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Medical Problems of Prisoners

Laura M. Maruschak, BJS Statistician

On this page:

● Summary ● Highlights ● Selected findings ● Statistical tables ● Methodology ● Related publications

Press release

Summary

Medical problems of prisoners presents findings on state and federal prisoners who reported a current medical problem, a physical or mental impairment, a dental problem, or an injury since admission based on data from the 2004 Survey of Inmates in State and Federal Correctional Facilities. The prevalence of specific medical problems and conditions is also included. The report examines medical problems and other conditions by gender, age, and select background characteristics. NCJ 221740

Highlights

● An estimated 44% of state inmates and 39% of federal inmates reported a current medical problem other than a cold or virus.

● Arthritis (state 15%; federal 12%) and hypertension (state 14%; federal 13%) were the two most commonly reported medical problems.

● Among inmates who reported a medical problem, 70% of state and 76% of federal inmates reported seeing a medical professional because of the problem.

● More than 8 in 10 inmates in state and federal prisons reported receiving a medical exam or a blood test since

admission. ● Almost all state and federal inmates reported being tested for TB (95% and 96%, respectively). ● More than a third (36%) of state inmates and nearly a quarter (24%) of federal inmates reported having an

impairment. ● Learning was the most commonly reported impairment among state and federal inmates (23% and 13%,

respectively). ● 16% of state inmates and 8% of federal inmates reported having multiple impairments.

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Selected findings

Characteristics of inmates with medical problems

Female inmates in both state and federal prisons were more likely to report having a current medical problem than male inmates, but were equally likely to report a dental problem. Among both state and federal inmates, females were more than 1 ½ times more likely to report 2 or more current medical problems than male inmates. The percentages of state and federal inmates who reported a medical problem, a dental problem, or having had surgery since admission increased with age.

Among state and federal inmates current medical problems were most commonly reported by those who were homeless in the year before arrest, who used a needle to inject drugs, and who reported receiving government assistance as compared to those who had not been homeless, who had not used a needle to inject drugs, and who did not receive government assistance.

Characteristics of inmates with impairments

Male and female inmates in state and federal prisons were equally likely to report having at least 1 of 6 impairments which include learning, speech, hearing, vision, mobility, or mental impairment. Female inmates (11%) in state prisons were more likely to report a mental impairment than male inmates (6%).

The percentage of state and federal inmates reporting hearing and vision impairments increased with age. Among state inmates reports of having a learning impairment decreased with age. More than a quarter (28%) of state inmates age 24 or younger reported a learning impairment compared to 16% of those 45 or older. The number of impairments reported varied little between inmates 34 years of age or younger and those 35 years of age or older.

Twenty-one percent of state inmates and 16% of federal, reported having only one impairment. Among state inmates, 16% reported having two or more impairments; 8% of federal inmates.

Impairments were most commonly reported among state and federal inmates who were homeless in the year

before arrest, who used a needle to inject drugs, and who reported receiving government assistance as compared to those who had not been homeless, who had not used a needle to inject drugs, and who did not receive government assistance.

Characteristics of inmates who reported injuries

State inmates were about 1½ times more likely to report an accidental injury (22%) than a fight-related injury (16%). Federal inmates were more than 2½ times more likely to report an accidental injury (23%) than a fight- related injury (8%). In state prisons, male inmates were more likely than female inmates to be accidentally injured or injured in a fight. Among state inmates, 17% of those age 24 or younger and ages 25-34 reported being injured in a fight compared to 13% of those age 45 or older.

Health assessments and medical services received by inmates

Most state and federal inmates received some type of medical services either at admission or since admission to prison. About 9 in 10 state and federal inmates reported that at the time of admission they were asked about their health or medical history. About three-quarters reported that staff checked to see if they were sick, injured, or intoxicated at the time they were admitted. Nearly all state (88%) and federal (91%) inmates reported that they were asked about thoughts of suicide at admission to prison.

The majority of inmates in state and federal prisons had received a medical exam, blood test, or TB test since admission. More than 7 in 10 state and 8 in 10 federal inmates were tested for HIV since admission.

Among inmates who reported a current medical problem, 70% of state inmates and 76% of federal inmates reported seeing a medical professional. Among inmates admitted to state and federal prisons, about an eighth reported having had surgery.

