Recommendation	Rationale
Explore federal, state, and local policy as primary exposures	The current public health literature on criminal legal system exposure is primarily focused on its interpersonal manifestations (e.g., legal intervention injury), which can inadvertently narrow the scope for intervention to just those who operate at the interpersonal level (e.g., community policing). Thus, study of the institutional-level determinants of this exposure may inform preventive measures at institutional levels. Quasiexperimental/selection on unobservables designs may be useful methodological approaches for examining these exposures. For studies that do explore interpersonal manifestations of criminal legal system exposure, researchers should consider using the Introduction and Discussion sections to situate these analyses in federal, state, and local policy contexts.
Conduct intersectional analyses	Empirically, analyses that center multiple marginalizations may help to uncover important ways these associations may be uniquely affecting young people (e.g., whereas boys and Black children are the most likely targets of school discipline, an intersectional analysis suggests that Black girls are more likely than almost all boys, aside from Black boys and American Indian/Alaska Native boys, to experience school discipline. Furthermore, its consequences for Black girls may also differ7).
Account for multiple domains across which exposure is operating	Assessing exposure to the criminal legal system in a single domain may result in misclassification of young people’s total exposure and therefore bias estimates of the association between total criminal legal system exposure and health. In addition to addressing this issue, accounting for multiple domains may also facilitate inquiry on how exposures in an institutional setting can be synergistic with exposures in another setting and throughout the life course. We recommend incorporating a transdisciplinary literature (e.g., legal, education, and public health studies) to guide these analyses.
Document how this exposure operates in young people’s lives	Although all young people’s early life course experiences are marked by several critical and sensitive developmental periods, studies suggest that the extent to which their chronological age coincides with their biological (e.g., stress-induced premature aging) or social (e.g., “adultification”) age varies by race.11 To build on the previous recommendation of conducting intersectional analyses, research should endeavor to capture the unique ways racially marginalized young people differentially experience the criminal legal system with respect to dimensions of time. This may facilitate a better understanding of disproportionalities in its immediate and cumulative impacts on health outcomes.
Ground research using theory	Using theory to delineate underlying mechanisms, situate analyses, and interpret results is key to implementing these recommendations. We recommend theories such as critical race theory and ecosocial theory of disease distribution to guide research in this area. Given their (1) application across disciplines, (2) recognition of racism as central in the structuring of systems and health consequences, (3) interrogation of the intersections between race and other axes of marginalization, and (4) examination of the role that institutions and researchers play in shaping and understanding pathways to embodiment, they facilitate an understanding of the role of the criminal legal system in US society and the inequitable distribution of outcomes to which it has been linked.12,13