Advertisement

Journal of Urban Health

, Volume 87, Issue 3, pp 486–503 | Cite as

Prevalence of Chronic Medical Conditions among Inmates in the Texas Prison System

  • Amy J. HarzkeEmail author
  • Jacques G. Baillargeon
  • Sandi L. Pruitt
  • John S. Pulvino
  • David P. Paar
  • Michael F. Kelley
Article

Abstract

Given the rapid growth and aging of the US prison population in recent years, the disease profile and health care needs of inmates portend to have far-reaching public health implications. Although numerous studies have examined infectious disease prevalence and treatment in incarcerated populations, little is known about the prevalence of non-infectious chronic medical conditions in US prison populations. The purpose of this study was to estimate the prevalence of selected non-infectious chronic medical conditions among inmates in the Texas prison system. The study population consisted of the total census of inmates who were incarcerated in the Texas Department of Criminal Justice for any duration from September 1, 2006 through August 31, 2007 (N = 234,031). Information on medical diagnoses was obtained from a system-wide electronic medical record system. Overall crude prevalence estimates for the selected conditions were as follows: hypertension, 18.8%; asthma, 5.4%; diabetes, 4.2%; ischemic heart disease, 1.7%; chronic obstructive pulmonary disease, 0.96%; and cerebrovascular disease, 0.23%. Nearly one quarter (24.5%) of the study population had at least one of the selected conditions. Except for asthma, crude prevalence estimates of the selected conditions increased monotonically with age. Nearly two thirds (64.6%) of inmates who were ≥55 years of age had at least one of the selected conditions. Except for diabetes, crude prevalence estimates for the selected conditions were lower among Hispanic inmates than among non-Hispanic White inmates and African American inmates. Although age-standardized prevalence estimates for the selected conditions did not appear to exceed age-standardized estimates from the US general population, a large number of inmates were affected by one or more of these conditions. As the prison population continues to grow and to age, the burden of these conditions on correctional and community health care systems can be expected to increase.

Keywords

Prisoners Prison health care Hypertension Heart disease Asthma Diabetes 

Notes

Acknowledgments

The research described herein was coordinated in part by the Texas Department of Criminal Justice (TDCJ), research agreement no. 515-MR07. In accordance with this agreement and TDCJ guidelines, the manuscript was reviewed by the TDCJ committee which oversees external research. All publications resulting from research approved by TDCJ are required to include the following legal disclaimer: “The contents of this manuscript reflect the views of the authors and do not necessarily reflect the views or policies of the TDCJ.” Excluding Dr. Pruitt and Dr. Kelley, the authors are employed by and supported in full or in part by the University of Texas Medical Branch (UTMB), Correctional Managed Care Division (CMC), Galveston, TX. The UTMB CMC is a partner organization of the Correctional Managed Health Care program, which is legislatively mandated and funded by the state of Texas and is directed by an independently appointed committee. The UTMB CMC serves as the health care provider for inmates in all TDCJ facilities in the eastern and southern areas of Texas. Dr. Pruitt is supported by a postdoctoral fellowship from the Barnes Jewish Hospital Foundation, Alvin J. Siteman Cancer Center Prevention and Control Program. Dr. Kelley was employed by TDCJ as the Director of the Office of Preventive Medicine in the Health Services Division at the time the study was conducted (retired August 2009). Deeanne Novakosky from UTMB CMC coordinated data management. Leonard Pechacek, also from UTMB CMC, provided editorial assistance.