More than 8 in 10 state and federal inmates who reported a dental problem reported seeing a health care professional. Eighty percent of state inmates and 86% of federal inmates who reported an injury since admission reported seeing a health care professional.

Problems reported and medical services received by female inmates

More than half of female inmates in state (57%) and federal (52%) prisons reported having a current medical problem. About a quarter of female inmates reported one medical problem and another quarter reported multiple problems. Females reported higher percentages of most of the specific types of medical problems than male inmates. Arthritis, asthma, and hypertension were the most commonly reported medical problems among female inmates.

Nearly all females in state (91%) and federal (94%) prisons reported having a medical exam since admission

to prison. Among females, 86% of those in state prisons and 78% of those in federal prisons reported receiving a pelvic exam.

Among female prisoners, 4% of state and 3 % of federal inmates said they were pregnant at the time of admission. Of those in state prisons who said they were pregnant at admission, 94% received an obstetric exam. More than half (54%) received some type of pregnancy care.

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Statistical Tables

To access an individual table, click on the table number below:

Table 1. Prison inmates who reported a medical problem by gender and age, 2004 Table 2. Medical problems reported by prison inmates by gender and age, 2004 Table 3. Number of medical problems reported by prison inmates by gender, 2004 Table 4. Impairments reported by prison inmates by gender and age, 2004 Table 5. Number of impairments reported by prison inmates by age, 2004 Table 6. Prison inmates who reported an injury since admission by gender and age, 2004 Table 7. Health-related conditions reported by prison inmates by background characteristics, 2004 Table 8. Medical services received by prison inmates, 2004 Table 9. Prison inmates who saw a health-care professional, 2004 Table 10. Medical services received by female prison inmates, 2004 Appendix table 1. Standard errors of state and federal inmates with medical problems, impairments, or injuries since admission by gender and age, 2004 Appendix table 2. Standard errors of state and federal inmates who reported specific current medical problems by gender, 2004 Appendix table 3. Standard errors of state and federal inmates with an impairment by gender, 2004

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Methodology

Surveys of Inmates in State and Federal Correctional Facilities, 2004

The Survey of Inmates in State and Federal Correctional Facilities, 2004, is comprised of two separate surveys: one in state adult correctional facilities and one in federal correctional facilities. The surveys provide nationally representative data on state prison inmates and sentenced federal inmates. Both surveys used the same questionnaire and a stratified two-stage sample design where facilities were selected in the first stage and inmates to be interviewed in the second stage. Findings from the 2004 Survey of Inmates in State and

Federal Adult Correctional Facilities presented in this summary should not be compared to findings from the 1997 survey due to a redesign of the medical problems and impairment measures.

The state prison sample was selected from a universe of 1,585 facilities that were enumerated in the 2000 Census of State and Federal Correctional Facilities, or had opened between the completion of the Census and April 1, 2003. A total of 287 state prisons participated in the survey; 2 refused, 11 were closed or had no inmates to survey, and 1 was erroneously included in the universe.

The federal prison sample was selected from 148 federal prisons and satellite facilities holding inmates on January 4, 2003. Thirty-nine of the 40 federal prisons selected participated in the survey.

A total of 14,499 inmates in the state facilities were interviewed; 1,653 inmates refused to participate, resulting in a second-stage nonresponse rate of 10.2%. In the federal survey, after the initial sample of inmates, a secondary sample of 1 in 3 drug offenders was selected for participation in the survey. A total of 3,686 inmates in federal facilities were interviewed and 567 refused to participate, for a second-stage nonresponse rate of 13.3%.

The accuracy of the 2004 Survey of Inmates in State and Federal Correctional Facilities depends on sampling and measurement errors. Sampling errors occur by chance because a sample rather than a complete enumeration of the population was conducted. Measurement error can be attributed to many sources, such as nonresponse, recall difficulties, differences in the interpretation of questions among inmates, and processing errors.

The sampling error, as measured by an estimated standard error, varies by the size of the estimate and the size of the base population. These standard errors may be used to construct confidence intervals around percentages. For example, the 95-percent confidence interval around the percentage of state inmates who reported a current medical problem is approximately 43.8% plus or minus 1.96 times .73% (or 42.4% to 45.2%).

These standard errors may also be used to test the statistical significance of the difference between two sample statistics by pooling the standard errors of the two sample estimates. For example, the standard error of the difference between male and female state prisoners who had a current medical problem would be 1.37% (or the square root of the sum of the squared standard errors for each group). The 95% confidence interval around the difference would be 1.96% times 1.37% (or 2.69%). Since the difference of 13.8% (56.7% minus 42.9%) is greater than 2.69%, the difference would be considered statistically significant.

