Advanced Practice Nurses in Correctional Health Care

Abstract

f the over 2 million persons incarcerated in the United States, approximately O209,000 are in federal prisons. About 82% of these predominately male (93.5%) prisoners are confined in Bureau of Prisons-operated facilities, while the remainder are imprisoned in private or community-based facilities and local jails. Over the past 30 years, the number of incarcerated persons has increased, but their health status has worsened. The funding available for medical services has not kept pace with the needs, and limited funds are spread among an increasing number of inmates. Further, the prevalence of most chronic medical conditions, including hypertension, asthma, cervical cancer, and hepatitis, is higher in inmates than in the general population, even adjusting for sociodemographic differences and alcohol consumption. Correctional facilities are also common sites for transmission of infectious diseases. Further, an estimated 15% to 16.9% of adults (up to 31% of women) in US correctional facilities have a serious mental illness. The lifetime prevalence of substance abuse/ dependence disorders among persons in prison remains at markedly elevated rates. Recently, substance abuse among the incarcerated has been found to be 7 times higher than among the general population. In addition, female prisoners have higher rates of drug and alcohol dependence/abuse than male prisoners. Many prisoners have dual diagnoses of substance abuse and mental health disorders in addition to chronic physical diseases. A recent study found that 40% of male and 60% of female prisoners had comorbid physical health, mental health, and substance abuse conditions.