Prevalence of Chronic Health Conditions Among Adults Released From the North Carolina Prison System, 2015-2016

Abstract

background In the United States each year nearly 570,000 people return from state prisons to the community. Prevalence data of chronic health problems for this population are lacking, impeding planning of health care programs to serve people with chronic conditions who are re-entering the community. method We used medication dispensing records as a proxy for diagnoses in assessing the prevalence of 10 major and 20 substituent health conditions among incarcerated people released from the North Carolina state prison system from July 2015 through June 2016. results Among 20,585 released people, 13% were female; 50% were black; 43% were white; and 4% were aged 55 years or older. Thirtythree percent had ≥ 1 condition and 13% had two or more. The prevalence of chronic health conditions was the following: psychiatric, 15%; cardiovascular, 15%; neurologic, 7%; pulmonary, 6%; diabetes mellitus, 3%; and infectious, 3%. Seventy-one percent of those aged 55 years or older had a chronic medical condition. Among those with a psychiatric condition, 56% had another chronic illness. limitations We could not identify unmedicated health conditions; medications prescribed across multiple disease categories were excluded from our analysis. conclusion In North Carolina, at least one in three people released from the state prison system had a chronic health condition, and among those with psychiatric conditions, most had comorbid medical disease. Coordination of health care after release from incarceration is essential to avoid preventable complications and unnecessary utilization of acute care services. Greater eligibility for Medicaid is needed to scale up transition programs for this population.

Correctional Medical Care for Female Prisoners: Legal Issues Surrounding Inadequate Treatment of Chronic and/or Preexisting Health Conditions

“…The quality of the mental health care female prisoners receive is a pressing concern (Chandler, 2003), especially since a North Carolina study reported that the “prevalence of comorbid chronic medical problems was particularly high among those [inmates] with mental health diagnoses” (Rosen et al, 2019, p. 337). Consider, for example, a situation where a female inmate with a history of bipolar disorder died after four days of grossly incompetent and callous treatment.…”

“…In addition to needing specialized care, inmates with chronic conditions have medical needs that require vigilant monitoring and higher diagnostic consideration (Rosen et al, 2019). Studies have found that some correctional facilities do not regularly monitor chronic illnesses according to clinical best practices (Rosen et al, 2019; Wilper et al, 2009). In Fraher v. Heyne (2014 ) , the plaintiff believed that a correctional physician overlooked complications with her heart condition.…”

Menopause-related medication use among women age 45-75 experiencing incarceration in North Carolina 2015-2016

“…This secondary analysis of de-identified data was approved by the University of North Carolina Institutional Review Board [IRB 16-2040, PI: Ashkin] and the North Carolina Department of Public Safety (DPS) Human Subjects Research Committee [HSRC # 1611-01, PI: Ashkin]. Additional study data and methodology are reported elsewhere (Rosen et al , 2019). A list of all unique medications dispensed between July 1, 2015 and June 30, 2016 was reviewed for relevance to clinical menopause management.…”

The Health and Health Needs of People under Community Supervision

“…They also have higher rates of hypertension, heart disease, lung disease, depression, and post-traumatic stress disorder (PTSD) (Massoglia 2008; Wilper et al 2009). Having to manage multiple chronic health conditions is also common among those being released (Rosen et al 2019). In two prospective cohort studies, people released from prisons report an increased number of chronic conditions, a decrease in their self-reported health status, and a higher risk of reporting a severe health impairment relative to peers who were not incarcerated during the study period (Massoglia 2008; Schnittker and John 2007).…”