By Johns Hopkins University
For their analysis, the researchers used national health survey data covering 2018 to 2020 to estimate rates of chronic conditions among recently incarcerated people, and a commercial prescription database to estimate the distribution of medication treatments to the jail and prison population. Their analysis suggests that for many common and serious conditions, incarcerated people are substantially less likely to be treated compared to the general US population.
The study finds that recently incarcerated individuals with type 2 diabetes represented about 0.44% of the US burden of the condition, but got only 0.15% of oral anti-hyperglycemic medications—nearly a threefold difference. Incarcerated individuals with asthma accounted for 0.85% of the total US asthma population, but just 0.15% of asthma treatment volume, a more than fivefold difference.
The study appears in JAMA Health Forum.
“Our findings raise serious concerns about the access to and quality of pharmacologic care for very common chronic health conditions among the incarcerated,” says study senior author G. Caleb Alexander, professor in the epidemiology department at the Johns Hopkins Bloomberg School of Public Health. “We knew going in that the US incarcerated population has a higher prevalence of some chronic diseases. But we were really surprised by the extent of potential undertreatment that we identified.”
PRISON HEALTH CARE
Prior studies have found evidence that health care provided to the US incarcerated population—roughly two million individuals—is often understaffed, underfunded, and of poor quality. Yet studying health care issues among the incarcerated involves many challenges. Few studies have examined treatment of common and chronic diseases such as diabetes and asthma.
“Health care provided in jails and prisons is provided by a patchwork of health care providers, most commonly private contractors who do not widely share information about the services they provide to incarcerated people,” says study coauthor Brendan Saloner, an associate professor in the Bloomberg School’s department of health policy and management. “The lack of transparency means that advocates and policymakers have a very incomplete picture of the medicines that are available during a stay in jail or prison.”
The lack of transparency also makes it difficult to research. For their study, the researchers generated two sets of estimates: one for the prevalence of specific conditions among recently incarcerated inmates, the other on the percentage of common chronic illness prescriptions going to jails and state prisons.
INCARCERATED PEOPLE AND COMMON CONDITIONS
For the disease prevalence estimates, the researchers used recent data from US government-sponsored National Surveys on Drug Use and Health. These annual surveys don’t cover prison and jail populations directly, but the researchers estimated condition prevalence among adult survey respondents who either had or had not reported being on parole or having been arrested and booked in the prior year. They combined these figures with US Census data, and generated population estimates for state prisons and local jails to gauge the approximate numbers of incarcerated and non-incarcerated individuals with different conditions.
To get a sense of prescriptions dispensed to the incarcerated vs. the non-incarcerated populations, the researchers used data from the same time period from the health care technology company IQVIA. Because of the lack of data on federal prison inmates, the incarcerated population for the analysis included only individuals in local jails and state prisons. The authors made adjustments for the possibility of missing data, and note that their numbers may underestimate disparities between incarcerated individuals and their counterparts.
The analysis yielded estimates for the prevalence of chronic conditions that suggested particularly heavy burdens of some illnesses in the incarcerated population—for example, hepatitis (6.08% prevalence among the incarcerated vs. 1.41% for the non-incarcerated), HIV infection (0.84% vs. 0.28%), depression (15.10% vs. 7.64%), and severe mental illness (13.12% vs. 4.89%).
As for prevalence-treatment differentials among the incarcerated, the study also found that incarcerated individuals with HIV represented about 2.2% of the US burden of the condition, but got only 0.73% of HIV antivirals—a threefold difference. Incarcerated individuals with severe mental illness represented an estimated 1.97% of disease burden, but only 0.48% of treatment volume consisting of antipsychotics and mood stabilizers, a fourfold difference.
Alexander says that the findings may reflect not only institutional neglect but also factors such as the temporary nature of many local jail stays, and the high prevalence of mental illness—which tends to complicate treatment of other conditions—in the incarcerated population.
“We hope our results will motivate further investigations that continue to explore these vital matters using a variety of data sources,” he says.
Source: Johns Hopkins University
Original Study DOI: 10.1001/jamahealthforum.2023.0482
—
This post was previously published on FUTURITY.ORG and is republished here under a Creative Commons license.
***
From The Good Men Project on Medium
 What Does Being in Love and Loving Someone Really Mean? |
 My 9-Year-Old Accidentally Explained Why His Mom Divorced Me |
 The One Thing Men Want More Than Sex |
 The Internal Struggle Men Battle in Silence |
Join The Good Men Project as a Premium Member today.
All Premium Members get to view The Good Men Project with NO ADS.
A $50 annual membership gives you an all access pass. You can be a part of every call, group, class and community.
A $25 annual membership gives you access to one class, one Social Interest group and our online communities.
A $12 annual membership gives you access to our Friday calls with the publisher, our online community.
Register New Account
Log in if you wish to renew an existing subscription.
Username
First Name
Last Name
Password
Password Again
Choose your subscription level
- Yearly – $50.00 – 1 Year
- Monthly – $6.99 – 1 Month
Credit / Debit Card PayPal Choose Your Payment Method
Auto Renew
Subscribe to The Good Men Project Daily Newsletter By completing this registration form, you are also agreeing to our Terms of Service which can be found here.
Need more info? A complete list of benefits is here.
—
Photo credit: iStock.com
The post Common Health Conditions Are Undertreated in Prison appeared first on The Good Men Project.
