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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    • "On any given day, 1.5 million Americans are imprisoned (Carson & Golinelli, 2013), prompting interest in the health and wellbeing of prisoners (Binswanger, Krueger & Steiner, 2009; Mumola, 2007; Noonan, 2012; Patterson et al., 2010; Rosen, Wohl & Schoenbach., 2011; Schnittker & John, 2007; Spaulding et al., 2011; Wilper et al., 2009; Fazel & Baillargeon, 2011). Some, although certainly not all, of this research has compared the mortality risks of prisoners to individuals in the general population, finding consistent evidence of a mortality advantage for black male prisoners and somewhat less consistent evidence of a mortality advantage for black female prisoners and white male and female prisoners (Noonan, 2012; Patterson et al., 2010; Rosen et al., 2011; Spaulding et al., 2011). "
    [Show abstract] [Hide abstract] ABSTRACT: Although much research considers the relationship between imprisonment and mortality, little existing research has tested whether the short-term mortality advantage enjoyed by prisoners extends to Hispanics. We compared the mortality rates of non-Hispanic white, non-Hispanic black, and Hispanic male and female state prisoners to mortality rates in the general population using data from the Deaths in Custody Reporting Program, the National Prisoner Statistics, the National Corrections Reporting Program, and the Centers for Disease Control and Prevention. The results indicate that the mortality advantage for prisoners was greatest for black males, followed by black females, Hispanic males, white females, and white males. Hispanic female prisoners were the only group not at a mortality advantage relative to the general population, with an SMR of 1.18 [95% CI: 0.93–1.43]. Taken together, the results suggest that future research should seek to better understand the curious imprisonment–mortality relationship among Hispanic females, although given the small number of inmate deaths that happen to this group (~0.6%), this research should not detract from broader research on imprisonment and mortality.
    Full-text · Article · Jan 2016
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    • "By comparison, non-infectious diseases have received less attention [19], and studies describing specific chronic conditions and their frequencies among offenders are limited. Available data highlight higher rates of diabetes, hypertension and asthma among inmates when compared to the general population in the USA [22] , whereas in Switzerland the prevalence of these conditions among the prison population has been in line with that of the general population [3]. Most of the abovementioned studies present health information for young male prisoners, who form the bulk of the prison population (more than 90 % in most coun- tries) [23]. "
    [Show abstract] [Hide abstract] ABSTRACT: Background: Literature on the disease profile of prisoners that differentiates by age and gender remains sparse. This study aimed to describe the health of correctional inmates in terms of substance abuse problems and mental and somatic health conditions, and compare it by gender and age. Methods: This study examined cross-sectional data from the Canton of Vaud in Switzerland on the health conditions of detainees who were in prison on January 1, 2011 or entered prison in 2011. Health conditions validated by physician examination were reported using the International Classification of Diseases (ICD) version 10. The analyses were descriptive by groups of prisoners: the entire sample (All), Men, Older adults and Women. Results: A total of 1,664 individuals were included in the analysis. Men comprised 91.5 % of the sample and had a mean age of 33 years. The other 8.5 % were women and had an average age of 39. Older adults (i.e., age 50 and older) represented 7 % of the total sample. Overall, 80 % of inmates were non-Swiss citizens, but the proportion of Swiss prisoners was higher among the older adults (51 %) and women (29 %). Overall, 41 % of inmates self-reported substance abuse problems. Of those, 27 % were being treated by psychiatrists for behavioral disorders related to substance abuse. Chronic infectious diseases were found in 9 % of the prison population. In addition, 27 % of detainees suffered from serious mental health conditions. Gender and age had an influence on the disease profile of this sample: compared to the entire prison population, the older inmates were less likely to misuse illegal drugs and to suffer from communicable infections but exhibited more problems with alcohol and a higher burden of chronic health conditions. Female prisoners were more disposed to mental health problems (including drug abuse) and infectious diseases. In terms of chronic diseases, women suffered from the same conditions as men, but the diseases were more prevalent in women. Conclusion: It is important to understand the different disease profiles of prisoners by gender and age, as it helps identify the needs of different groups and tailor age-and gender-specific interventions.
    Full-text · Article · Sep 2015 · BMC Public Health
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    • "However, continuity of medication management is especially challenging for incarcerated Veterans with HIV and/or HCV (HIV/HCV). This has much to do with limited access to care within correctional institutions and barriers to obtaining post-release care, e.g., perceived unavailability of civilian health services, [1] lack of health insurance [4] and poor discharge planning [3,5]. Although the healthcare of incarcerated Veterans is the responsibility of correctional facilities, eventually the majority of HCV/HIV-infected Veterans are released from incarceration, where care responsibility shifts to the United States Department of Veterans Affairs Veterans Health Administration (VA) in most instances [6]. "
    Preview · Article · Jan 2015 · Journal of AIDS & Clinical Research
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