The health conditions of prison inmates in Tuscany

Objective

To investigate health conditions of prison inmates in Tuscany, Italy, compared with the non-institutionalized population and literature data.

Design

A cross-sectional descriptive study of a sample recruited for a prospective cohort study.

Setting and participants

Prison inmates detained in Tuscany on 15 June 2009. Istat data concerning the survey “Aspects of daily life” 2006–2009 has been used for comparison.

Main outcome measures

The measures used for the analysis are prevalence data by age classes and odds ratios obtained through a logistic regression model. The outcome variables are broad disease groups, in particular infectious and parasitic diseases and psychiatric disorders.

Results

Prison inmates from northern Africa and eastern Europe comprised 40% of the population studied. A high consumption of tobacco was observed, with 70.6% of prisoners being regular smokers, compared to 33.2% among free citizens. The most frequently occurring diseases are digestive system diseases (25.1%), followed by infectious and parasitic diseases (15.7%). Among digestive disease, more than half are teeth and oral cavity pathologies, which affect 13.7% of prisoners. Other frequently reported disease groups were diseases of the bone-muscular and connective systems (11.0%), of the circulatory system (10.8%), of the endocrine and metabolic systems (9.2%), traumatisms and poisonings (6.8%), respiratory system diseases (5.9%) and nervous system diseases (4.9%). The prevalence of ischemic heart disease, diabetes, obesity and esophagitis, gastritis and gastro-duodenal ulcers is significantly higher among prisoners than in the general population. The most frequent infectious and parasitic diseases are hepatitis C virus (HCV) with a prevalence of 9.0%, hepatitis B virus (HBV) (2.2%), and HIV (1.4%). HCV, HIV and hepatitis A have a higher prevalence among inmates of Italian nationality, while syphilis is more common among prisoners from eastern Europe (1.2%). The prevalence of psychiatric disorders among prison inmates is 33.3% (compared to 11.6% in the general population), while it decreases to 29.3% if we exclude the population detained in the psychiatric prison.

Conclusions

According to previous national and international studies, the cohort is more affected than the general population by physical and psychiatric disorders, partly associated with the prison inmate’s country of origin.