PRISONERS HEALTH DISPARITIES
Infectious disease is more prevalent among incarcerated populations than in the general population.1 Compared to the general population, individuals living in correctional facilities are approximately three times more likely to have HIV or AIDS17 and are more likely to have hepatitis C18 and tuberculosis.18 However, access to screening and evidence-based treatment for HIV is not consistently available in many prisons.17, 19 Rates of other sexually transmitted infections (STIs), such as chlamydia, gonorrhea, and syphilis, are also higher in individuals who are incarcerated.20 In correctional facilities, STI rates are higher in women than men.20 Additionally, individuals who are incarcerated or held in detention centers may not receive necessary immunizations,21 which may lead to outbreaks of infectious diseases like influenza and COVID-19. .
MENTAL HEALTH AND SUBSTANCE USE
It is estimated that greater than 65% of individuals who are incarcerated meet the Diagnostic and Statistical Manual (DSM)-IV criteria for alcohol or other drug dependence or abuse.24 Unfortunately, only 11% of individuals who have a substance use disorder receive drug treatment while incarcerated.24 For this reason, individuals who have chronic addictions have a higher risk of going through withdrawal while in custody25 and then overdosing when they return to the community.26 Since 2000, the rate of deaths from drug overdoses in the U.S. has increased 137%, including a 200% increase involving opioids. Opioids, primarily prescription pain relievers and heroin, account for the majority of drug overdoses in the U.S.27 While these deaths were initially related to prescription opioids, beginning in 2016, illicit forms of opioids (e.g. heroin and fentanyl) became the main source of deaths due to overdoses.28 With an increase in illicit drug use, there may be an increase in the number of individuals incarcerated with opioid use disorders. Evidence-based treatment of substance use disorders improve health outcomes and reduce the spread of infectious diseases. Additionally, treatment of substance use disorders of inmates has been shown to reduce mortality29, 30 and recidivism.31
VIOLENCE AND SELF-HARM
Intentional and accidental injuries to individuals who are incarcerated, corrections officers, and correctional facility staff are common. In one survey, more than 32% people in state correctional facilities reported being injured since their admission.32 Suicide has been the leading cause of death in local jails every year from 2000 to 2014, accounting for nearly one-third of all deaths in local jails during that period.33.
Dallas Reed, MD
Chief of Genetics, Obstetrician / Gynecologist
Tufts Medical Center
860 Washington St. Boston MA 02111 Hours 8am - 5pm
Phone Number : (617) 636-5000