violent death among serious violent youth offenders, we drew on the narratives of Black male adolescents transferred to adult court. We explored how these youth offenders negotiated the social context of inner-city violence while they were on the “outside.” We asked questions regarding “disrespect” as well as the following questions: Did they carry firearms? In what situations would they use a firearm? What role does violence play in their lives? How do drugs, alcohol, and violence fit into the social context of their lives and the communities where they reside? Were they chronically exposed to violence? Have they ever been violently victimized? How do they negotiate violence in the context of jail?

CODE OF THE STREET

We used Anderson’s Code of the Street¹⁹ to theoretically frame these questions. Anderson performed an ethnographic study on violence on Black male youths in inner-city Philadelphia, Pennsylvania. He argues that high rates of poverty, joblessness, violence, alienation, lack of faith in the police and the judicial system, and hopelessness have produced a neighborhood street culture “code” that influences how individuals, particularly Black male youths, negotiate interpersonal violence. The structural inequalities and institutional racism that have disconnected them from educational and labor market opportunities have resulted in a subculture in poor communities where an underground economy provides the social and economic means for young Black men to survive.^20–24 Their social dislocation from job opportunities and mainstream institutions has created an oppositional culture that embraces norms, values, and behaviors that value violence and aggression. The inclination to violence springs from the circumstances of life among the ghetto poor: lack of jobs that pay a living wage, the stigma of race, the fallout from rampant drug use and drug trafficking, and a general sense of alienation. In response, a street culture has evolved in which violence regulates public space and everyday behavior.

Anderson¹⁹ defines “the code of the street” as a set of informal rules that govern interpersonal public behavior, including violence. The street oriented (those whose norms oppose mainstream values) establish and enforce the rules, but on the street the distinction between who is “street” and who is “decent” (those committed to middle-class values) is irrelevant. Everyone must know the rules or suffer the consequences of violating the code. At the heart of Anderson’s code is the issue of respect and the predisposition to violence to acquire, defend, and maintain respect through the use of violence and aggression. Respect is loosely defined as being treated right or granted the deference one deserves. For many street-oriented Black male youths, their identity, honor, and self-esteem are tied to their attributes; indeed, one may be willing to die rather than suffer being disrespected on the streets.^19,25–27

In communities where legitimate employment opportunities are elusive and often unattainable, particularly for young men with histories of criminal justice involvement, respect is regarded as a highly valued commodity. The distribution of respect is in short supply but in high demand.¹⁹ In the world of the street oriented, respect becomes a form of currency, an intangible form of social wealth. According to Anderson,¹⁹ respect is “hard to gain but easily lost.” As a result, some youths, such as the boys in this study, spend much of their adolescence in a state of hypervigilance, constantly seeking to acquire, maintain, and preserve their respect through violence and aggression. Anderson defines this process of constant vigilance as “campaigning for respect.” When this occurs, street youths give a public impression that they will not tolerate transgressions against their reputation, because something extremely valuable is at stake in every interaction.⁷ Those campaigning for respect can never be “caught slippin,” a street term defined as not being vigilant.

Chronic exposure to violence among Black male youths, as victims, perpetrators, and witnesses, may have severe consequences on their mental health. Rich and Grey²⁸ found that symptoms of posttraumatic stress disorder (PTSD) were especially prominent in the narratives of young Black men who ascribed to the code. Youths expressed symptoms such as chronic hyperarousal, blunting of normal fear and emotions (emotional numbing), nightmares, and flashbacks (reexperiencing).⁷

For the boys we studied, we believe that the code is an appropriate conceptual framework for examining and understanding the nuanced pathways to early violent death. We built on Anderson’s framework of inner-city Black male youths’ interpretation of the code and violence. We examined how young Black male serious violent offenders interpret and negotiate the code of the street and the implications for their pathway to early violent death.^6,19,28 Furthermore, we used the code to explore how chronic exposure to violence and mental health disorders, specifically PTSD, intersect.

MENTAL HEALTH AND YOUTH OFFENDERS IN ADULT JAILS

The prevalence of mental health disorders is significantly greater among youths detained in adult jails. Youths detained in adult jails are 36 times more likely to commit suicide than are youths detained in juvenile detention facilities and 19 times more likely to commit suicide than are youths in the general population.² Furthermore, juvenile perpetrators of violent crime are more likely to be victims of violent injury.²⁹ Previous studies that compared psychiatric disorders among youths processed in juvenile court and youths processed in adult criminal court indicate that for youths processed in adult criminal court the prevalence of specific and comorbid psychiatric disorders is as high as or higher than that for youths processed in juvenile court.³⁰ Among youths transferred to adult criminal court, the 6-month prevalence rate for major depression was 3 times greater (16%) than was the lifetime rate among adult male detainees.³⁰ Recent findings on youths transferred to adult court indicate that youths may experience worse long-term psychiatric outcomes than do youths processed in juvenile court; however, few empirical studies on this population of youths are available.³⁰ Although these findings suggest that youths transferred to adult criminal court may have a greater need for psychiatric services than do youths detained in juvenile prisons as well as detained adults, youths detained in adult jails have the lowest rate of service provision among all jail populations.⁶

Adult correctional systems are often not prepared to identify or treat transferred youths for mental health disorders. Few adult jails or prisons have culturally and developmentally appropriate mental health services for serious violent youth offenders. Studies of service provision and use among serious violent youth offenders processed in juvenile court and adult criminal court suggest that youths transferred to adult court and detained in adult jails or prisons receive far fewer services than do youths processed in juvenile court.^3,5 Furthermore, youths transferred to adult court and detained in adult jails are often detained in oppressive conditions (e.g., 23-hour-a-day lockdown). These “adult-like” conditions can create or exacerbate preexisting mental health disorders. Youths in adult jails will spend on average 261 days (almost 9 months) in adult jail with no rehabilitative or educational services.² Research has found that longer periods of detention and stressors associated with processing youths in adult criminal court may increase the risk of psychiatric disorders and other adverse developmental social and functional consequences.^30–32 Ultimately, most youths detained in adult jail will be released within 1 year. Reports on youths adjudicated in adult criminal court indicate that almost 50% of youths detained in adult jails will have their cases sent back to the juvenile court system or dismissed.³ On release, many will return to the same high-risk neighborhoods, where the threat of violence and the code govern interpersonal violence among young Black men.¹⁹

