Disease profiles of detainees in the Canton of Vaud in Switzerland: gender and age differences in substance abuse, mental health and chronic health conditions

BMC Public Health, Sep 2015

Background Literature on the disease profile of prisoners that differentiates by age and gender remains sparse. This study aimed to describe the health of correctional inmates in terms of substance abuse problems and mental and somatic health conditions, and compare it by gender and age. Methods This study examined cross-sectional data from the Canton of Vaud in Switzerland on the health conditions of detainees who were in prison on January 1, 2011 or entered prison in 2011. Health conditions validated by physician examination were reported using the International Classification of Diseases (ICD) version 10. The analyses were descriptive by groups of prisoners: the entire sample (All), Men, Older adults and Women. Results A total of 1,664 individuals were included in the analysis. Men comprised 91.5 % of the sample and had a mean age of 33 years. The other 8.5 % were women and had an average age of 39. Older adults (i.e., age 50 and older) represented 7 % of the total sample. Overall, 80 % of inmates were non-Swiss citizens, but the proportion of Swiss prisoners was higher among the older adults (51 %) and women (29 %). Overall, 41 % of inmates self-reported substance abuse problems. Of those, 27 % were being treated by psychiatrists for behavioral disorders related to substance abuse. Chronic infectious diseases were found in 9 % of the prison population. In addition, 27 % of detainees suffered from serious mental health conditions. Gender and age had an influence on the disease profile of this sample: compared to the entire prison population, the older inmates were less likely to misuse illegal drugs and to suffer from communicable infections but exhibited more problems with alcohol and a higher burden of chronic health conditions. Female prisoners were more disposed to mental health problems (including drug abuse) and infectious diseases. In terms of chronic diseases, women suffered from the same conditions as men, but the diseases were more prevalent in women. Conclusion It is important to understand the different disease profiles of prisoners by gender and age, as it helps identify the needs of different groups and tailor age-and gender-specific interventions.

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Disease profiles of detainees in the Canton of Vaud in Switzerland: gender and age differences in substance abuse, mental health and chronic health conditions

Moschetti et al. BMC Public Health Disease profiles of detainees in the Canton of Vaud in Switzerland: gender and age differences in substance abuse, mental health and chronic health conditions Karine Moschetti 1 2 7 Pierre Stadelmann 2 7 Tenzin Wangmo 0 Alberto Holly 6 Patrick Bodenmann 5 Jean-Blaise Wasserfallen 1 Bernice S. Elger 0 3 Bruno Gravier 4 0 Institute for Biomedical Ethics, Institute for Biomedical Ethics, University of Basel , Bernoullistrasse 28, Basel 4056 , Switzerland 1 Technology Assessment Unit (UET), University Hospital of Lausanne (CHUV) , Lausanne 1011 , Switzerland 2 Institut universitaire de médecine sociale et préventive, Unité d'evaluation des soins, University Hospital of Lausanne (CHUV) , Route de la Corniche 10, 1010 Lausanne , Switzerland 3 Centre universitaire romand de médecine légale, University of Geneva , Geneva , Switzerland 4 Service of Correctional Medicine and Psychiatry (SMPP), University Hospital of Lausanne (CHUV) , Prilly-Lausanne 1008 , Switzerland 5 Vulnerable Population Center, Department of Ambulatory Care and Community Medicine, University of Lausanne , Lausanne 1011 , Switzerland 6 Institut d'économie et management de la santé (IEMS), HEC Lausanne and Département d'économétrie et d'économie politique (DEEP), University of Lausanne , Internef Building, Lausanne 1015 , Switzerland 7 IEMS - Plateforme interfacultaire en économie et management de la santé, University of Lausanne CH , Internef Building, Lausanne 1015 , Switzerland Background: Literature on the disease profile of prisoners that differentiates by age and gender remains sparse. This study aimed to describe the health of correctional inmates in terms of substance abuse problems and mental and somatic health conditions, and compare it by gender and age. Methods: This study examined cross-sectional data from the Canton of Vaud in Switzerland on the health conditions of detainees who were in prison on January 1, 2011 or entered prison in 2011. Health conditions validated by physician examination were reported using the International Classification of Diseases (ICD) version 10. The analyses were descriptive by groups of prisoners: the entire sample (All), Men, Older adults and Women. Results: A total of 1,664 individuals were included in the analysis. Men comprised 91.5 % of the sample and had a mean age of 33 years. The other 8.5 % were women and had an average age of 39. Older adults (i.e., age 50 and older) represented 7 % of the total sample. Overall, 80 % of inmates were non-Swiss citizens, but the proportion of Swiss prisoners was higher among the older adults (51 %) and women (29 %). Overall, 41 % of inmates self-reported substance abuse problems. Of those, 27 % were being treated by psychiatrists for behavioral disorders related to substance abuse. Chronic infectious diseases were found in 9 % of the prison population. In addition, 27 % of detainees suffered from serious mental health conditions. Gender and age had an influence on the disease profile of this sample: compared to the entire prison population, the older inmates were less likely to misuse illegal drugs and to suffer from communicable infections but exhibited more problems with alcohol and a higher burden of chronic health conditions. Female prisoners were more disposed to mental health problems (including drug abuse) and infectious diseases. In terms of chronic diseases, women suffered from the same conditions as men, but the diseases were more prevalent in women. Conclusion: It is important to understand the different disease profiles of prisoners by gender and age, as it helps identify the needs of different groups and tailor age-and gender-specific interventions. - Background The prison population is increasing worldwide [1], and it is widely accepted that prison inmates have poor health due to accumulated vulnerability factors such as traumatic life experiences, lack of a social network and low socioeconomic background [2]. Studies have shown that poly-morbidity among prisoners is high, with substance abuse, mental illnesses and infectious diseases as the most common health problems [3–5]. Substance abuse and dependence are common problems encountered among the prison population [6, 7]. It is not uncommon to observe 1 out of 3 or even 1 out of 2 inmates with drug abuse or dependence [8]. Smoking and alcohol problems are also common in prisons [9–11]. The widely-known negative health outcomes of tobacco use and secondhand smoke are highly problematic, and even more so in confined environments [12, 13]. Psychotic and personality disorders, including antisocial personality problems and major depression, are often identified among incarcerated people [14]. A recent literature review conducted in 24 countries revealed a constant prevalence of psychotic disorders over time [15]. Although they have conflicting figures, empirical studies on psychiatric and psychological disorders among young prisoners have confirmed (...truncated)


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Karine Moschetti, Pierre Stadelmann, Tenzin Wangmo, Alberto Holly, Patrick Bodenmann, Jean-Blaise Wasserfallen, Bernice Elger, Bruno Gravier. Disease profiles of detainees in the Canton of Vaud in Switzerland: gender and age differences in substance abuse, mental health and chronic health conditions, BMC Public Health, 2015, pp. 872, 15, DOI: 10.1186/s12889-015-2211-6