Eberly Lauren A, Shultz Kaitlyn, Kishore Sanjay, Hayden Margaret, Turecamo Sarah, Julien Howard M, Niklaus Davis Emily, Nathan Ashwin, Khatana Sameed Ahmed M
Division of Cardiovascular Medicine, Department of Medicine Hospital of the University of Pennsylvania Philadelphia Pennsylvania USA.
Penn Cardiovascular Outcomes, Quality, and Evaluative Research Center Cardiovascular Institute, University of Pennsylvania Philadelphia Pennsylvania USA.
J Am Heart Assoc. 2025 Sep 16;14(18):e040983. doi: 10.1161/JAHA.125.040983. Epub 2025 Sep 5.
Incarcerated individuals have a disproportionate burden of cardiovascular risk factors. However, there is a paucity of data focusing on cardiovascular death and access to adequate health care among incarcerated individuals.
We used the Mortality in Correctional Institutions database from the US Bureau of Justice Statistics to examine cardiovascular deaths in all state prisons from 2001 to 2019, health care provision, as well as differences in these measures between racial and ethnic groups.
From 2001 to 2019, there were a total of 18 227 (28.0% of total) cardiovascular deaths among those incarcerated in state prisons. After declining from 2001, age-standardized cardiovascular mortality rates increased since 2012, and were 128.2 per 100 000 in 2019. Most cardiovascular deaths (40.8%) occurred after ≥120 months of incarceration, with 24.4% developing the condition that caused death after incarceration. Approximately 19% of individuals were not medically evaluated, 31% did not receive any diagnostic testing, and 27% did not receive medications during their incarceration for the cardiovascular condition causing death. Compared with White counterparts, Black individuals who died while incarcerated had a higher proportion of death related to a cardiovascular cause (30.9% versus 27.8%, <0.001) and were less likely to be medically evaluated (78.6% versus 81.9%, <0.0001) or receive treatment during incarceration for the cardiovascular condition determined to be the cause of death (68.1% versus 72.6%, <0.0001).
Cardiovascular disease is an important cause of death among individuals incarcerated in state prisons. A large number of individuals who died from cardiovascular disease, did not receive medical treatment during their incarceration, with racial disparities in carceral care provision. Strategies to ensure quality and equitable cardiovascular care for this population are needed.
被监禁者面临的心血管危险因素负担过重。然而，针对被监禁者的心血管死亡情况以及获得充分医疗保健的数据却很匮乏。
我们使用了美国司法统计局的惩教机构死亡率数据库，来研究2001年至2019年所有州立监狱中的心血管死亡情况、医疗保健提供情况，以及不同种族和族裔群体在这些指标上的差异。
2001年至2019年期间，州立监狱中被监禁者共有18227例（占总数的28.0%）心血管死亡。自2001年下降后，年龄标准化心血管死亡率自2012年起上升，2019年为每10万人128.2例。大多数心血管死亡（40.8%）发生在被监禁≥120个月之后，其中24.4%是在监禁后患上导致死亡的疾病。大约19%的人未接受医学评估，31%未接受任何诊断检测，27%在因导致死亡的心血管疾病被监禁期间未接受药物治疗。与白人相比，在被监禁期间死亡的黑人中，与心血管原因相关的死亡比例更高（30.9%对27.8%，<0.001），接受医学评估的可能性更低（78.6%对81.9%，<0.0001），或在因被判定为死亡原因的心血管疾病被监禁期间接受治疗的可能性更低（68.1%对72.6%，<0.0001）。
心血管疾病是州立监狱中被监禁者的一个重要死因。大量死于心血管疾病的人在被监禁期间未接受治疗，在监狱医疗保健提供方面存在种族差异。需要制定策略来确保为这一人群提供高质量和公平的心血管护理。
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