Through the use of narratives, we examined the perceptions of the code of the street among Black male serious violent youth offenders detained in an adult jail. We explored how Black male youth offenders who ascribe to the norms, values, and behaviors of the code may be at great risk for early violent death. We also explored how violent youth offenders negotiate the context of neighborhood violence and their coping mechanisms for dealing with trauma while on the outside. We chose to study Black male serious youth offenders detained in an adult jail because youths in adult jails are an understudied and neglected population of juvenile offenders. The few empirical studies on this population indicate that minority youths detained in adult jails are at greater risk for suicide, violence, aggression, and homicide than are youths detained in juvenile detention and in the general population.^6,30 Although several thousand Black male youths are detained in adult jails on any given day in the United States, little is known contextually about the risk factors that may increase the likelihood of early violent death among this vulnerable population of youths, which has a long history of neglect from policymakers, practitioners, and researchers. Several reports on juveniles in adult jails have referred to this population of youths as “invisible.”³³ To develop a hypothetical model of pathways to early violent death among Black male serious violent youth offenders, we built on Anderson’s conceptual framework with concepts of traumatic stress, substance use, accessibility to weapons, social networks, and equating violence to work.

METHODS

We collected the data we used for the analysis from a qualitative pilot study using focus groups on the health risk behaviors of youth offenders processed in adult criminal court for serious violent crimes and detained in an adult jail. We recruited a small sample of 15 Black male youth offenders aged 15 to 17 years. The average age of participants was 16.7 years. We recruited inmates at the Bay City Jail (pseudonym)

Bay City Jail is located in a large metropolitan area on the eastern seaboard. Although the facility houses primarily adult inmates, the jail also has a segregated juvenile unit that houses male youth offenders. The juvenile unit typically operates at or above maximum capacity.

At the time of this study 100% of the youth offender population was Black. The average length of stay for an offender was 210 days. Armed robbery was the most common offense (60%). All youths in the study reported being affiliated with a gang, and all resided in impoverished neighborhoods with high rates of crime, violence, and unemployment. The youths’ reading levels ranged from fourth to eighth grade, although some young men in the sample were functionally illiterate. All participants reported engaging in daily substance and alcohol use; 15% had experienced a violent firearm injury.

Procedures

The University of Maryland’s institutional review board waived the need for parental consent after we made several attempts to contact the parents via telephone, e-mail, and postal mail. The institutional review board acknowledged that researchers may not have access to the parents in a routine way, forcing them to expend a great deal of energy just to reach the parents, let alone secure their consent.³⁴

Participants consented to participate in the study. We informed participants that the purpose of the study was to collect data on their perceptions and attitudes regarding health risk behaviors among adolescents in Bay City, particularly youth offenders. We emphasized the voluntary nature of the study. We did not offer any monetary incentive; a key incentive for participation was the opportunity for inmates to be released from their cells for free time (2–3 hours). Twenty-three-hour-a-day lockdowns were typical for most youths on the unit. Participants acknowledged that the opportunity to engage in focus groups with other youths and adults, instead of spending the majority of the day confined to their cells, was a key incentive. The time participants spent in the focus groups instead of idle in their cells provided a break from the monotony of social isolation. In addition, we offered other incentives for participating in the study. For example, we gave participants books such as the Autobiography of Malcolm X and journals that they could use at their discretion. Participants were also given a weekly movie day, when they collectively selected a film to view. This incentive also provided participants an opportunity to interact outside their cells.

We collected data in focus groups. Two Black male researchers who were culturally competent in working with Black male youths led the focus groups. Both researchers were extensively trained in qualitative research methods and had conducted community-based participant observation ethnographic research in disadvantaged Black communities, jails, and prisons for more than 20 years. One researcher had an extensive history of incarceration. He was raised in many of the neighborhoods where several of the young men in the study resided. His history of criminal justice involvement added to his street credibility among participants and helped in developing rapport with the young men in the sample. The lead researcher had considerable expertise in conducting ethnographic research on the social context of adolescent violence among Black male youths in disadvantaged communities. He also had 5 years of experience working as a volunteer mentor with incarcerated youths in juvenile prisons. Researchers recruited participants for the study by making a presentation to the youth inmates. Following the group presentation, the researchers approached each inmate individually in the privacy of his cell during lockdown.³⁴ Each inmate had a private cell. Fifteen youths consented to participate in the study. For unknown reasons, not all youths agreed to participate in the study. We were unable to determine whether there were differences in youths who chose to participate and those who refused.

The research team conducted weekly focus groups with youth offenders on health risk behaviors such as unprotected sex, substance or alcohol abuse, and violence. The team collected data over a 6-month period. These focus groups were typically conducted on Saturday afternoon in a classroom located in the juvenile unit. The average length of the focus groups was 2 hours. Participants were actively engaged in the discussion for the 2-hour period. The incentive of free time reduced participant burden. We have referred to all participants by pseudonyms. To protect the confidentiality of participants, researchers instructed each participant to not discuss the context of the focus group discussions outside the classroom. Because most participants were members of gangs, they were instructed not to divulge the names of any individuals, gangs, or neighborhoods. The researchers routinely emphasized this rule, and it was instrumental in keeping participants from divulging certain facts that may have led to physical harm as a victim or perpetrator of violence while in jail. We also instructed participants to immediately inform the correctional staff and us if they were threatened or physically harmed as a result of their participation in the study. Participants did not report any threats or incidents of physical harm.

