“…Population management strategies can also be useful in identifying those at risk and planning interventions to reduce the risk of developing diabetes and thereby its health consequences. 11 Fortunately, the diabetes community has begun to address diabetes prevention programs and measure their efficacy. Unfortunately, these programs appear to be rare in the corrections environment.…”
In Brief Managing diabetes in correctional facilities brings challenges unique to the setting in addition to those encountered in community practice. Although national standards of care have been available to guide medical care of diabetes for many years, efforts to adapt these guidelines to the needs of correctional facilities are relatively new. This article focuses on the challenges of implementing clinical practice recommendations for diabetes in the corrections environment.
“…Population management strategies can also be useful in identifying those at risk and planning interventions to reduce the risk of developing diabetes and thereby its health consequences. 11 Fortunately, the diabetes community has begun to address diabetes prevention programs and measure their efficacy. Unfortunately, these programs appear to be rare in the corrections environment.…”
In Brief Managing diabetes in correctional facilities brings challenges unique to the setting in addition to those encountered in community practice. Although national standards of care have been available to guide medical care of diabetes for many years, efforts to adapt these guidelines to the needs of correctional facilities are relatively new. This article focuses on the challenges of implementing clinical practice recommendations for diabetes in the corrections environment.
Russia, despite recent legal reforms, still has one of the highest rates of imprisonment in the world. There are many reports of the adverse conditions in Russian prisons, often highlighting the consequences for health, in particular, risks of HIV, tuberculosis, and other infectious diseases. However, there are no reviews of the broader health issues in the Russian penal system. This paper reviews the available information on the health of the imprisoned population in Russia and the factors underlying it. It was undertaken by means of a search of Russian and international literature, including unpublished sources, supplemented by in-depth interviews with 27 key informants from the Ministry of Justice, prison administration, and non-governmental organizations. Published and unpublished data from the ministries of health and justice were used to describe the demographic characteristics of the imprisoned population and compare it with the general population. Although convicts are drawn disproportionately from disadvantaged groups in society and are detained in adverse physical conditions, the standardized mortality ratio from all causes is slightly over one-third of that in the overall Russian male population. This is mainly explained by an eight-fold lower mortality from external causes and a more than two-fold lower mortality from cardiovascular disease. These far outweigh the increased mortality from infectious diseases. The chances of survival of young men in Russia may actually be improved by being in prison, highlighting the need for policies that reduce the overall level of violence and other external risks, such as dangerous driving habits, in Russian society. Yet while conditions are improving in Russian prisons, with death rates falling, there are still many avoidable deaths and high levels of mental illness and infectious disease. There is also much that is not known about the health of Russian convicts, with what is available reflecting what is measured rather than what is important.
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