Association of vision impairment and hearing impairment with encounters in the criminal justice system among children and young people: a systematic review and meta-analysis.

Background: More than 250,000 children <18 years were incarcerated globally in 2020, and 1.5 million cycle through custody annually. We reviewed studies reporting associations of vision/hearing impairment with the criminal justice encounters among young people aged 10-24 years. Methods: We searched PubMed, EMBASE, PsycINFO, Web of Science, Scopus, Cochrane, legal and social science data bases to identify studies that describe vision impairment/eye disease and hearing impairment/ear disease among incarcerated youth from inception to 1 June 2025. We included studies of any design assessing criminal justice system contacts among young people with such impairments. Study selection, data extraction and evaluation of bias and quality were done by two reviewers. We performed narrative summaries of prevalence due to high heterogeneity and provided a meta-analysis for odds of vision/hearing impairment among incarcerated youth compared to controls. This study is registered with PROSPERO, CRD42022319876. Findings: We identified 94 eligible full-texts for screening among 10070 assessed. Twenty-three studies (median year of publication 1989) including 34,993 participants (mean age 15.8 years, range 10.2-20.9) were included in analyses. The reported prevalence of vision impairment among incarcerated youth ranged from 1.35% to 66.0% (16 studies), hearing impairment from 1.36% to 50.4% (11 studies). In meta-analysis of four studies providing control samples, odds of hearing impairment were increased among incarcerated youth compared to controls (Odds Ratio [OR] 4.20, 95% CI 1.79-9.86; p < 0.001, I2 = 48.4%). Six studies on vision impairment reported a pooled OR of 1.60 (95% CI 0.95-2·70; p = 0.08, I2 = 69.9%); leave-one-out meta-analysis found removal of a single outlying study left a highly significant OR (OR 1.90, 95% CI 1.65-2.19; p < 0.001). Interpretation: The prevalence of vision and hearing impairment are higher among incarcerated youth than the general population, although highly variable. These results highlight the need for screening and treatment of vision and hearing conditions at reception into prisons and follow up on release. Funding: Co-first author Mapa Prabhath Piyasena was funded by the Wellcome Trust United Kingdom (Grant No: 222490/Z/21/Z) from year May/2022 to April/2024. Co-author Thomas Hampton is supported by the Wellcome Trust United Kingdom (Grant No: 203919/Z/16/Z). Co-author Dr Rolvix Patterson is supported by the NIH NIDCD training grant R25DC020172, NIH Fogarty International Center Grant D43TW009340, and the Duke Hubert Yeargan Center for Global Health.