Approximately 70% of incarcerated people smoke tobacco, and an estimated 12% of all smokers in the United States leave correctional facilities annually. Many facilities prohibit smoking, but no published study has measured the relapse to tobacco after release. In a study of 200 people with chronic health conditions reentering the community from jail, 165 (83%) were cigarette smokers. Of these, 129 were interviewed at 1 and/or 6 months after release. Self-reported sustained abstinence rates were 37.3% at the end of the first day, 17.7% for the first week, 13.7% for 1 month, and 3.1% for 6 months. These abstinence rates are lower than those reported after military basic training and medical hospitalization but similar to rates after inpatient psychiatric and addiction programs. More efforts and resources are needed to determine successful tobacco cessation interventions during incarceration and after release.

. Wechsler H, Dowdall GW, Davenport A, Rimm EB. A gender-specific measure of binge drinking among college students. Am J Public Health. 1995;85:982-985. 22. Buckner JC. The development of an instrument to measure neighborhood cohesion. Am J Community Psychol. 1988;16:771- A B S T R A C TObjectives. This study obtained comprehensive health information from newly admitted correctional inmates.Methods. Interviews were conducted with 1198 inmates on day 3 of their incarceration.Results. Interviewers found a high prevalence of chronic medical and mental health issues, limited access to health care, high rates of infections and sexually transmitted diseases, substantial substance abuse, other unhealthy behaviors and violence, and a strong desire for help with health-related problems.Conclusions. The data document the need to apply the public health approach to correctional health care, including detection and early treatment of disease, education and prevention to facilitate health and behavior change, and continuity of care into the community. (Am J Public Health. 2000;90:1939-1941 Correctional institutions have long been seen as reservoirs of physical and mental illness and of psychosocial problems, all of which flow back into the community as inmates are released.3 However, only more recently have medical and correctional communities begun to recognize the full extent to which mental problems, substance abuse disorders, and communicable diseases are concentrated in the correctional system and the public health opportunity this presents. [4][5][6][7][8][9][10][11] To address these issues, the Hampden County Correctional Center (HCCC) over the past 5 years has been developing a systematic public health model of correctional medical care emphasizing detection, early and effective treatment, patient education, prevention, and continuity of care. A key feature of the system is the sharing of correctional health care with community health agencies through physicians and case managers dually based in the correctional center and in the communities to which inmates return on release. 12HCCC and the University of Massachusetts School of Public Health and Health Sciences in Amherst conducted a baseline health study of the HCCC correctional population to better elucidate the extent of inmate preincarceration health problems, health facility use, and health-related risky behaviors. MethodsHCCC is a medium-security correctional center located in western Massachusetts that houses 1800 inmates, including persons awaiting court appearances and sentenced prisoners. Approximately one third of the inmates remain 3 days or less, one third stay for 4 to 90 days, and one third stay for 91 days to 2 years. Successive inmates newly admitted to HCCC over a 5-month period were interviewed on the third day of their incarceration concurrently with, but separately from, their clinical examination.The interviews were conducted in a private room in the medical facility by trained, ethnically diverse interviewers employed specifically for ...

A cooperative, community-oriented "public health model of correctional healthcare" was developed to address the needs of persons temporarily displaced into jail from the community, and to improve the health and safety of the community. It emphasizes 5 key elements: early detection, effective treatment, education, prevention, and continuity of care. In the program, physicians and case managers are "dually based"-they work both at the jail and at community healthcare centers. This, together with discharge planning, promotes continuity of care for inmates with serious and chronic medical conditions. This report characterizes the health status and healthcare in this group, and identifies facilitators and barriers to engagement in primary medical and mental health care after release from jail.

The goal of this study was to evaluate the relationship between hair lead levels of children and their attention-deficit behaviors in the classroom. Scalp hair specimens were obtained from 277 first-grade pupils, teachers completed the abbreviated Boston Teacher's Rating Scale for rating classroom attention-deficit behavior, and parents completed a short questionnaire. The children's hair lead concentrations ranged from less than 1 to 11.3 ppm (microg/g). The striking dose-response relationship between levels of lead and negative teacher ratings remained significant after controlling for age, ethnicity, gender, and socioeconomic status. An even stronger relationship existed between physician-diagnosed attention-deficit hyperactivity disorder and hair lead in the same children. There was no apparent 'safe' threshold for lead. Scalp hair should be considered a useful clinical and epidemiologic approach for the measurement of chronic low-level lead exposure in children.

Telephone interviews were completed in Western Massachusetts in April 1983 for 399 households (91.5 per cent) in a random sample of households with elementary school children. Woodstoves were used in 64.7 per cent of the homes, but such use was not associated with acute respiratory illness. However, formaldehyde exposure was significantly related, with a risk ratio of 2.4 (95 per cent confidence interval 1.7-3.4). New construction/remodeling and new upholstered furniture had additive effects. Neither woodstove use nor formaldehyde exposure were significantly associated with asthma, chronic bronchitis, or allergies.

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High school sophomores residing in a community with elevated levels of sodium in the drinking water (107 mg/1) exhibited a marked upward shift in blood pressure distribution patterns for systolic and diastolic blood pressures in both males and females as compared with a similar group in the control community (8 mg/1). The students group from the high sodium community appears to exhibit a blood pressure distribution characteristic of persons several years older.

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