References

  1. 1.
    West HC, Sabol WJ. Prisoners in 2007. Bureau of Justice Statistics Bulletin (NCJ 224280). Washington, DC: US Department of Justice; 2008. http://www.ojp.usdoj.gov/bjs/pub/pdf/p07.pdf. Accessed May 11, 2009.
  2. 2.
    Beck AJ, Mumola CJ. Prisoners in 1998. Bureau of Justice Statistics Bulletin (NCJ 175687). Washington, DC: US Department of Justice; 1999. http://www.ojp.usdoj.gov/bjs/pub/pdf/p98.pdf. Accessed May 12, 2009.
  3. 3.
    Hughes T, Wilson DJ. Inmates returning to the community after serving time in prison. In: Reentry Trends in the U.S. Washington: Department of Justice; 2003. http://www.ojp.usdoj.gov/bjs/reentry/reentry.htm. Accessed May 15, 2009.
  4. 4.
    Colsher PL, Wallace RB, Loeffelholz PL, Sales M. Health status of older male prisoners: a comprehensive survey. Am J Public Health. 1992; 82: 881-884.CrossRefPubMedGoogle Scholar
  5. 5.
    Baillargeon J, Black SA, Pulvino J, Dunn K. The disease profile of Texas prison inmates. Ann Epidemiol. 2000; 10: 74-80.CrossRefPubMedGoogle Scholar
  6. 6.
    Wilper AP, Woolhandler S, Boyd JW, et al. The health and health care of US prisoners: results of a nationwide survey. Am J Public Health. 2009; 99: 666-671.CrossRefPubMedGoogle Scholar
  7. 7.
    Binswanger IA, Krueger PM, Steiner JF. Prevalence of chronic medical conditions among jail and prison inmates in the USA compared with the general population. J Epidemiol Community Health. 2009; 63: 912-919.CrossRefPubMedGoogle Scholar
  8. 8.
    US Department of Justice, Bureau of Justice Statistics. Survey of inmates in state and federal correctional facilities, 2004. [Computer file, ICPSR04572-v1]. Ann Arbor, MI: Inter-university Consortium for Political and Social Research [producer and distributor]; 2007.Google Scholar
  9. 9.
    One in 100: Behind Bars in America 2008. Washington: Pew Center on the States; 2008. http://www.pewcenteronthestates.org/report_detail.aspx?id=35904. Accessed January 25, 2009.
  10. 10.
    Texas Department of Criminal Justice Statistical Report: Fiscal Year 2007. Huntsville: Texas Department of Criminal Justice, Executive Services. http://www.tdcj.state.tx.us/publications/executive/Fiscal%20Year%202007%20Statistical%20Report.pdf. Accessed January 14, 2010.
  11. 11.
    Correctional Managed Health Care Policy Manual. Huntsville: Correctional Managed Care; June, 2009. http://www.cmhcc.state.tx.us/CMHC_Policy_Manual/Table%20of%20Contents%20Oct%202006%20Updates.doc. Accessed November 10, 2009.
  12. 12.
    Zepeda S, Johnson MT, eds. Correctional Managed Care Formulary, 15th ed., 2008–2009. Huntsville: Correctional Managed Care, Pharmacy and Therapeutics Committee; 2009. http://www.cmhcc.state.tx.us/Files/FORMULARY%2015th%20Edition%20with%20Bookmark.pdf. Accessed November 10, 2009.
  13. 13.
    National Commission on Correctional Health Care. Standards for Health Services in Prisons. Chicago: National Commission on Correctional Health Care; 2008.Google Scholar
  14. 14.
    American Correctional Association. Performance-Based Standards for Correctional Health Care for Adult Correctional Institutions. Alexandria: American Correctional Association; 2002.Google Scholar
  15. 15.
    United States Preventive Services Task Force (USPSTF). Guide to clinical preventive services. Washington, DC: United States Department of Health and Human Services; 2009. http://www.ahrq.gov/CLINIC/cps3dix.htm. Accessed November 10, 2009.
  16. 16.
    National Heart, Lung, and Blood Institute. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. NIH Publication No. 04-5320. Washington, DC: United States Department of Health and Human Services; 2004. http://www.nhlbi.nih.gov/guidelines/hypertension/jnc7full.pdf. Accessed November 10, 2009.
  17. 17.
    National Center for Health Statistics. International Classification of Diseases, Clinical Modification (ICD-9-CM). Hyattsville: National Center for Health Statistics; 2008.Google Scholar
  18. 18.
    Brown LD, Cai TT, Das Gupta A. Interval estimation for a binomial proportion. Stat Sci. 2001; 16: 101-133.Google Scholar
  19. 19.
    Klein RJ, Schoenborn CA. Age adjustment using the 2000 projected population. Healthy People Statistical Notes, No. 20. Hyattsville: National Center for Health Statistics. January 2001. http://www.cdc.gov/nchs/data/statnt/statnt20.pdf. Accessed December 17, 2009.
  20. 20.
    Centers for Disease Control and Prevention/National Center for Health Statistics. Health Data Interactive. http://www.cdc.gov/nchs/hdi.htm. Accessed December 17, 2009.
  21. 21.
    StatsDirect Statistical Software, version 2.7.2. Cheshire, WA, UK: StatsDirect Ltd.; 2008.Google Scholar
  22. 22.
