Date of Award

January 2012

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Frederick L. Altice

Second Advisor

Mayur M. Desai

Abstract

Background: Aside from documented high prevalence of infectious disease, little is known about the health status of prisoners in developing countries. In Haiti, prisons typically lack adequate food, clean water, and medical care. Some prisoners, however, may receive additional food from visitors during designated food delivery hours. This study sought to characterize the overall health status of Haitian prisoners as well as to begin to explore the impact of incarceration on health status. We hypothesized that prisoners who had more visitors and shorter lengths of detention would be more likely to have better overall health status, measured by having a higher body mass index (BMI) and better scores on several standardized measures of physical and mental health.

Methods: Data was available for 290 male prisoners in 3 regional Haitian prisons. Socio-demographic information, number of visitors, days of incarceration, and a range of health indicators including standardized measurements of BMI, health-related quality of life, depression, perceived stress, and food insecurity were collected as part of a health surveillance questionnaire. Completed questionnaires were subsequently filed in prison medical records, permitting a medical record review.

Results: Overall, prisoners were generally in poor health: 17% of the sample was underweight (BMI < 18.5), 87.1% rated their health as poor or fair, 91% met criteria for depression, and 65% were highly food insecure. Prisoners with fewer visitors had increased likelihood of being underweight (p = 0.045), having lower BMIs (p < 0.001), worse physical function (p = 0.002), and higher levels of food insecurity (p = 0.003). Length of incarceration was negatively associated with physical function (p = 0.007) and self-reported overall health status (p = 0.005), but was not associated with BMI, food insecurity, or any mental health indicator.

Conclusions: In general, prisoners had poor health outcomes among all three prisons. Our results also suggest that prisoners who do not receive additional food from visitors are at an increased risk for poor nutritional status and physical health and demonstrate the importance of visitors to prisoner health. Last, our finding that physical function and self-reported overall health was worse among prisoners with longer lengths of incarceration implies that prolonged incarceration may be a risk factor for diseases and health conditions not measured our study, indicating the need for additional research to further define health conditions in Haitian prisons.

Comments

This is an Open Access Thesis.

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