National Study Sheds Light on Inmate Health

WASHINGTON — Roughly 40 percent of state and federal prisoners and jail inmates reported having a current chronic medical condition, according to the 2011-2012 National Inmate Survey released in January from the Bureau of Justice Statistics (BJS).

The report, “Medical Problems of State and Federal Prisoners and Jail Inmates, 2011–12 (NCJ 248491),” was written by Laura Maruschak of BJS and Marcus Berzofsky and Jennifer Unangst of RTI International, a nonprofit research organization based in Research Triangle Park, N.C.
Chronic conditions involve persistent health problems that have long-lasting effects and include noninfectious medical problems, such as cancer, high blood pressure, stroke-related problems, diabetes, heart-related problems, kidney-related problems, arthritis, asthma and cirrhosis of the liver.

Half of state and federal prisoners and jail inmates reported a history of a chronic medical condition, according to the survey. A doctor, nurse or other health care provider had told them at least once in their lifetime that they had a chronic medical condition.

The percentage of inmates who reported currently having a chronic condition was lower than those who reported ever having a chronic condition because over time a past condition may have been resolved, gone into remission or no longer required treatment. The measure of ever having a chronic medical condition indicates the percentage of inmates who may be at risk for future medical problems while the measure of current conditions indicates the percentage of inmates who may have needed health care services at the time of the interview.

About a fifth (21 percent) of prisoners and 14 percent of jail inmates reported ever having an infectious disease (excluding HIV or AIDS), such as tuberculosis, hepatitis B and C, and other sexually transmitted diseases.

An estimated 1 percent of prisoners and jail inmates who had been tested for HIV reported being HIV positive. The rate of HIV or AIDS among prisoners declined from 145 per 10,000 prisoners in 2011 to 143 per 10,000 in 2012, which was consistent with declines observed over the previous decade.

State and federal prisoners and jail inmates were more likely than the general population (standardized to match the prison and jail populations by sex, age and race) to report ever having a chronic condition or infectious disease. In 2011–12, instances of ever having high blood pressure, diabetes and asthma were about 1.5 times more prevalent among prisoners and nearly two times more prevalent among jail inmates, compared to the standardized general population.
A history of high blood pressure was the most common chronic condition reported by prisoners (30 percent) and jail inmates (26 percent) in 2011–2012. Among prisoners, arthritis and asthma were the second-most reported chronic conditions (15 percent each), while among jail inmates, asthma (20 percent) was the second-most reported chronic condition, followed by arthritis (13 percent).

Nearly a quarter (24 percent) of prisoners and jail inmates reported ever having at least two chronic conditions. About a 10th of prisoners (12 percent) and jail inmates (9 percent) reported ever having both a chronic condition and an infectious disease.

Chronic conditions and infectious diseases were more prevalent among females than males in prisons and jails. About two-thirds of females in prisons (63 percent) and jails (67 percent) reported ever having a chronic condition, compared to about half of males in prisons (50 percent) and jails (48 percent).

At the time of the survey, the majority of prisoners (74 percent) and jail inmates (62 percent) were overweight, obese or morbidly obese, which was consistent with the general population age 20 or older. Although males in prisons and jails were more likely than females to be overweight, females were more likely to be obese or morbidly obese.

More than eight in 10 prisoners (85 percent) and jail inmates (82 percent) reported being questioned at admission by correctional staff about their health or medical history. The majority (80 percent) of prisoners and nearly half (47 percent) of jail inmates reported seeing a doctor, nurse or other health care professional for any reason since admission.

An estimated two-thirds (66 percent) of prisoners and 40 percent of jail inmates with a current chronic condition reported taking prescription medication. Among those who did not, the most common reason given by prisoners was that a doctor did not think medication was necessary or that the facility would not provide the medication.

More than half of prisoners (56 percent) and jail inmates (51 percent) reported being somewhat or very satisfied with the health care services received since admission. Fewer than half of prisoners (48 percent) and jail inmates (43 percent) reported that health care services they received while incarcerated were about the same as or better than services they received in the 12 months prior to incarceration.