Care for prisoners will improve public health

November 18, 2010

GALVESTON, Texas -- In a comprehensive global survey, researchers in Texas and England have concluded that improving the mental and physical health of inmates will improve public health.

In their article, "The health of prisoners," Seena Fazel of the University of Oxford and Jacques Baillargeon of the University of Texas Medical Branch at Galveston, write that caring for the mental and physical health of prisoners has a direct and important impact on public health that should be recognized. Their findings, to be published Online First in the British medical journal The Lancet on Nov. 19, are based on a survey of available literature on prisoner health across the world (with most data from high-income countries*).

"Prisoners act as reservoirs of infection and chronic disease, increasing the public health burden of poor communities," they write. "Most prisoners return to their communities with their physical and psychiatric morbidity occasionally untreated and sometimes worsened."

More than 10 million people are incarcerated worldwide, a number that has increased by about a million during the last decade. The United States has the highest number of prisoners per population, with 756 per 100,000 compared to a mean of 145 per 100,000 worldwide. The authors note that "prisoners bear a substantial burden of physical and psychiatric disorders relative to the general population." This health disparity has been attributed to various behavioral and socioeconomic conditions.

"For these individuals, prison provides an opportunity for diagnosis, disease management education, counseling and treatment they would not receive in the general community," they write.

Baillargeon, an associate professor and epidemiologist in the department of preventive medicine and community health at UTMB, has substantial experience in prisoner research.

"Scientists around the world have consistently observed a disproportionate burden of chronic and infectious disease among prisoners," said Baillargeon. "In many cases, incarceration presents a rare opportunity to receive disease screening and preventive health care, treatment and education.

He noted that many prisoners with serious mental illness such as schizophrenia and other psychotic disorders cycle in and out of the prison system. For these individuals, linkage to appropriate community-based psychiatric care is critical if we are to remove them from this cycle of recurrent imprisonment..

While there may some resistance to spending money on prisoner care, Baillargeon said "the vast majority of offenders are incarcerated for a relatively short period of time and will be in the community eventually." And while most people understand the public health importance of treating infectious diseases, he added that "for most US inmates, who are without private health insurance upon release from prison, treatment of chronic conditions, such as diabetes, asthma, and congestive heart failure will ultimately require substantial use of public resources."

The authors recommend that health-care resources be targeted at prisons since they provide an opportunity for screening, prevention, and early intervention. Failure to prevent disease, reduce transmission, or treat conditions at an early stage may result in inefficient use of scarce public resources for health care. Statistics on prisoner health should be publicly available and national, prison-specific policies and guidelines should be developed. There should be a discharge program for released prisoners that links them to community health programs to ensure effective treatment.

They write that prisons should become more research-friendly environments. Protecting prisoners from coercive and abusive research is important. However, it is also important to ensure that inmates are not systematically excluded from important clinical studies. Understanding how to identify, prevent and treat disease in inmate populations holds public health relevance that extends far beyond prison walls.
-end-
For full paper see: http://press.thelancet.com/prisoner.pdf

Note to editors: *There is information on HIV, hepatitis and TB (i.e., infectious diseases) from both low and high income countries. For the other health problems (mental disorders, chronic physical problems, suicide), almost all the information is from high income countries.ABOUT UTMB HEALTH: Established in 1891, Texas' academic health center comprises four health sciences schools, three institutes for advanced study, a research enterprise that includes one of only two national laboratories dedicated to the safe study of infectious threats to human health, and a health system offering a full range of primary and specialized medical services throughout Galveston County and the Texas Gulf Coast region. UTMB is a component of the University of Texas System.

University of Texas Medical Branch at Galveston

Related Public Health Articles from Brightsurf:

COVID-19 and the decolonization of Indigenous public health
Indigenous self-determination, leadership and knowledge have helped protect Indigenous communities in Canada during the coronavirus disease 2019 (COVID-19) pandemic, and these principles should be incorporated into public health in future, argue the authors of a commentary in CMAJ (Canadian Medical Association Journal) http://www.cmaj.ca/lookup/doi/10.1503/cmaj.200852.

Public health consequences of policing homelessness
In a new study examining homelessness, researchers find that policy such a lifestyle has massive public health implications, making sleeping on the street even MORE unhealthy.

Electronic health information exchange improves public health disease reporting
Disease tracking is an important area of focus for health departments in the midst of the COVID-19 pandemic.

Pandemic likely to cause long-term health problems, Yale School of Public Health finds
The coronavirus pandemic's life-altering effects are likely to result in lasting physical and mental health consequences for many people--particularly those from vulnerable populations--a new study led by the Yale School of Public Health finds.

The Lancet Public Health: US modelling study estimates impact of school closures for COVID-19 on US health-care workforce and associated mortality
US policymakers considering physical distancing measures to slow the spread of COVID-19 face a difficult trade-off between closing schools to reduce transmission and new cases, and potential health-care worker absenteeism due to additional childcare needs that could ultimately increase mortality from COVID-19, according to new modelling research published in The Lancet Public Health journal.

The Lancet Public Health: Access to identification documents reflecting gender identity may improve trans mental health
Results from a survey of over 20,000 American trans adults suggest that having access to identification documents which reflect their identified gender helps to improve their mental health and may reduce suicidal thoughts, according to a study published in The Lancet Public Health journal.

The Lancet Public Health: Study estimates mental health impact of welfare reform, Universal Credit, in Great Britain
The 2013 Universal Credit welfare reform appears to have led to an increase in the prevalence of psychological distress among unemployed recipients, according to a nationally representative study following more than 52,000 working-age individuals from England, Wales, and Scotland over nine years between 2009-2018, published as part of an issue of The Lancet Public Health journal on income and health.

BU researchers: Pornography is not a 'public health crisis'
Researchers from the Boston University School of Public Health (BUSPH) have written an editorial in the American Journal of Public Health special February issue arguing against the claim that pornography is a public health crisis, and explaining why such a claim actually endangers the health of the public.

The Lancet Public Health: Ageism linked to poorer health in older people in England
Ageism may be linked with poorer health in older people in England, according to an observational study of over 7,500 people aged over 50 published in The Lancet Public Health journal.

Study: Public transportation use linked to better public health
Promoting robust public transportation systems may come with a bonus for public health -- lower obesity rates.

Read More: Public Health News and Public Health Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.