Background: Despite growing inmate populations in the USA, inmates are excluded from most national health surveys and little is known about whether the prevalence of chronic disease differs between inmates and the non-institutionalised population.
Methods: Nationally representative, cross-sectional data from the 2002 Survey of Inmates in Local Jails, 2004 Survey of Inmates in State and Federal Correctional Facilities and 2002–4 National Health Interview Survey Sample Adult Files on individuals aged 18–65 were used. Binary and multinomial logistic regression were used to compare the prevalence of self-reported chronic medical conditions among jail (n = 6582) and prison (n = 14 373) inmates and non-institutionalised (n = 76 597) adults after adjusting for age, sex, race, education, employment, the USA as birthplace, marital status and alcohol consumption. Prevalence and adjusted ORs with 95% CIs were calculated for nine important chronic conditions.
Results: Compared with the general population, jail and prison inmates had higher odds of hypertension (ORjail 1.19; 95% CI 1.08 to 1.31; ORprison 1.17; 95% CI 1.09 to 1.27), asthma (ORjail 1.41; 95% CI 1.28 to 1.56; ORprison 1.34; 95% CI 1.22 to 1.46), arthritis (ORjail 1.65; 95% CI 1.47 to 1.84; ORprison 1.66; 95% CI 1.54 to 1.80), cervical cancer (ORjail 4.16; 95% CI 3.13 to 5.53; ORprison 4.82; 95% CI 3.74 to 6.22), and hepatitis (ORjail 2.57; 95% CI 2.20 to 3.00; ORprison 4.23; 95% CI 3.71 to 4.82), but no increased odds of diabetes, angina or myocardial infarction, and lower odds of obesity.
Conclusions: Jail and prison inmates had a higher burden of most chronic medical conditions than the general population even with adjustment for important sociodemographic differences and alcohol consumption.
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Appendix available online only at http://jech.bmj.com/content/vol63/issue11
Funding IAB was supported by the Robert Wood Johnson Foundation Physician Faculty Scholars Program and the Division of General Internal Medicine, Department of Medicine, University of Colorado Denver School of Medicine. PMK was supported by the Population Research Center at the University of Texas at Austin (NICHD R24 HD42849) and the Population Program at the University of Colorado-Boulder (NICHD R21 HD51146). The funders had no role in the design and conduct of the study; the collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.
Competing interests None declared.
Ethics approval The protocol was approved by the Colorado Multiple Institutional Review Board and University of Texas Health Sciences Center, Houston review board.
Provenance and peer review Not commissioned; externally peer reviewed.