Impact of Interventions for At-Risk and Criminally Involved Youths and Adults on Premature Mortality over the Life-Course: a Systematic Review and Meta-analysis

Premature mortality represents an important outcome for crime and violence prevention and related social interventions, but little is known about premature mortality in relation to these interventions. This article assesses the impact of interventions for at-risk and criminally involved youths and adults on premature mortality over the life-course. Systematic review methods are used, including comprehensive search strategies to identify, screen, and code eligible studies. Meta-analytic techniques are used to assess the impact of interventions on premature mortality, the influence of key moderators, and cause of mortality (natural vs. unnatural). A total of 11 studies met the inclusion criteria. Studies originated in five countries and were reported in the last two decades. Sample size can be considered large (> 500 participants) for all but two of the studies. Analysis of pooled effects showed a non-significant impact of interventions on premature mortality (OR = 0.89; 95% CI: 0.46, 1.74). Life-course stage, intervention type, and evaluation design did not moderate the mean effect. Of the nine studies that reported cause of mortality, interventions were associated with an increased likelihood of death by unnatural causes (OR = 1.78; 95% CI: 1.05, 2.39; p = .03). We conclude that greater attention needs to be paid to evaluating and understanding premature mortality over the life-course as part of the study of the effectiveness of crime and violence prevention interventions, and research opportunities exist to make an immediate contribution to this body of knowledge.