Detailed descriptions of the methodology for each of these surveys, including standard error tables and links to other reports or findings from these surveys, are available at the National Archive of Criminal Justice Data (NACJD).

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Related publications

Medical Problems of Inmates, 1997, 1/01 Presents survey data on offenders who were in prison who reported a medical problem since admission or a physical impairment or mental condition. NCJ 181644

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Table 1. Prison inmates who reported a medical problem by gender and age, 2004

Current medical problem*

Had surgery since admission

Dental problem since admission

Number Percent Number Percent Number Percent

State inmates All inmates 531,500 43.8 % 149,400 12.3 % 609,400 50.3 % Gender Male 485,200 42.9 % 139,600 12.4 % 569,600 50.4 % Female 46,300 56.7 9,700 11.9 39,800 48.8 Age 24 or younger 51,500 24.4 % 12,200 5.8 % 76,800 36.4 % 25-34 136,300 34.1 36,800 9.2 190,500 47.7 35-44 184,500 50.0 50,000 13.5 202,300 54.8 45 or older 159,200 68.5 50,400 21.7 139,800 60.3 Federal inmates All inmates 48,800 38.5 % 15,100 12.0 % 63,200 50.0 % Gender Male 44,100 37.5 % 13,700 11.7 % 58,700 50.0 % Female 4,700 52.2 1,400 16.0 4,500 50.0 Age 24 or younger 2,400 21.3 % 400 3.6 % 4,000 35.1 % 25-34 13,800 28.3 4,200 8.6 21,900 45.0 35-44 14,400 39.8 3,700 10.2 18,800 52.0 45 or older 18,200 60.0 6,900 22.9 18,500 61.2

Note: Number of inmates with each problem was estimated and then rounded to the nearest 100. See Appendix tables for standard errors for the survey estimates. *Inmates were determined to have a current medical problem if they reported currently having at least 1 of 14 specific problems: arthritis, asthma, cancer, diabetes, heart problems, hypertension, kidney problems, liver problems, paralysis, problems due to a stroke, hepatitis, HIV, a sexually transmitted disease, or tuberculosis.

Source: Survey of Inmates in State and Federal Correctional Facilities, 2004. See also Methodology.

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Table 2. Medical problems reported by prison inmates by gender and age, 2004

Current medical problem All inmates

Gender

Age

Male Female 24 or younger 25-34 35-44 45 or older

State inmates Arthritis 15.3 % 14.6 % 24.5 % 5.4 % 8.6 % 17.4 % 32.6 % Asthma 9.1 8.4 19.2 10.1 9.1 8.3 9.6 Cancer 0.9 0.8 2.4 0.1 0.3 0.6 2.8 Diabetes 4.0 3.9 5.5 0.4 1.5 4.1 11.3 Heart problems 6.1 5.9 9.0 2.7 4.1 5.7 13.3 Hypertension 13.8 13.6 16.8 3.4 8.0 15.4 30.6 Kidney problems 3.2 2.9 6.9 1.5 2.2 3.6 5.7 Liver problems 1.1 1.1 1.3 0.1 0.4 1.4 2.9 Paralysis 1.4 1.4 1.4 0.5 1.0 1.8 2.4 Stroke 2.6 2.5 3.7 1.3 1.7 3.1 4.6 Hepatitis 5.3 5.0 9.5 0.9 2.4 6.8 11.7 HIV 1.6 1.6 1.9 0.3 0.8 2.5 2.6 Sexually transmitted disease 0.8 0.7 2.0 0.6 0.7 1.1 0.7 Tuberculosis* 9.4 9.6 6.1 4.0 6.5 11.5 15.8

Federal inmates Arthritis 12.4 % 11.5 % 23.8 % 3.8 % 5.7 % 10.8 % 28.3 % Asthma 7.2 6.7 13.7 10.5 5.5 7.9 7.8 Cancer 0.6 0.6 1.0 0.0 0.1 0.4 2.0 Diabetes 5.1 5.0 6.9 0.7 2.0 4.2 12.9 Heart problems 6.0 5.7 10.0 2.2 3.9 4.4 12.8 Hypertension 13.2 12.6 20.7 2.1 7.5 11.5 28.4 Kidney problems 3.1 2.8 6.9 1.8 2.1 2.7 5.5 Liver problems 1.1 1.1 1.1 0.0 0.3 1.2 2.9