Researchers conducted 10 focus groups. The average range of participation was 13 to 15 participants for each focus group. All the participants remained in the study until completion. Researchers were able to establish validity and reliability through practicing trustworthiness.^23,35–37 One of the strengths of our study was our reliance on our cultural competence as Black male researchers and the numerous focus groups we conducted with the same group of youths. Our continuous and routine presence allowed us to establish trust with the participants.

We explicitly framed focus group sessions as voluntary conversations. The focus group questions were open ended and tended to be free-flowing.³⁸ We chose focus groups rather than one-on-one elicitation methods because data collection in the jail setting was more time efficient and effective,³⁹ participant interactions enhanced the quality of the data,⁴⁰ and the range of views could be easily and quickly assessed.⁴¹ The researchers also used a semistructured discussion guide composed of open-ended questions about the code of the street. The discussion guide was framed by questions taken from a previous ethnographic research study on the code of the street, violence, traumatic stress, and substance use among young Black men.²⁸

Our overall goal was to describe the social context of violence among youth offenders detained in adult jail. We focused on gaining a better understanding of the contextual experiences related to violence and the code of the street.¹⁹

The researchers leading the focus groups developed rapport with the participants over the course of the pilot study, which allowed more in-depth discussions of violence and the code of the street. Conversations that began with simple questions concerning violence often moved into the realm of social contexts, interactions, and the embedded meanings and perspectives of the participants themselves.³⁸ As participants elaborated on their views regarding violence, they delved into their narratives regarding participating in and observing violence. Participants also elaborated on their views regarding respect, violence on the street, and what contextual factors framed how, why, when, and where interpersonal violence and aggression should be used.

Researchers usually initiated discussions by using the first 30 minutes of the focus group to screen a film, typically a documentary or docudrama. They then used the film’s subject matter to frame the theme of the focus group discussion. For example, I (J. B. R.) used the HBO series “The Wire,” which dramatized drug use, crime, violence, and poverty in inner-city Baltimore, Maryland, to frame focus group discussions. I attempted several approaches (some successful and others not) to learn that I “had to meet the participants where they were.” Initially, I attempted to use readings from autobiographies such as Monster: The Autobiography of an L. A. Gang Member⁴² but quickly learned that some boys in the group were unable to read. In fact, some participants divulged to the research team that they were unable to read and suggested to the researchers that watching films would be a more effective approach for framing our discussions. This method was quite successful in eliciting responses from the participants. We asked the following focus group questions to assess the adoption and utilization of behaviors associated with the street code.²⁸

• How do you define respect?

• In what ways do you acquire and maintain respect on the street?

• How do you lose respect on the street?

• What defines being a “sucker” or a “punk?”

• Do you trust or have faith in the police?

• Who do you rely on for protection?

• How do you protect yourself?

• Have you ever been violently injured?

• Have you ever witnessed someone harmed or killed?

• Is your neighborhood dangerous?

• How important is it to be respected in your neighborhood?

• What are signs of disrespect on the street?

• What does disrespect mean to you?

• How do you respond in situations in which you think you have been disrespected?

• Do you carry a weapon?

• When is it necessary to use a weapon?

• Are you in a gang?

• Have you ever engaged in gang-related violence or crime?

• Do you smoke marijuana or drink alcohol?

• Is the jail a dangerous place?

Data Analysis

Jail restrictions prohibited audiotaping. We assigned a researcher to take detailed notes on the discussions while the lead researcher facilitated the discussion. After the focus group sessions were completed, the facilitators met to debrief and discuss the notes and context of the group discussion. We made transcripts of each focus group session. We analyzed the notes from the discussion using qualitative analysis software, ATLAS.ti, version 7.0 (ATLAS.ti Scientific Software Development GmbH, Berlin, Germany). We conducted content data analysis after each focus group session. Content analysis involved analytic induction that applies first a deductive analysis approach and then an inductive approach that allowed us to identify emergent themes.⁴¹ We used a grounded theory approach for the data analysis, and the themes and subcategories evolved from the data.⁴³ We coded data according to themes and subcategories.²⁸

We extracted all the segments related to the research questions from each of the 10 transcripts of the focus groups. We and a research assistant (unfamiliar with the data) independently coded a subset of transcripts to note major themes, concepts, and patterns.⁴⁴ We compared coding decisions and found that they reflected a high level of consistency. The 2 coders found strikingly similar initial data patterns. This procedure allowed the coders to conduct reliability checks to ensure consistency with the interview data collection.

The initial broad coding categories were as follows: respect, substance or alcohol use, exposure to violence, carrying a weapon, code of the street, and social networks, peers, and gang affiliation. When we had completed the coding procedure, we constructed a table with the main organizing categories and subcodes in the left column and a summary of what youths reported across focus groups in the right column.^34,45 While examining the data, we found that being enmeshed in the culture of the street and ascribing to the code shaped participation in violence. Once we identified the data pattern, we revisited the transcripts to challenge and refine our major findings.⁴⁴

RESULTS

We have highlighted the social context of violence among Black male serious youth offenders detained in an adult jail. The following themes emerged in the narratives of the participants in this study: the code of the street (respect and disrespect), violence as a form of labor, chronic exposure to violence, carrying a weapon, social networks, substance or alcohol use, institutional violence, and services. We have summarized the themes and presented selected responses from the focus group participants.

