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

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.

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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.

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Correspondence to Amy J. Harzke.

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Harzke, A.J., Baillargeon, J.G., Pruitt, S.L. et al. Prevalence of Chronic Medical Conditions among Inmates in the Texas Prison System. J Urban Health 87, 486–503 (2010). https://doi.org/10.1007/s11524-010-9448-2

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Keywords

  • Prisoners
  • Prison health care
  • Hypertension
  • Heart disease
  • Asthma
  • Diabetes