Paralysis 1.6 1.6 1.5 0.2 1.6 1.3 2.6 Stroke 1.7 1.6 2.9 0.1 1.1 1.5 3.7 Hepatitis 4.2 4.2 4.5 0.0 1.9 5.6 7.9 HIV 1.0 1.0 1.4 0.7 0.4 1.9 1.1 Sexually transmitted disease 0.4 0.4 0.4 0.5 0.5 0.5 0.2 Tuberculosis* 7.1 7.2 6.2 2.7 5.7 8.0 10.1

*Includes all inmates who reported ever having TB.

Source: Survey of Inmates in State and Federal Correctional Facilities, 2004. See also Methodology.

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Table 3. Number of medical problems reported by inmates by gender, 2004

Percent of prison inmates

Total Male Female

State inmates Number of current medical problems 0 56.2 % 57.1 % 43.3 % 1 26.0 25.8 28.6 2 10.3 10.0 14.3 3 or more 7.5 7.1 13.9

Federal inmates Number of current medical problems 0 61.5 % 62.5 % 47.8 % 1 23.5 23.3 26.4 2 8.4 8.0 13.0 3 or more 6.7 6.2 12.8

Source: Survey of Inmates in State and Federal Correctional Facilities, 2004. See also Methodology.

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Table 4. Impairments reported by prison inmates by gender and age, 2004

Percent of inmates who reported an impairment

Any impairment

Physical

MentalTotal Learning Speech Hearing Vision Mobility*

State inmates All inmates 36.2 % 34.3 % 23.3 % 3.8 % 7.0 % 10.3 % 2.5 % 5.9 % Gender Male 36.2 % 34.5 % 23.6 % 3.9 % 6.9 % 10.2 % 2.5 % 5.6 % Female 36.8 32.0 18.7 2.6 7.6 12.0 2.1 11.0 Age 24 or younger 34.7 % 33.4 % 28.0 % 3.4 % 3.1 % 6.0 % 0.8 % 5.1 % 25-34 34.4 32.5 24.6 3.6 5.1 7.2 1.4 5.9 35-44 36.0 33.6 23.4 3.9 7.2 10.3 2.5 6.5 45 or older 41.2 39.5 16.4 4.2 13.4 19.4 6.1 5.9

Federal inmates All inmates 24.4 % 23.4 % 12.7 % 1.5 % 5.0 % 8.6 % 2.3 % 3.0 % Gender Male 24.3 % 23.3 % 12.9 % 1.5 % 4.9 % 8.4 % 2.2 % 2.8 % Female 26.1 24.0 10.0 2.0 6.6 10.8 3.2 5.3 Age 24 or younger 22.6 % 22.3 % 16.8 % 2.9 % 2.5 % 5.0 % 0.5 % 2.9 % 25-34 20.5 19.2 13.2 0.6 3.2 5.5 1.0 2.7 35-44 22.5 22.0 12.9 1.4 4.6 8.1 1.6 2.6 45 or older 33.8 32.1 10.1 2.8 9.4 15.4 6.0 3.9

*Includes use of a cane, wheelchair, walker, hearing aid, or other aids in daily activity.

Source: Survey of Inmates in State and Federal Correctional Facilities, 2004. See also Methodology.

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Table 5. Number of impairments reported by prison inmates by age, 2004

Percent of prison inmates by age

Total 34 or younger 35 or older

State inmates Number of impairments 0 63.8 % 65.5 % 62.0 % 1 20.5 19.9 21.2 2 9.9 9.9 9.9 3 or more 5.8 4.7 6.9

Federal inmates Number of impairments 0 75.6 % 79.1 % 72.3 % 1 16.3 14.1 18.2 2 5.9 5.2 6.6 3 or more 2.3 1.6 2.8

Source: Survey of Inmates in State and Federal Correctional Facilities, 2004. See also Methodology.

