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Many in U.S. Prisons Lack Good Health Care

Report finds high rate of chronic disease that often goes untreated

FRIDAY, Jan. 16 (HealthDay News) -- The 2.3 million Americans currently being held in correctional facilities across the country suffer a much higher rate of serious and chronic illness than the general population does, a new report finds.

These individuals -- representing about 1 percent of the total U.S. population -- also have difficulty accessing care both inside and outside the correctional system, according to research published online Jan. 15 and set to appear in the April issue of the American Journal of Public Health.

It's the first such study to look at the health of all inmates nationwide at once, the researchers said.

"We largely ignore mental health in our society, and it's exacerbated here," said Craig Blakely, associate dean for academic affairs and professor of health policy and management at the Texas A&M Health Science Center School of Rural Public Health in College Station. "The findings suggest that health and mental health problems are linked to higher rates of arrest and incarceration."

"Devoting more resources to community mental health care could reduce crime rates and reduce incarceration," added study author Dr. Andrew P. Wilper, an instructor in medicine at the University of Washington School of Medicine.

Largely due to the war on drugs, the U.S. prison population has increased fourfold in the past 25 years, surpassing any other nation in the world in number of people incarcerated per capita, according to background information in the paper.

Prisoners have a constitutional right to health care via the Eighth Amendment concerning cruel and unusual punishment, yet such services are often sorely lacking, the report's authors contend.

Good data on the subject is also lacking, Wilper added. He said that he filed two federal government freedom-of-information requests -- both of which were denied -- to review copies of an U.S. Surgeon General's report on prison health care.

In their study, the authors analyzed responses contained in two Bureau of Justice Statistics surveys: the 2002 Survey of Inmates in Local Jails and the 2004 Survey of Inmates in State and Federal Correctional Facilities.

"Of these roughly 2 million inmates, about 800,000 suffered from a chronic condition that generally requires medical attention: diabetes, hypertension, a prior heart attack or a previously diagnosed cancer, among a few other diagnoses," Wilper said.

Compared to non-incarcerated citizens, inmates in state jails were 31 percent more likely to have asthma, 55 percent more prone to have diabetes, and 90 percent more likely to have suffered a heart attack.

In federal, state and local jails, 38.5 percent of inmates, 42.8 percent of inmates and 38.7 percent of inmates, respectively, had a chronic medical condition.

Among inmates with mental conditions that had been treated on the outside, 69.1 percent of federal prison inmates, 68.6 percent of those in state facilities, and 45.5 percent of those in local jails were not taking their medication at the time of their arrest. The treatment rate for mental health woes tripled after incarceration.

Fourteen percent of those in federal prisons, 20 percent of state prison inmates and 68.4 percent of those in local jails had not yet seen a health-care provider since their incarceration, despite persistent health problems, the report found.

"There's some alarming data that suggests that those [inmates] with chronic conditions don't get the care they need when incarcerated and that's Eighth-Amendment illegal," Blakely said. "The whole war on drugs has made a disaster of our judicial system and created a nightmare we can't control."

"Given the huge cost of incarceration, we're foolish not to ensure that inmates get the basic care that would allow them to have a better chance of rehabilitation," he continued. "This suggests the need for universal access to health care."

More information

Visit the U.S. National Commission on Correctional Health Care for more on this issue.

SOURCES: Andrew P. Wilper, M.D., instructor in medicine, University of Washington School of Medicine, Seattle; Craig Blakely, Ph.D., associate dean, academic affairs, and professor, health care policy and management, Texas A&M Health Science Center School of Rural Public Health, College Station; Jan. 15, 2009, American Journal of Public Health, online

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