2016 - 2017年美国州立监狱和地方监狱中孕妇的心理健康、慢性疾病和传染病情况
Mental health, chronic and infectious conditions among pregnant persons in US state prisons and local jails 2016-2017.
作者信息
Hendricks Caitlin A, Rajagopal Karissa M, Sufrin Carolyn B, Kramer Camille, Jiménez Monik C
机构信息
School of Medicine, University of California, San Francisco, San Francisco, CA, USA.
College of Osteopathic Medicine, University of New England, Biddeford, ME, USA.
出版信息
Womens Health (Lond). 2024 Jan-Dec;20:17455057241228748. doi: 10.1177/17455057241228748.
BACKGROUND
Pregnant individuals in incarcerated settings have unique healthcare needs. Rates of mental health, infectious diseases, and chronic disease are higher among nonpregnant incarcerated women compared with those who are not, but the prevalence of these conditions among pregnant people in custody has not been documented.
OBJECTIVES
The objective of this study is to describe the prevalence of metabolic, infectious, and mental health conditions in pregnant people to identify the medical needs of high-risk pregnancies in US state prisons and local jails.
STUDY DESIGN
This was a prospective epidemiologic surveillance of a convenience sample of state prisons ( = 20) and local jails ( = 3).
METHODS
We used purposive and snowball sampling to recruit a national sample of prisons and jails of a range of sizes and geographies. Reporters submitted to our study database monthly data on selected pregnancy comorbidities for 6 months between 2016 and 2017. Screening, diagnosis, and tracking of these conditions are derived from each facility's medical record and health care delivery systems.
RESULTS
Of the 445 newly admitted pregnant people in prisons and 243 in jails, the most prevalent conditions were mental health conditions and hepatitis C. Specifically, 34.1% ( = 152) in prison and 23.5% ( = 57) in jail had a substance use disorder, and 27.4% ( = 122) of those in prison and 17.7% ( = 43) in jail had a psychiatric diagnosis. Finally, 20.2% ( = 91) in prison and 6.6% ( = 16) in jail had hepatitis C.
CONCLUSIONS
This study demonstrates that chronic medical and mental health conditions are prevalent among pregnant people in US prisons and jails. However, significant variability in the reported number of cases of these conditions from state to state and between facility types implies a lack of or inadequate screening practices. These data indicate the need for comprehensive screening and appropriate care for the complex needs of pregnant incarcerated people.
背景
被监禁环境中的孕妇有独特的医疗保健需求。与未被监禁的女性相比，未怀孕的被监禁女性的心理健康、传染病和慢性病发病率更高，但被监禁孕妇中这些疾病的患病率尚无记录。
目的
本研究的目的是描述孕妇中代谢、感染和心理健康状况的患病率，以确定美国州立监狱和地方监狱中高危妊娠的医疗需求。
研究设计
这是一项对20所州立监狱和3所地方监狱的便利样本进行的前瞻性流行病学监测。
方法
我们采用目的抽样和滚雪球抽样方法，招募了一系列规模和地理位置的全国监狱样本。报告者在2016年至2017年期间每月向我们的研究数据库提交6个月内选定妊娠合并症的数据。这些疾病的筛查、诊断和跟踪来自每个机构的病历和医疗保健提供系统。
结果
在监狱新收治的445名孕妇和监狱新收治的243名孕妇中，最常见的疾病是心理健康问题和丙型肝炎。具体而言，监狱中有34.1%（152人）、监狱中有23.5%（57人）患有物质使用障碍，监狱中有27.4%（122人）、监狱中有17.7%（43人）有精神疾病诊断。最后，监狱中有20.2%（91人）、监狱中有6.6%（16人）患有丙型肝炎。
结论
本研究表明，美国监狱中的孕妇普遍存在慢性医疗和心理健康问题。然而，各州之间以及不同设施类型之间报告的这些疾病病例数存在显著差异，这意味着筛查措施不足或缺乏。这些数据表明，需要对被监禁孕妇的复杂需求进行全面筛查和适当护理。
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