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Table 6. Prison inmates who reported an injury since admission by gender and age, 2004

Characteristics

Percent of inmates who reported an injury since admission

Total In an accident In a fight

State inmates Total 32.6 % 22.3 % 15.9 % Gender

Male 33.2 % 22.6 % 16.5 %

Female 24.7 18.9 8.5 Age 24 or younger 31.9 % 21.4 % 16.8 % 25-34 34.7 23.8 16.7 35-44 32.5 22.2 16.1 45 or older 29.7 21.0 13.4

Federal inmates Total 28.2 % 22.9 % 8.3 % Gender Male 28.3 % 22.8 % 8.7 % Female 26.9 24.9 3.6 Age 24 or younger 28.9 % 24.4 % 7.7 % 25-34 30.7 25.0 8.9 35-44 27.4 22.0 8.7 45 or older 24.8 20.1 7.2

Source: Survey of Inmates in State and Federal Correctional Facilities, 2004. See also Methodology.

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Table 7. Health-related conditions reported by prison inmates by background characteristics, 2004

Percent of inmates

Current medical problem

Any impairment

Since admission

Injured Surgery Dental problem

State inmates Homeless in year before arrest Yes 51.2 % 48.9 % 35.1 % 12.2 % 53.6 % No 43.0 34.8 32.3 12.3 49.9 Employed in month before offense Yes 43.8 % 34.9 % 32.7 % 12.6 % 51.0 % No 43.8 39.2 31.9 11.5 48.1 Source of income Wages/salary 43.6 % 34.6 % 33.0 % 12.4 % 50.9 % Government transfers 61.0 55.7 31.4 15.8 52.5 Other 41.9 36.3 37.2 12.7 51.9 Alcohol dependence or abuse Yes 44.6 % 39.2 % 34.7 % 11.8 % 51.9 % No 43.1 33.6 30.8 12.7 49.0 Ever used drugs Yes 43.2 % 37.1 % 33.6 % 11.7 % 50.8 % No 47.2 31.9 27.9 15.5 47.7 Used drugs in month before arrest Yes 42.9 % 37.2 % 34.3 % 11.8 % 51.2 % No 45.2 34.8 30.7 13.4 49.6 Used needle to inject drugs Yes 60.4 % 43.0 % 34.3 % 15.1 % 57.5 % No 40.2 34.8 32.2 11.7 48.7

Drug dependence or abuse Yes 44.3 % 39.3 % 34.4 % 11.6 % 51.6 % No 43.2 32.7 30.6 13.1 48.7

Federal inmates Homeless in year before arrest Yes 55.9 % 33.5 % 36.1 % 18.7 % 53.7 % No 37.8 24.1 27.8 11.7 49.9 Employed in month before offense Yes 37.9 % 23.5 % 28 % 12.4 % 50.0 % No 40.4 25.8 28.9 11.2 49.3 Source of income Wages/salary 37.0 % 22.5 % 27.6 % 11.8 % 50.1 % Government transfers 59.1 43.9 29.6 16.4 54.1 Other 39.2 23.9 32.5 12.6 52.7 Alcohol dependence or abuse Yes 38.4 % 25.1 % 29.2 % 9.3 % 49.0 % No 38.6 24.1 27.7 13.5 50.4 Ever used drugs Yes 39.1 % 24.6 % 29.1 % 11.8 % 51.9 % No 36.1 24.0 24.3 12.9 43.0 Used drugs in month before arrest Yes 37.8 % 24.2 % 29.8 % 11.1 % 52.6 % No 39.3 24.7 26.6 13.2 47.5 Used needle to inject drugs Yes 58.2 % 31.3 % 35.5 % 16.5 % 62.1 % No 36.0 23.6 27.2 11.5 48.5 Drug dependence or abuse Yes 37.9 % 25.2 % 31.2 % 11.4 % 52.7 % No 38.8 23.9 25.4 12.5 47.4

Source: Survey of Inmates in State and Federal Correctional Facilities, 2004. See also Methodology.

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Table 8. Medical services received by prison inmates, 2004

Medical service provided

Percent of all prison inmates

State Federal

At time of admission Staff checked to see if you were sick, injured, or intoxicated? 74.3 % 79.1 % Staff asked questions about your health or medical history? 88.6 91.1 Staff asked if you had ever thought about suicide? 87.6 90.9

Since admission

Has anyone pricked your skin to test for TB? 95.1 % 95.9 % Have you had a blood test for any reason? 87.4 93.1 Has your blood been tested for HIV? 73.1 83.5 Have you had a medical exam? 84.4 91.5

Source: Survey of Inmates in State and Federal Correctional Facilities, 2004. See also Methodology.

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