Suchergebnisse

Worldwide, there is a lack of systematically collected health data on people who are incarcerated. Our objective in this paper was to describe a process model of formative work for a project to strengthen health surveillance for people incarcerated under a Canadian prison authority. We have developed project structures and processes, and we are evaluating project partnerships. To inform prison health surveillance foci, we are conducting a review of literature on best practices, a qualitative study to understand stakeholders' needs and priorities, and mapping work to understand available prison health-related data. Developing and implementing prison health surveillance is gradual and developmental, necessitating time to build relationships and obtain approvals. The needs and interests of knowledge users should be prioritized, but there may be challenges to achieving a coherent vision due to feasibility and differing needs and objectives of various stakeholders. Developing collaborative relationships could help bridge this gap.

AbstractBackgroundThere is little research with people who experience intellectual/developmental disabilities and imprisonment.MethodsThe study linked health and correctional data to examine prevalence of intellectual/developmental disabilities and health and correctional characteristics among adults experiencing their first federal incarceration between 1 January 2002 and 31 December 2011 (n = 9278) and two non‐incarcerated groups (n = 10,086,802).ResultsThe prevalence of intellectual/developmental disabilities was 2.1% in the incarcerated group and 0.9% in the non‐incarcerated group. Before incarceration, those with, versus without, intellectual/developmental disabilities were at greater risk of traumatic brain injury, mental illness, and substance use disorders. While incarcerated, those with intellectual/developmental disabilities were more likely to incur serious institutional disciplinary charges. Post‐incarceration, persons with intellectual/developmental disabilities were at greater risk of emergency department visits, and psychiatric and acute hospitalizations, than the non‐incarcerated groups.ConclusionsPeople with intellectual/developmental disabilities are overrepresented in Canadian federal correctional institutions. The authors offer strategies to support people prior to, during, and post‐incarceration.

IntroductionMore than 30 million adults are released from incarceration globally each year. Many experience complex physical and mental health problems, and are at markedly increased risk of preventable mortality. Despite this, evidence regarding the global epidemiology of mortality following release from incarceration is insufficient to inform the development of targeted, evidence-based responses. Many previous studies have suffered from inadequate power and poor precision, and even large studies have limited capacity to disaggregate data by specific causes of death, sub-populations or time since release to answer questions of clinical and public health relevance.

ObjectivesTo comprehensively document the incidence, timing, causes and risk factors for mortality in adults released from prison.
MethodsWe created the Mortality After Release from Incarceration Consortium (MARIC), a multi-disciplinary collaboration representing 29 cohorts of adults who have experienced incarceration from 11 countries. Findings across cohorts will be analysed using a two-step, individual participant data meta-analysis methodology.
ResultsThe combined sample includes 1,337,993 individuals (89% male), with 75,795 deaths recorded over 9,191,393 person-years of follow-up.
ConclusionsThe consortium represents an important advancement in the field, bringing international attention to this problem. It will provide internationally relevant evidence to guide policymakers and clinicians in reducing preventable deaths in this marginalized population.
Key wordsMortality; incarceration; prison; release; individual participant data meta-analysis; consortium; cohort.