Acquisition and Maintenance of Street Respect

Violence, negotiation of the code of the street, and the importance of respect and protecting oneself were topics that participants openly discussed.^19,28 In the focus group discussions, the threat of violent victimization and the adherence to the code framed when, how, and where to use violence. All the participants carried firearms daily, and all had witnessed a serious violent assault (shooting, stabbing, or beating). Approximately 75% of the participants had witnessed a homicide. Three of the participants witnessed the homicide of a friend or relative, and half reported confronting violence regularly, for example, while attending school or spending time with friends. Most youths expected to confront violence on a daily basis. BL and BG discuss the threat of violence, the maintenance of street respect, and always being prepared for conflict:

You got to be ready to put in your work [violence] at any time; it doesn’t matter what it’s over: disrespect, money, whatever. Work is work. (BG, aged 17 years)

You have to be ready because it [violence] can happen at any time…. Someone is always going to try [disrespect] you. Once you violate [disrespect] my space, you gotta get dealt with [use violence]. (BL, aged 16 years)

Violence as a Form of Labor

The findings suggest that some youth offenders equated violence to labor. In communities where Black male youths are often chronically unemployed and marginalized from mainstream opportunities and labor markets, economic violence—meaning violence associated with economic crime—represents a form of work. Accumulated engagements in violent events on the street give an individual credibility and respect and in a sense build the “street resume.” Youths considered both noneconomic violence and economic violence, such as fighting for a gang or murdering a rival over drug territory, as “working.” Several youths used the phrase “putting in work” to describe violence as work. The concept of putting in work translates into the respect and deference that one properly deserves for the cumulative experiences of engaging in violence. Putting in work is a central part of low-income young Black men making their way through the dangerous world in which they live.²⁸ Many youths in the study perceived building a reputation and acquiring and maintaining respect through the use of violence as a full-time occupation.⁴² During their waking hours, they appeared to be constantly working to protect their self-respect and build and defend their reputations while simultaneously working to earn income from crime and violence. Here Mo and Dre describe the concept of putting in work.

I have put in too much work [violence and crime] in my “hood” to give it up [respect and reputation] to some other dude. Plus, I got a family name to protect … ’cause they killed my brother, so I can’t be soft in no way. (Mo, aged 17 years)

Nobody around our neighborhoods is working. So hitting someone’s head [murder], it’s like working. Youngins [adolescents] in my hood [neighborhood] already know they’re not going to get no job and they’re not going to college. So for them this is work; this is how they work. This is how they earn their rep [reputation]. Bottom line, no matter what world you in, the underworld, the real world, whatever world, people want to be respected. In the underworld, the street world, you progress and get respect by putting in work [violence], doing things that other people in the real world might think is wrong, like laying somebody down [murder]. For us, hitting somebody’s head [murder] might be the only way to deal with a situation. For some, it might bother you at first, you might have nightmares about it, but after you put in more work you get used to it. That’s just how it is. (Dre, aged 16 years)

Mechanisms for Coping With Chronic Exposure to Violence

The most common forms of violence that youth offenders experienced as perpetrators, victims, and witnesses were fights, threats with weapons, and shootings. The interviews revealed that most youths in the study expressed no fear of these sorts of violence. Several boys were desensitized to the threat of violent victimization. Participants routinely described a loss of fear and lack of emotion toward violence and death. The participants also expressed that early violent death was an inevitable outcome in their lives. Faced with the looming danger of being killed or violently injured, many youths did not envision living beyond young adulthood. This fatalistic form of PTSD is defined as emotional numbing.²⁸ Eleven of the 15 (73%) participants expressed symptoms of emotional numbness and thought that their life expectancy would not exceed young adulthood. Many inner-city adolescents crave respect to such a degree that they will risk their lives to attain and maintain it and feel that it is acceptable to risk dying over the principle of respect. To display a lack of fear of dying portrays “true nerve.”¹⁹ Consequently, they often lead an existential life. Not being afraid to die is by implication to have no compunction about taking another’s life if the situation demands it. Method and Ice provide their narratives describing their lack of emotional connectedness to victims of homicide and the inevitability of early violent death.

It’s not about being scared. You got to show no fear. All I need to know is a guy got beef … after that, it’s on [attack or defend yourself]. And, we always say in my neighborhood, “If you got did [murdered or violently assaulted] … then your ass deserved it!” It’s like when I see a guy laying out, dead in the street. I like to look and see if his eyes are open. If they are open, then I say he deserved it. (Method, aged 16 years)

No matter what you do out here, you gonna die anyway; you can die stepping off a bus into the street. We all got to die. Beef [disputes] on the street, f-king raw [unprotected sex], it’s all the same to me; you can die from anything out here. I mean what’s the difference? We all got to die. (Ice, aged 17 years)

Chronic Exposure to Violence Across Contexts

Some participants lived in peaceful communities but faced numerous conflicts at school or traveling on public transportation. Many worried about being hassled, threatened, or challenged to fight while in or on their way to and from school. Violence often occurred in public, densely populated places in the neighborhood or school setting. Anderson¹⁹ characterizes these public spaces as the “staging area”—a physical space where the campaign for respect is most often waged. Staging areas typically are neighborhood establishments youths frequent, such as fast-food carryouts, street corners, basketball courts, schoolyards, liquor stores, bars, and public transportation (bus stops and subway stations). In these staging areas, young Black men “perform” by engaging in violence as a means to acquire and maintain respect. In the staging area, the basic requirement is the display of a certain predisposition to violence. One’s bearing must send the unmistakable if sometimes subtle message to other persons in the staging area that one is capable of violence and mayhem when the situation requires it, that one can take care of oneself.^19,46 Here Ray and Ali discuss school and public transportation as the staging areas in their campaign for respect.

Yeah, I live in a decent neighborhood, but I had to go to the same school with some dudes who were always looking for something to get into … and they be going hard every day [instigating violence]. So my crew always had beef [disputes] with them. I had to be ready to fight at any time. They were always trying to take somebody’s heart [respect]. (Ray, aged 17 years)

I had to take 2 buses to school that go through neighborhoods with dudes I got beef with. I lost a fight real bad once on the bus. So I just stopped going to school. Something was popping off [violence] every day; either I was going to kill them, or they were going to kill me. (Ali, aged 17 years)

We asked participants to rate the safety of their neighborhoods on a scale of 1 (safe) to 10 (dangerous). They rated safety in their communities as dangerous. Several youths indicated that they had witnessed the homicide of a relative or close friend.

