Chronic Health Conditions and Behaviors Among Persons Entering Maximum Security Prison

Monday, 28 July 2014: 8:30 AM

Elaine Larson, RN, BSN, MA, PhD1
Dhritiman Mukherjee, PhD2
Montina B. Befus, BS, MPH3
Jennifer Bai, BS, MPH1
Zoltan L. Apa, BS1
Franklin D. Lowy, BA, MD4
(1)Columbia University School of Nursing, New York, NY
(2)College of Physicians and Surgeons and School of Nursing, Columbia University, New York, NY
(3)Mailman School of Public Health and School of Nursing, Columbia University, New York, NY
(4)Division of Infectious Diseases, College of Physicians and Surgeons, New York, NY

Purpose: To describe health conditions and risk behaviors among persons entering maximum security prison in New York State.


Between January 2011 and March 2013 as part of a  study to assess the prevalence of methicillin-resistant Staphylococcus aureus (MRSA), male (n=426) and female (n=404) inmates at intake to two New York State maximum-security prisons were interviewed regarding demographic, social, and health issues, their medical records were reviewed, and anterior nares and oropharyngeal samples were collected.  The majority (>96%) were entering from other jails or prisons. 


Approximately one-third each were aged <30, between 30-40, or >40 years; 47% were black, 24% white, 20% Hispanic, and 8% other.  The largest proportion (44%) had <high school education, 36% completed high school, and 20% had some college education; the majority (80%) rated their health as excellent or good.  The estimated prevalence of medical conditions was: asthma (31.4%), hypertension (14.1%), hepatitis C (9.1%), diabetes (6.9%), HIV (5.9%), renal disease (2.7%).  For health-related behaviors, prevalence was: cigarette smoking (74.2%), illicit drug use ever (83.8%), marijuana use ever (76.6%), cocaine use ever (41.3), tattoos (59.1%).  Antibiotic use within the previous 6 months was reported by 17.7%. All medical conditions and most behavioral risk factors except tattooing were reported with greater frequency among women than men.  Overall, >50% of inmates were colonized with S. aureus; 5.9% of men and 10.6% of women were colonized with MRSA, a rate approximately 10 times higher than in the general population.


Men and women entering prison have high rates of chronic health conditions and behaviors that increase their risk of disease and infection.  Adequate provision of health services in prison is important to reduce morbidity and prevent transmission of infectious diseases within the prison and after parole.