By Cara Murez HealthDay Reporter
(Health Day)
FRIDAY, April 14, 2023 (HealthDay News) — Inmates in US prisons may be severely undertreated for common chronic health conditions, such as asthma, type 2 diabetes, HIV and mental illness, according to news reports. research.
While the researchers lacked comprehensive data on inmates, they reached this conclusion using a variety of sources, including national health survey data from 2018 to 2020 and a commercial prescription database.
They found that recently incarcerated people with type 2 diabetes accounted for about 0.44% of cases in the United States. Yet they were receiving about 0.15% of the oral anti-hyperglycemic drugs. That’s almost threefold difference.
According to the study, imprisoned people with asthma accounted for 0.85% of the US asthmatic population, but only 0.15% of asthma treatment volume, a difference of more than five times.
“Our findings raise serious concerns about access to, and quality of, pharmacological care for very common chronic health conditions among incarcerated people,” said the lead author. Dr. G. Caleb Alexanderprofessor of epidemiology at the Johns Hopkins Bloomberg School of Public Health in Baltimore.
“We knew from the start that the US prison population had a higher prevalence of certain chronic diseases,” he said in a school press release. “But we were really surprised by the magnitude of the potential under-processing that we identified.”
Previous research has found evidence that the roughly 2 million people incarcerated in the United States receive shoddy health care under conditions that include too little funding and too few staff.
The researchers said few studies have looked at the treatment of common and chronic conditions such as diabetes and asthma.
“Health care provided in jails and prisons is provided by a patchwork of health care providers, most often private contractors who do not widely share information about the services they provide to incarcerated people,” said said the co-author of the study. Brendan Salonierassociate professor of health policy and management at Johns Hopkins.
“The lack of transparency means that advocates and policy makers have a very incomplete picture of the drugs available while in jail or in jail,” he noted in the statement.
The researchers worked with two sets of estimates. One estimated the prevalence of particular conditions among recently incarcerated prisoners. The other looked at the percentage of prescriptions for common chronic conditions going to local jails and state prisons. Federal data was not available.
The authors adjusted for the possibility of missing data and noted that disparities between incarcerated and non-incarcerated people may be underestimated.
The analysis revealed a heavy burden of certain illnesses behind bars.
For hepatitis, the researchers estimated a prevalence of 6.08% among prisoners against 1.41% among non-prisoners. For HIV infection, the researchers estimated the prevalence at 0.84% among prisoners against 0.28% among others.
For depression, the estimated prevalence was 15% among prisoners against 7.64% among others. Severe mental illness was 13.12% compared to 4.89% among others.
Incarcerated people living with HIV made up about 2.2% of the US total, but received only 0.73% of HIV antivirals, a three-fold difference, the researchers estimated.
Prisoners with severe mental disorders accounted for about 2% of cases in the United States. But they received about 0.48% of treatment, including antipsychotics and mood stabilizers, a fourfold difference, the study found.
Alexander said the findings could reflect not just institutional neglect, but also factors such as the temporary nature of many local jail stints. They may also reflect a high prevalence of mental illness, which may complicate the treatment of other conditions in the prison population.
The results of the study were published online April 14 in JAMA Health Forum.
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