Interviewer: On a scale of 1 to 10, 1 meaning your neighborhood is safe and 10 meaning that your neighborhood is dangerous. How would you rate it?

Malik (aged 16 years): I would rate it a 20. It’s always somebody getting shot in my neighborhood.

Kenny (aged 16 years): I would rate it a 10. Two of my friends were murdered right beside me in a drive-by. Somebody drove by shooting, so we all fell on the ground, but they didn’t get up; they died right there in front of me.

G (aged 16 years): I would give it a 10. I seen my man [friend] shot in the head right in front of me; he died in my arms.

Mo (aged 17 years): No doubt it would be a 10 maybe 20. I got shot in my neighborhood, and my brother was killed in front of me. He got killed in a new pair of Jordan’s. I still have them. I have the sweat suit he was killed in too. It still has the blood on it.

Carrying a Weapon

All the youth offenders in this study expressed the need to carry a weapon at all times for protection. Weapons played an important and complicated role in establishing respect and self-image.¹⁹ For many young inner-city men, a weapon is part of an individual’s personal possessions, like clothes, jewelry, and sneakers, that speak for him in his campaign for respect. Carrying a weapon commands respect and gives the appearance in the staging area that he will not tolerate transgressions by others.

Interviewer: Have you ever carried a weapon for protection?

All participants agreed that carrying a firearm is necessary.

Ice (aged 17 years): I carry my gun anywhere I go. I mean if I got to crush [kill or maim] someone, then I will. I don’t care. It’s either him or me.

Tee (aged 17 years): I carry my gun around anywhere, even if my mother is around. I mean if I see the guy I got beef with [dispute] then I’m gonna crush him regardless of who is around.

Mo (aged 17 years): Yeah, I’ve even carried my gun to Juma [Muslim prayer at a local mosque on Friday afternoon]. It’s plenty of dudes in Juma with gats [guns] on them. You might be safe in Juma, but you still have to get back home.

Social Networks

All the boys in the study were members of a gang. Their strong social ties to the gang were characterized by loyalty to their peers. Studies have shown that Black male delinquent youths who co-offend with other delinquent youths, particularly violently, are more likely to be victims of violence.⁴⁷ Here, Mo, a victim of violent firearm injury, discusses engaging in violence.

I got 4 friends I run with; we all been friends since we was little. We chop dope up and get money together. We put in work together [selling drugs and engaging in violence associated with drug dealing] and have taken charges for each other. I’ve taken a bullet for one of them. (Mo, aged 17 years)

Substance and Alcohol Use

Twelve (80%) participants reported that they smoked marijuana on a regular basis. Two (13%) participants reported smoking “wet” (marijuana and PCP [phencyclidine]) regularly and using cocaine periodically. Five (33%) participants reported drinking regularly. The reasons they used drugs or drank alcohol varied. Some smoked marijuana regularly with members of their family at home and when gathering with peers. Others drank alcohol before engaging in sex. Some youths who sold drugs (specifically crack cocaine) exchanged sex for drugs. As part of the exchange, they would often get high with their sexual partners.

I chief [smoke marijuana] all day, every day. I love smoking with the Backwoods [cigars used for smoking marijuana]. (Mo, aged 17 years)

I like to get my drink on. I like to drink that Goose, E&J, or Henny [brands of alcohol] but I might chief every now and then. I won’t have sex, though, unless I’m drunk off that Goose. (G, aged 16 years)

I’ve been raised on smoking Backwoods all my life, so that’s all I smoke. (Lenny, aged 17 years)

I like to smoke that wet [marijuana and PCP,] and sometimes I like to sniff a little bit [cocaine]. (BL, aged 16 years)

I trick [exchange drugs for sex] all the time. I give these hoes [women] 2 stones [crack] for some head [oral sex]. (Ice, aged 17 years)

Negotiating Violence in Jail

For many, negotiating the social context of violence in the adult jail system was quite similar to negotiating violence on the streets. The code that governed interpersonal violence on the streets also governed the use of violence and aggression in jail. Youths appeared to be in a perpetual state of hypervigilance, always cognizant of the potential risk for violent victimization.

You can’t trust nobody in here; ain’t nobody your friend; you got to watch your back at all times. You can never get caught slipping [not being alert], or somebody might stab you or jump you. Whatever. I just stay to myself and read my bible. This ain’t nothing like juvie [juvenile detention], where everything is nice and sweet. Once you’re here, it’s no joke. You can’t show no signs of weakness up in here. If you do, you’ll be asking for pc [protective custody]. That’s when everybody knows you’re a b-tch. (Ace, aged 17 years)

Adult jail is the real deal. Once I put on that orange jumper, I realized this ain’t no Pine Mills [juvenile detention facility]. That was child’s play up there. Ain’t nothing sweet about being in here. This is gladiator school. (Darius, aged 17 years)

Services

According to research, services for youth offenders detained in adult jails are limited.⁵ The sanctions and services youth offenders receive may affect the future trajectory of their lives. We asked youths if they received any services while incarcerated.

Interviewer: Are there any violence prevention programs for you here at the jail?

G (aged 16 years): Nah, we don’t get sh-t up in here but the GED [general equivalency diploma] program. There ain’t no other programs in here for us.

Ice (aged 17 years): All we get is GED and the math teacher. He don’t even know what he’s doing. Besides y’all [researchers] coming here, all we have is a poetry program.

