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Youth involved in the juvenile justice system experience a disproportionately high prevalence of serious mental health issues, including substance use and depression; they are also at high risk having or acquiring a sexually transmitted disease; and they very often experience two or three of these problems. Studies have identified longitudinal continuity of these problems, and a link to risk behaviors and youth recidivism. In spite of research findings highlighting the importance of public health factors in understanding youth offending, many recidivism studies continue to focus on non-public health factors. We present results from a longitudinal study of arrested youth to address five research questions: (1) Do marijuana use, STD status, and depression reflect a latent construct (factor) of health risk? (2) If so, is the health risk factor invariant across the youth three entry occasions? (3) How do the health risks relate to post arrest risk to recidivate? (4) How do the risk to recidivate levels relate to each other over time? (5) What sociodemographic, family problem and sexual assault factors correlate with health risk? Results confirm the importance of health risk as a critical dynamic risk factor in youth repeated conflict with the law.