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NEWS FROM
CAMBRIDGE HEALTH ALLIANCE
January 15, 2009
U.S. Inmates Suffer from Chronic Illness and Poor Access to
Health Care
New study from Harvard Medical School researchers at Cambridge
Health Alliance suggests that under-treatment of mental illness
contributes to crime and incarceration
Cambridge, MA……The nation's inmate population struggles
with high rates of serious illness and poor access to care, according
to the first nationwide study of inmate health and health care.
The research, conducted by physicians from Cambridge Health Alliance
and Harvard Medical School and published today by the American Journal
of Public Health, analyzed data collected from U.S. inmates in the
2002 Survey of Inmates in Local Jails and the 2004 Survey of Inmates
in State and Federal Correctional Facilities.
Nationally, over 800,000 inmates - 40% of the total prison and
jail population - reported a chronic medical condition, an illness
rate far higher than other Americans of similar age. Over 20% of
these sick inmates in state prisons, 68.4% of jail inmates, and
13.9% in federal prisons had not seen a doctor or nurse since incarceration.
The authors also analyzed mental illness care among inmates, both
before and during incarceration. While about a quarter of inmates
had a history of chronic mental illnesses such as schizophrenia,
bipolar disorder, depression, or anxiety, two-thirds of them were
off treatment at the time of their arrest. Only after incarceration
did most of these people receive treatment.
Other key findings include:
-- Compared to other Americans of the same age, the 1.2 million
state prison inmates are 31% more likely to have asthma, 55% more
likely to have diabetes, and 90% more likely to have suffered a
heart attack.
-- Access to care was worst in local jails and best in federal
prisons; one quarter of jail inmates who suffered severe injuries
received no medical attention, vs. 12% in state prisons and 8% at
federal prisons.
-- Inmates with medical problems like diabetes that require drug
treatment often had vital medications stopped after their incarceration,
including one quarter of chronically ill state prisoners and 36.5%
of ill local jail inmates.
Study co-author Dr. Steffie Woolhandler, an associate professor
of medicine at Harvard Medical School and a primary care physician
at Cambridge Health Alliance, stated, "The U.S. incarcerates
more people per capita than any other nation. For many of them,
treatment of their mental illness before their arrest might have
prevented criminality and the staggering human and financial costs
of incarceration."
"A substantial percentage of inmates have serious medical
needs yet many of them don't get even minimal care," said lead
author Dr. Andrew Wilper, who currently teaches at the University
of Washington School of Medicine. "These prisoners are denied
their constitutionally guaranteed right to care."
Improved management of chronic conditions in prisons and jails
may have important implications for community health and the reduction
of health care disparities, explained Dr. Wilper. "Twelve million
Americans are released from incarceration each year. These individuals
and the communities to which they return suffer as many carry with
them the costs of untreated illness and preventable disability.
Inmates are over-paying their debt to society when they are denied
access to health care."
The Health and Health Care of US Prisoners: A Nationwide Survey
published by the American Journal of Public Health. E-publication
ahead of print: April 2009, Vol. 99, No. 4. Authors: Andrew P. Wilper,
MD, MPH, Steffie Woolhandler, MD, MPH, J. Wesley Boyd, MD, PhD,
Karen E. Lasser, MD, MPH, Danny McCormick, MD, MPH, David H. Bor,
MD, and David U. Himmelstein, MD. The study was supported by a National
Service Research Award.
Cambridge Health Alliance is an innovative, award-winning
health system that provides high quality care in Cambridge, Somerville,
and Boston's metro-north communities. It includes three hospital
campuses, more than 20 primary care and specialty practices, the
Cambridge Public Health Dept., and the Network Health plan. CHA
is a Harvard Medical School teaching affiliate and is also affiliated
with Harvard School of Public Health, Harvard School of Dental Medicine,
and Tufts University School of Medicine.
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Media Contact
David Cecere
Media Relations Manager
Phone: 617-503-8428
Cell: 617-921-9613
Pager: 617-546-1879
dcecere@challiance.org
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