DISCUSSION

The narrative analysis we have presented demonstrates that Black male serious violent youth offenders are at great risk for violent injury. The contextual data we have presented also suggest possible pathways to early violent death. Youths transferred to adult court face considerable challenges as they negotiate the social context of violence in high-risk communities. They have few options to avoid danger. The participants suggested that once involved in a criminal and violent lifestyle, it is often difficult to escape. Studies have shown that the contextual factors we have discussed, such as disrespect, carrying a weapon, delinquent social networks, exposure to violence and substance and alcohol use, increase the risk for early violent death.^{6,8,9,19,47–49} One of the pathways to early violent death that thematically emerged in our analysis was the concept of violence as a form of labor. We found that with few prospects for employment, inner-city young men often rely on crime and violence as work,⁵⁰ which includes such activities as selling drugs, robbery, drive-by shootings, and burglary. Participants characterized gun violence as an essential aspect of labor and most often associated it with economic crime. Violence as labor may heighten the risk for violent injury and early violent death. Furthermore, unlike youth offenders processed in juvenile court, where crimes are automatically removed from individuals’ record once they become legal adults, youth offenders processed in adult court (if convicted) acquire an adult felony on their record. This may further stigmatize and marginalize Black male youth offenders as they seek legitimate employment opportunities.^20,51

These boys share a sense of alienation from mainstream opportunities and live in environments where an oppositional culture thrives.¹⁹ Respect is a highly valued commodity in their social worlds; it is viewed as a salient form of social capital in disadvantaged communities where resources are often scarce. Consequently, Black boys and young adults work hard to earn respect and protect it.¹⁹ In their social worlds, this is a full-time job, which occasionally requires the use of violence.⁴² In a culture where masculinity is defined by respect, not showing fear, and not appearing to be weak, youths spend much of their waking hours protecting their reputations. In the social hierarchy of the streets, a young man who is perceived as a “punk” or “weak” falls to the bottom of the social ladder.^19,26,28 He must work his way up the social ladder through the use of violence or face the risk of greater violent victimization. In either scenario, one cannot escape the risk of being violently injured. Consequently, many youths perceive the possibility of being violently injured or killed as inevitable.²⁶

The literature on crime as work for inner-city Black males has received significant attention in several classic ethnographies.^19,24,50,52 Building on those studies of crime as work, we found that participants perceived noneconomic and economic violence as work. For Black male youths who have been socially alienated, dislocated, and marginalized from mainstream opportunities and labor market connections, the oppositional culture legitimizes violence as work.^19–22 In response to blocked labor market opportunities, young Black men create their own value system of what work means. The perception of violence and crime as work heightens the risk for early violent death. This type of work is literally an occupational hazard. In the code of the streets, being disrespected on the job results in violent retaliation. Whether working as drug dealers or gangbangers, a violation of the code requires swift and immediate action.⁴² Sanyika Shakur’s autobiography, Monster: The Autobiography of an L. A. Gang Member, captures the concept of violence as labor. Shakur describes the process of building a reputation for himself and his gang as work:

For the past 5 years I had gotten up every morning and ironed my gear [clothes] with thoughts of nothing else but doing propaganda for the set [gang]. I did this with the zeal of a religious fanatic… . I felt nothing but a sense of duty. Revenge was my only thought. Only when I had put work in [violently injuring or murdering a rival gang member] could I feel good that day; otherwise I couldn’t sleep. Work does not always constitute shooting someone, though this is the ultimate. Anything from wallbangin [writing your gang’s name on a wall] to spitting on someone to fighting—it’s all work. And I was a hard worker.^42(p52)

They also developed different coping mechanisms to “get through” chronic exposure to violence in the community.^53–56 Some young men in the focus groups described symptoms of emotional numbing or the lack of emotional responsiveness to witnessing trauma and the possibility of early violent death.^57–60 This form of PTSD is commonly found among combat veterans.⁶¹ Some youths coped with witnessing homicide by using rationalizations such as “the person deserved it.” Others embraced the inevitability of an early violent death with a sense of fatalism, using such phrases as “We all gotta die.” Many adolescents live in violent neighborhoods where witnessing violent trauma paralleled the experiences of soldiers in combat. In fact, some boys often referred to their peers as “soldiers” and “generals.”

Some youth offenders expressed being in a constant state of hypervigilance or hyperarousal in their neighborhoods, and as they traveled across other social contexts violence could happen at any place and at any time.⁶² Using public transportation, going to school, or even attending religious services at a church or mosque required hypervigilance as youths crisscrossed through unfamiliar neighborhoods. The phrase “something can pop off” (meaning violence may occur) at any time was thematic. Being prepared to engage in violence was central to self-preservation. This sometimes real and other times exaggerated sense of vulnerability resulted in youths feeling compelled to carry guns. All the participants in the study reported carrying a gun regularly for protection. Previous studies on violence and trauma among young Black men suggest that violent interactions cause hyperarousal and emotional numbing and that carrying a weapon increases the likelihood of violent injury.^8,9,28,62

Peer groups also influenced participation in violence and crime. All the participants in the study were members of gangs. Thrasher⁶³ observed that gangs engage in many collective behaviors, violence being a primary behavior, a behavior that is normative.⁶⁴ Violence is integral to the life of a gang and gang members tend to engage in more violence than do other youths.^29,65,66 Threats of violence play an important role in gangs because they have consequences for future violence. Gangs are merely a macrolevel extension of the individuals who constitute gangs, and the respect and the reputation of the gang must be protected at all cost. Gangs, like individuals, believe that they must retaliate against rival gangs if they are disrespected or they will be at greater risk for victimization.

Engaging in violence on the individual level offers a certain level of autonomy and rational choice.⁶⁷ Individuals can decide if and when they should engage in violence. This is not the case once an individual joins a gang. In the context of a gang, the strong ties to other members and their commitment to each other enable members to engage in acts of violence that they might not have committed otherwise.⁶⁴ A common principle among gang members is that they must violently retaliate against rival gangs if a fellow member is disrespected, threatened, or injured. Furthermore, gangs must also defend spatial territory or turf. Violating the sanctity of turf is a form of disrespect that requires retaliation.¹⁹

Although gangs provide safety in numbers, they also increase the risk for violent victimization. One aspect of gang membership that increases the risk of violent injury and early violent death is “contagion.”⁶⁸ Contagion refers to subsequent acts of violence caused by the initial act, which typically takes form in retaliation.⁶⁸ Contagion may explain the cycle of gang violence.

