The Health and Health Care of US Prisoners: Results of a Nationwide Survey

Departmentof Medicine, Cambridge Health Alliance, Cambridge, USA.
American Journal of Public Health (Impact Factor: 4.55). 02/2009; 99(4):666-72. DOI: 10.2105/AJPH.2008.144279
Source: PubMed


We analyzed the prevalence of chronic illnesses, including mental illness, and access to health care among US inmates.
We used the 2002 Survey of Inmates in Local Jails and the 2004 Survey of Inmates in State and Federal Correctional Facilities to analyze disease prevalence and clinical measures of access to health care for inmates.
Among inmates in federal prisons, state prisons, and local jails, 38.5% (SE = 2.2%), 42.8% (SE = 1.1%), and 38.7% (SE = 0.7%), respectively, suffered a chronic medical condition. Among inmates with a mental condition ever treated with a psychiatric medication, only 25.5% (SE = 7.5%) of federal, 29.6% (SE = 2.8%) of state, and 38.5% (SE = 1.5%) of local jail inmates were taking a psychiatric medication at the time of arrest, whereas 69.1% (SE = 4.8%), 68.6% (SE = 1.9%), and 45.5% (SE = 1.6%) were on a psychiatric medication after admission.
Many inmates with a serious chronic physical illness fail to receive care while incarcerated. Among inmates with mental illness, most were off their treatments at the time of arrest. Improvements are needed both in correctional health care and in community mental health services that might prevent crime and incarceration.

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    • "Given the link between mental health issues and the increased likelihood of re-incarceration, of particular concern is the mental health of former prisoners (Baillargeon, Binswanger, Penn, Williams, & Murray, 2009; Baillargeon et al., 2010). A significant number of prisoners experience mental health problems (Fazel & Lubbe, 2005; Freudenberg, 2001; Freudenberg, Daniels, Crum, Perkins, & Richie, 2005; Mallik- Kane & Visher, 2008), with some studies reporting that between 15% and 26% of former prisoners having been diagnosed with a mental health problem (Ditton, 1999; Wilper et al., 2009). Currently, prisons are the largest institution housing the mentally ill (Dumont et al., 2012; Freudenberg, 2001; Torrey, 1995). "
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    ABSTRACT: A significant number of prisoners experience mental health problems, and adequate social support is one way that facilitates better mental health. Yet, by being incarcerated, social support, particularly family support, is likely to be strained or even negative. In this study, we examine whether familial support-either positive or negative-in-prison and after release affects mental health outcomes post-release. Using the Serious and Violent Offender Reentry Initiative (SVORI) dataset, we regress post-release mental health on in-prison familial support, post-incarceration familial support, and changes in familial support. We find that while in-prison family support does not affect mental health, post-release familial support does. Also, experiencing an increase in negative familial support is associated with lower post-incarceration mental health. We conclude with a discussion of policies which may facilitate better familial support environments.
    International Journal of Offender Therapy and Comparative Criminology 08/2014; DOI:10.1177/0306624X14548023 · 0.84 Impact Factor
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    • "Overall, the prison population is a vulnerable population with increased health needs compared to the general population . These needs are very inadequately met at present leading to a prison environment that is characterised by high transmission rates of communicable disease, increased risks of mental disease and specific health conditions, stressful and violent conditions of detention, and poor if not completely lacking measures to control detrimental health habits [7] [8]. As a result, prisoners' health and health related quality of life (HRQoL) can be significantly affected by the prison environment [9]. "
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    ABSTRACT: Background. Prisoners constitute a group with increased health and social care needs. Although implementing policies that aim at improving outcomes within this population should be a priority area, studies that attempt to assess health outcomes and health related quality of life (HRQoL) in this population are limited. Aim. To assess HRQoL in a prison population in Greece and to explore the relationship between HRQoL and a set of individual sociodemographic and health related characteristics and characteristics of detention. Methods. A cross-sectional study involving 100 male prisoners was conducted in the prison of Corinth in Greece. HRQoL was assessed through the use of the SF-36 and the EQ-5D. Results. The mean physical and mental summary scores of the SF-36 were 55.33 and 46.82, respectively. The EQ-VAS mean score was 76.41%, while the EQ-5D index was 0.72. Multivariate analysis identified a statistical relationship between HRQoL and the conditions of detention, controlling for the effect of sociodemographic characteristics, morbidity, and mental problems. The use of narcotics in particular is significantly associated with lower HRQoL. Conclusions. Implementation of policies that aim at preventing the use of narcotics within the prison environment is expected to contribute to improved HRQoL in this population.
    BioMed Research International 07/2014; 2014:274804. DOI:10.1155/2014/274804 · 3.17 Impact Factor
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    • "However, recent release from prison may make experiences of discrimination more salient and thereby overestimate this exposure compared to individuals with more remote criminal justice involvement (Kressin et al. 2008). Of note, important attributes of our study sample such as rates of common chronic diseases and reported use of correctional healthcare are similar to those found in the prison population nationally (Wilper et al. 2009). Third, the small size of our sample raises the possibility of a Type II error. "
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    ABSTRACT: Background Healthcare discrimination based on race/ethnicity is associated with decreased healthcare access and utilization among racial/ethnic minority patients. Discrimination based on criminal record may also negatively impact healthcare access and utilization among ex-prisoners. Methods We conducted a secondary analysis of data from a cross-sectional survey of 172 men recently released from state prison. We examined the association between self-reported criminal record discrimination by healthcare workers and utilization of 1) emergency department (ED) and 2) primary care services. We created staged logistic regression models, adjusting for sociodemographic characteristics and self-reported racial/ethnic discrimination. Results Among 172 male participants, 42% reported a history of criminal record discrimination by healthcare workers. Participants who reported discrimination were older (mean, 42 vs. 39 years; p = .01), more likely to be college educated (26% vs. 11%; p = .03), and had more extensive incarceration histories (median years incarcerated, 16 vs. 9; p = .002) compared to those who did not report discrimination. Self-reported criminal record discrimination by healthcare workers was significantly associated with frequent ED utilization [odds ratio (OR) = 2.7, 95% confidence interval 24 (CI) 1.2–6.2] but not infrequent primary care utilization [OR = 1.6, 95% CI 0.7–3.8]. Conclusions Recently released prisoners report criminal record discrimination by healthcare workers, and this experience may impact healthcare utilization. Future studies should seek to further characterize criminal record discrimination by healthcare workers and prospectively examine its impact on health outcomes.
    03/2014; 2(6):1-8. DOI:10.1186/2194-7899-2-6
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