    Esteve J, Benhamou E, Raymond L. Statistical methods in cancer research, vol. IV. Descriptive epidemiology. Lyon: International Agency for Research on Cancer; 1994 (also IARC Sci Publ. 128:1–302).Google Scholar
  23. 23.
    Sahai H, Khurshid A. Statistics in Epidemiology: Methods, Techniques, and Applications. Boca Raton: CRC; 1996.Google Scholar
  24. 24.
    SPSS for Windows, Rel. 16.0. Chicago, IL: SPSS Incorporated; 2008.Google Scholar
  25. 25.
    US Census Bureau. Texas Profile of General Demographic Characteristics: 2000, from Census 2000 Gateway. Washington, DC: US Census Bureau; 2004. http://factfinder.census.gov/servlet/QTTable?_bm=y&-geo_id=04000US48&-qr_name=DEC_2000_SF1_U_DP1&-ds_name=DEC_2000_SF1_U&-redoLog=false. Accessed December 17, 2009.
  26. 26.
    Simon PA, Zeng Z, Wold CM, Fielding JE, Burrows NR, Engelgau MM. Diabetes among Hispanics—Los Angeles County, California, 2002–2003. MMWR Morb Mortal Wkly Rep. 2003; 52: 1152-1155.Google Scholar
  27. 27.
    Flegal KM, Ezzati TM, Harris MI, et al. Prevalence of diabetes in Mexican Americans, Cubans, and Puerto Ricans from the Hispanic Health and Nutrition Examination Survey, 1982–1984. Diabetes Care. 1991; 14: 628-638.CrossRefPubMedGoogle Scholar
  28. 28.
    Rosen DL, Schoenback VJ, Wohl DA. All-cause and cause-specific mortality among men released from state prison, 1980–2005. Am J Public Health. 2008; 98: 2278-2284.CrossRefPubMedGoogle Scholar
  29. 29.
    Springer SA, Pesanti E, Hodges J, Macura T, Doros G, Altice FL. Effectiveness of antiretroviral therapy among HIV-infected inmates: reincarceration and lack of sustained benefit after release to the community. Clin Infect Dis. 2004; 38: 1754-1760.CrossRefPubMedGoogle Scholar
  30. 30.
    Stephenson B, Wohl D, Golin DE, Tien HC, Steward P, Kaplan AH. Effect of release from prison and reincarceration on the viral loads of HIV-infected individuals. Public Health Rep. 2005; 120: 84-88.PubMedGoogle Scholar
  31. 31.
    Freudenberg N. Adverse effects of US jail and prison policies on the health and well-being of women of color. Am J Public Health. 2002; 92: 1895-1899.CrossRefPubMedGoogle Scholar
  32. 32.
    Hornung CA, Greifinger RB, Gadre S. A projection model of the prevalence of selected chronic diseases in the inmate population. In: Health Status of Soon-to-be-Released Inmates: a Report to Congress, vol. 2. Chicago: National Commission on Correctional Health Care; 2002.Google Scholar
  33. 33.
    Binswanger IA. Treatment for individuals with HIV/AIDS following release from prison [letter]. JAMA. 2009; 302: 147.CrossRefPubMedGoogle Scholar
  34. 34.
    Baillargeon J, Giordano TP, Rich JD, et al. Accessing antiretroviral therapy following release from prison. JAMA. 2009; 301: 838-857.CrossRefGoogle Scholar
  35. 35.
    Baillargeon J, Penn JV, Knight K, Harzke AJ, Baillargeon G, Becker EA. Risk of reincarceration among prisoners with co-occurring severe mental illness and substance use disorders. Adm Policy Ment Health.; 2010. Published on-line October 22, 2009 (in press).Google Scholar
  36. 36.
    Watson J, Solomon AL, LaVigne NG, Travis J. A portrait of prisoner reentry. Washington: The Urban Institute Justice Policy Center; 2004. http://www.urban.org/UploadedPDF/410972_TX_Reentry.pdf. Accessed May 20, 2009.Google Scholar
  37. 37.
    Harzke AJ, Ross MW, Scott DP. Predictors of post-release primary care utilization among HIV-positive prison inmates: a pilot study. AIDS Care. 2006; 18: 290-301.CrossRefPubMedGoogle Scholar
  38. 38.
    Binswanger IA, Stern MF, Deyo RA, et al. Release from prison—a high risk of death for former inmates. N Engl J Med. 2007; 356: 157-165.CrossRefPubMedGoogle Scholar
  39. 39.
    Rich JD, Holmes L, Salas C, et al. Successful linkage of medical care and community services for HIV-positive offenders being released from prison. J Urban Health. 2001; 78: 279-289.PubMedGoogle Scholar
  40. 40.
    Hammett T, Roberts C, Kennedy S. Linkages between in-prison and community-based health services. J Correct Health Care. 2004; 10: 333-368.CrossRefGoogle Scholar

Copyright information

© The New York Academy of Medicine 2010

Authors and Affiliations

  • Amy J. Harzke
    • 1
    Email author
  • Jacques G. Baillargeon
    • 1
  • Sandi L. Pruitt
    • 2
  • John S. Pulvino
    • 1
  • David P. Paar
    • 1
  • Michael F. Kelley
    • 3
  1. 1.Division of Correctional Managed CareUniversity of Texas Medical BranchGalvestonUSA
  2. 2.Division of Health Behavior ResearchWashington University School of MedicineSt. LouisUSA
  3. 3.Texas Department of Criminal Justice, Office of Preventive MedicineHuntsvilleUSA

Personalised recommendations