Previous studies on violent trauma and the code of the street suggest that substance and alcohol use precipitate violent trauma.^{7–9,28,69,70} Substance (particularly marijuana) and alcohol use was consistent among the young men in the sample. Eighty percent of participants smoked marijuana daily, 33% drank alcohol daily, and 13% smoked marijuana mixed with PCP regularly. Some youths acknowledged periodic cocaine and crack cocaine use primarily in the exchange of sex for drugs.

None of the participants indicated that substance or alcohol use was tied to violence. We did not explore whether substance and alcohol use was used to self-medicate symptoms of PTSD, such as emotional numbing or hyperarousal. Furthermore, we did not explore whether youths were intoxicated at the time of their offense. This was a limitation of the focus groups. Research indicates that violent adolescents have 1.5 to 3.0 times the use rates for different kinds of drugs than do nonviolent youths.⁷¹ Other studies suggest that substance use is one of the best predictors for engaging in youth violence among youths aged 15 to 25 years.^29,72,73 The contextual role substance and alcohol use plays in violence among serious violent youth offenders requires further exploration.

Regarding the bidirectional flow of violence between jails and communities, we found that the code governed interpersonal violence in the community as well as in the jail setting.^74,75 The acquisition and maintenance of respect through the use of violence and aggression paralleled the use of violence on the street. Grouping violent youth offenders in the same setting created a culture in which forms of disrespect and violations of the code were quickly responded to with violence. A social hierarchy of power existed in jail similar to the social order on the street, and, similar to the street, in this setting respect was the most highly valued form of social capital. Social distrust was exacerbated; some youths reported being in a perpetual state of hypervigilance, constantly wary of the risk for violent victimization. Violence in this setting was normative. On several occasions the researchers were prevented from entering the juvenile unit as a result of violent gang-related incidents. Remaining in this fight-or-flight physiological state for several months takes a toll on the psychological and physical health and well-being of youths. Research suggests that the prevalence of psychological disorders among youths processed in adult court and detained in adult jails is as high or higher than are those among youths processed in juvenile court.³⁰

Finally, culturally and developmentally appropriate program services such as behavioral health counseling, substance and alcohol use counseling, and HIV and violence prevention and intervention programs were unavailable to youths detained in this adult jail. This finding is consistent with results of other studies that found that adult jails often do not have culturally and developmentally appropriate services for youth offenders.^3,5 For youths returning to high-risk communities with undiagnosed and untreated mental health disorders, the lack of treatment services in adult jails may play a role in early violent death.

Limitations

One limitation of our study is that self-reported accounts of violent behavior are notably susceptible to distortion and hyperbole.³⁸ We tried to limit this by asking repeat questions that addressed recurring themes, and we plan to address these issues in a larger mixed methods study. The majority of participants expressed a consensus on most of the topics we explored. The tendency toward uniformity when individuals interact in a group is a concern.⁷⁶ Conformity also appears to be related to age. The research literature on focus group methodology suggests that there may be a linear relationship between conformity and age in focus groups, particularly among adolescents of the same age and socioeconomic class. Although the most effective method for decreasing conformity is to have a mix of participants from various age groups, studies on adolescent behavior require homogeneous groups in which participants are close in age.⁷⁶

Although participants in this study may have exaggerated or underreported their behaviors, the qualitative data are congruent with much of the quantitative data collected on violent risk behaviors among youth detainees held in juvenile detention facilities.⁶ Shaw’s⁷⁷ classic ethnographic research on delinquent youths notes that it is not expected that delinquents will necessarily describe their life situations objectively, but even the highly subjective record has a value for behavioral study. Youths may compensate for feelings of inferiority with exaggeration or elaboration, but the participant’s view of the situation may be the most important element for interpretation.

We found that their own story, or voice, reveals useful information concerning at least 3 important aspects of delinquent conduct: (1) the viewpoint of the youth offender, (2) the social and cultural situation in which the youth offender is responsive, and (3) the consequence of past experiences and situations in the lives of youth offenders.⁷⁷ Ethnographic research on the social context of violence among this population of youth offenders can provide rich descriptive data on the context of violent interactions as well as on the shared experiences among violent youth offenders regarding how they negotiate violence in high-risk communities. This information has important implications for correctional health care research and public health policy.

The research team was unable to access the jail at times because of lockdowns, which affected the continuity of the research. Lockdowns were often the result of violence in the juvenile unit. In some instances, inmates in the juvenile unit were locked in their cells for weeks. During lockdowns, civilians were prohibited from entering the jail. This unexpected protocol reduced the number of focus group sessions we were able to conduct. However, we believe the sheer number of focus groups we conducted with the same group of youths strengthened the study. Focus groups are not typically conducted longitudinally with the same group of participants. This approach fostered trustworthiness, thus increasing the reliability of the responses.

An additional limitation of this study was the daunting task for 2 researchers to conduct a study with a sample size of 15 youths in focus groups that on average lasted for 2 hours. The task of facilitating focus groups and taking notes without the aid of audio recording equipment was quite difficult. In the future, a study of this magnitude requires more researchers to ensure the integrity of the findings. Splitting large groups into smaller more manageable focus groups is advisable. Conducting research in jails is quite difficult.^78,79 Some correctional officers’ lack of support adversely affected how we conducted the study. For example, getting inmates to the focus groups on time was problematic.

The study could have also been stronger had we used a triangulation approach.^44,45 The use of individual interviews as an additional data collection method would have provided more validity to the findings. Individual interviews may have been more conducive to investigating highly sensitive topics that youths were unwilling to discuss in a group setting. Individual interviews may have provided the opportunity for youths to express more empathy and vulnerability, which they may have been reluctant to express in a group. In future studies on this population, individual interviews and participation observations should be used as an additional data collection method. Finally, the data collected was exploratory and collected at 1 institution. The sample was small (n = 15). Therefore, the findings may not be generalizable to a broader population of youths transferred to adult criminal court and detained in adult jails.

