Health criminology explores the connection between crime and health factors. Less is understood about longitudinal health risks and adolescents entering the juvenile justice system. This study used a sample of n = 388 males involved in the juvenile justice system to examined longitudinal associations of a latent health risk factor, comprised of depression, marijuana use, and sexually transmitted infections (STIs), with post-juvenile assessment center (JAC) intake placement. Results using Bayesian estimation indicated the health risk factor was relatively stable over three time points of JAC entry and associated with present and, indirectly, future justice system placement. Youths who were Hispanic, Black, older, or living with a family member struggling with alcohol use had higher health risk. These findings underscore the need for juvenile justice system services that address health risks among persistent juvenile offenders, with consideration of cultural and family dynamics.