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      Public Health and the Epidemic of Incarceration

      Author(s): 1 , 1 , 2 , 3 , 1 , 3 , 4
      Publication date Created:
      Publication date (Print):
      Journal: Annual Review of Public Health
      Publisher: Annual Reviews

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          Abstract

          An unprecedented number of Americans have been incarcerated in the past generation. In addition, arrests are concentrated in low-income, predominantly nonwhite communities where people are more likely to be medically underserved. As a result, rates of physical and mental illnesses are far higher among prison and jail inmates than among the general public. We review the health profiles of the incarcerated; health care in correctional facilities; and incarceration's repercussions for public health in the communities to which inmates return upon release. The review concludes with recommendations that public health and medical practitioners capitalize on the public health opportunities provided by correctional settings to reach medically underserved communities, while simultaneously advocating for fundamental system change to reduce unnecessary incarceration.

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          The health and health care of US prisoners: results of a nationwide survey.

          Andrew P. Wilper, Steffie Woolhandler, J Boyd … (2009)
          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.
          Article 0 comments Cited 172 times – based on 0 reviews     Review now
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            Prevalence of chronic medical conditions among jail and prison inmates in the USA compared with the general population.

            I. A. Binswanger, P. Krueger, J. F. Steiner (2009)
            Despite growing inmate populations in the USA, inmates are excluded from most national health surveys and little is known about whether the prevalence of chronic disease differs between inmates and the non-institutionalised population. Nationally representative, cross-sectional data from the 2002 Survey of Inmates in Local Jails, 2004 Survey of Inmates in State and Federal Correctional Facilities and 2002-4 National Health Interview Survey Sample Adult Files on individuals aged 18-65 were used. Binary and multinomial logistic regression were used to compare the prevalence of self-reported chronic medical conditions among jail (n = 6582) and prison (n = 14,373) inmates and non-institutionalised (n = 76 597) adults after adjusting for age, sex, race, education, employment, the USA as birthplace, marital status and alcohol consumption. Prevalence and adjusted ORs with 95% CIs were calculated for nine important chronic conditions. Compared with the general population, jail and prison inmates had higher odds of hypertension (OR(jail) 1.19; 95% CI 1.08 to 1.31; OR(prison) 1.17; 95% CI 1.09 to 1.27), asthma (OR(jail) 1.41; 95% CI 1.28 to 1.56; OR(prison) 1.34; 95% CI 1.22 to 1.46), arthritis (OR(jail) 1.65; 95% CI 1.47 to 1.84; OR(prison) 1.66; 95% CI 1.54 to 1.80), cervical cancer (OR(jail) 4.16; 95% CI 3.13 to 5.53; OR(prison) 4.82; 95% CI 3.74 to 6.22), and hepatitis (OR(jail) 2.57; 95% CI 2.20 to 3.00; OR(prison) 4.23; 95% CI 3.71 to 4.82), but no increased odds of diabetes, angina or myocardial infarction, and lower odds of obesity. Jail and prison inmates had a higher burden of most chronic medical conditions than the general population even with adjustment for important sociodemographic differences and alcohol consumption.
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              Treatment of medical, psychiatric, and substance-use comorbidities in people infected with HIV who use drugs.

              Adeeba Kamarulzaman, Fredrick Altice, Gerald Friedland … (2010)
              HIV-infected drug users have increased age-matched morbidity and mortality compared with HIV-infected people who do not use drugs. Substance-use disorders negatively affect the health of HIV-infected drug users, who also have frequent medical and psychiatric comorbidities that complicate HIV treatment and prevention. Evidence-based treatments are available for the management of substance-use disorders, mental illness, HIV and other infectious complications such as viral hepatitis and tuberculosis, and many non-HIV-associated comorbidities. Tuberculosis co-infection in HIV-infected drug users, including disease caused by drug-resistant strains, is acquired and transmitted as a consequence of inadequate prescription of antiretroviral therapy, poor adherence, and repeated interfaces with congregate settings such as prisons. Medication-assisted therapies provide the strongest evidence for HIV treatment and prevention efforts, yet are often not available where they are needed most. Antiretroviral therapy, when prescribed and adherence is at an optimum, improves health-related outcomes for HIV infection and many of its comorbidities, including tuberculosis, viral hepatitis, and renal and cardiovascular disease. Simultaneous clinical management of multiple comorbidities in HIV-infected drug users might result in complex pharmacokinetic drug interactions that must be adequately addressed. Moreover, interventions to improve adherence to treatment, including integration of health services delivery, are needed. Multifaceted, interdisciplinary approaches are urgently needed to achieve parity in health outcomes in HIV-infected drug users. Copyright 2010 Elsevier Ltd. All rights reserved.
              Article 0 comments Cited 141 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Title: Annual Review of Public Health
                Abbreviated Title: Annu. Rev. Public Health
                Publisher: Annual Reviews
                ISSN (Print): 0163-7525
                ISSN (Electronic): 1545-2093
                Publication date Created: April 21 2012
                Publication date (Print): April 21 2012
                Volume: 33
                Issue: 1
                Pages: 325-339
                Affiliations
                [1 ]The Center for Prisoner Health and Human Rights, Providence, Rhode Island 02906; email: ,
                [2 ]Harvard Medical School, Boston, Massachusetts 02115; email:
                [3 ]Warren Alpert Medical School, Brown University, Providence, Rhode Island 02903; email: ,
                [4 ]Division of Infectious Diseases, The Miriam Hospital, Providence, Rhode Island 02906
                Article
                DOI: 10.1146/annurev-publhealth-031811-124614
                PMC ID: 3329888
                PubMed ID: 22224880
                SO-VID: dc0f0cf7-c6b9-49e9-b7bb-ab2cdc113b2f
                Copyright © © 2012
                History

                ScienceOpen disciplines: Earth & Environmental sciences,Environmental change,General environmental science,Health & Social care,Public health,Infectious disease & Microbiology
                Data availability:
                ScienceOpen disciplines: Earth & Environmental sciences, Environmental change, General environmental science, Health & Social care, Public health, Infectious disease & Microbiology

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