Finally, because of the critical nature of respect described in the study, it is highly likely that the focus group setting distorted reporting, as participants may not have been able to express weakness or empathy in that setting.

Implications for Public Health Policy

Correctional health care systems cannot assume that assessment and treatment approaches developed for youths detained in juvenile detention facilities will be effective for youths processed in adult court and detained in adult jails.³⁰ Developmentally and culturally appropriate services and treatments for youths processed in adult court and detained in adult jails must be implemented in jail settings. The data from this study support findings from previous studies on pathways to early violent deaths among youths processed in the juvenile and adult court that suggest that violence prevention and intervention programs are critically needed in both juvenile detention and adult jails.⁶

Youth offenders detained in adult jail have the lowest rate of service provision. Violence prevention and intervention strategies could reduce the risk for violent injury and help youths deconstruct the code of the street. Violence intervention programs could be effective in establishing alternative ways to establish self-expression, self-esteem, social identity, and masculinity. To date, little is known about the effectiveness of violence prevention and intervention treatments delivered to youths in adult correctional facilities.

Psychiatric services for youths processed in adult court should address the unique characteristics of serious violent youth offenders transferred to adult court. Research suggests that two thirds of youths in detention have 1 or more mental health disorders.^6,80,81 Youths in adult jails have the highest rate of suicide among all inmates. Undiagnosed and untreated mental health problems may contribute to increased aggressive and violent behavior on release that may have serious implications for pathways to early violent death. Unfortunately, for the thousands of juvenile offenders held in detention centers across the United States, mental health services are rarely provided in correctional settings and on release, and few community-based mental health care resources are accessible to high-risk adolescent youths.^82–85

Youths transferred to adult criminal court should be diagnosed and treated for mental health disorders and periodically evaluated while detained in adult jails. We found that youths were chronically exposed to violent trauma in the local community. Additionally, the oppressive conditions of confinement in an adult jail may exacerbate or create mental health disorders. A standardized assessment of PTSD should also be used in the evaluation of mental health disorders.⁸⁶ Studies have shown that the odds of having a psychiatric disorder were greater among youths transferred to adult criminal court and sentenced to prison.³⁰ On average, youths transferred to adult criminal court and sentenced to prison had more than 1 psychiatric disorder, and 15% had all 4 major types of psychiatric disorders.³⁰ Symptoms of PTSD were also prevalent among youths in this study. Psychiatric service providers need to consider the disproportionate representation of individuals from racial/ethnic minority groups in the transfer process when developing and implementing developmentally and culturally appropriate mental health services in jail settings.

Mandatory screenings and treatment of substance and alcohol misuse must also be implemented in jail settings. Use of marijuana, PCP, cocaine, and alcohol has consequences that may contribute to recurrent violence and heighten the risk for early violent death. Substance and alcohol use interventions for youth offenders detained in adult jails could reduce high-risk behaviors that may lead to early violent death. Studies on violent trauma among young Black men have found that victims of recurrent violence and individuals chronically exposed to violence report higher levels of substance use and are more likely to self-medicate to relieve their symptoms of trauma, particularly PTSD.^{7–9,28,62,69,70}

Finally, reentry programs are needed in the communities to which these youth offenders will return. The majority of youths detained in adult jails will return to distressed communities where violence, crime, and infectious diseases are pervasive. These communities also lack adequate health care services. Poor Black male youths, particularly those with histories of criminal justice involvement, are often estranged from traditional health care systems. Lack of insurance coverage and access to culturally competent community-based physical and mental health services make it difficult for those who are in distress to find treatment in high-risk communities.

Effective reentry programs may interrupt substance use, carrying a firearm, and adhering to the code of the street, which studies have shown raise the risk for violent injury.^25,27,28 Community-based health care providers should work to ensure that youths returning from adult jails are not at great risk for violent victimization, substance use, and infectious diseases such as HIV/AIDS. Reentry programs could provide continuity of care for youths transitioning from jail to the community. These programs should also address educational failure and employment. Chronic unemployment is significantly correlated with violence among low-income Black male youths.^27,76,87 Thus, reentry programs for high-risk youth offenders may combat the risk factors that significantly contribute to negative health outcomes, particularly violent injury.

Despite the relatively small number of youth offenders detained in adult jails, research on youths in adult jails is needed. This is an understudied population of youth offenders. More longitudinal descriptive studies are needed on violence and trauma among serious violent youth offenders. A comparative study of serious violent youth offenders processed in juvenile and adult court could provide information about resilience to violent victimization among 2 high-risk groups. Longitudinal studies are critically needed on the transition from adolescence to young adulthood among serious violent youth offenders, and the following questions need to be asked: What are the challenges for this population of vulnerable youths as they move into young adulthood? What are their challenges on release back into the community?

Although studies suggest differences in mental health outcomes and service provision among youths processed in juvenile court and adult court, to our knowledge no studies have examined differences in risk factors for violent victimization among the 2 groups.³⁰ More research must be conducted on services for serious violent youth offenders in juvenile detention settings and in adult jails.

Conclusions

The voices of these boys speak directly to the crisis faced by thousands of Black male youths who have been marginalized and socially dislocated from mainstream opportunities. They have been placed on the margins of society and are asked to make sense of their lives. On the basis of their limited options, engaging in violence to acquire and maintain the respect needed for day-to-day survival makes sense. For many in the mainstream, this approach to life may seem unfathomable and senseless. The onus falls on researchers to provide a deeper understanding of their social worlds. Far too often their voices have been absent from our research and discourse in shaping public health policy. Pathways to early violent death can be altered. Death among Black male youths should be neither early nor violent.