Inequalities in Health Risks and Outcomes Faced by Mexico’s Incarcerated Population

Abstract

Abstract Incarcerated populations are particularly vulnerable. Few studies quantify the prevalence of health-related exposures and conditions among incarcerated people in comparison to the free-living people, especially for non-high-income countries. We studied incarcerated and free-living Mexican adults aged 20-79 in 2021 using the National Survey of the Incarcerated Population (ENPOL) and the National Health and Nutrition Survey (ENSANUT). For demographics, nutritional and sanitation exposures, behavioral risk factors, physical health conditions, and sexual and mental health conditions, we computed sex- and age group-specific prevalences for incarcerated and free-living people along with overall prevalences, age-standardized to the incarcerated population, accounting for the complex survey sampling designs. Compared to its free-living population, Mexico’s incarcerated population has higher frequencies of sexual assault (females: 3.4% versus 0.05% of free-living; males: 1.6% versus 0.06% of free-living), violence (females: 8.3% versus 2.1%; males: 9% versus 3.3%), and suicidality (females: 18% versus 12%; males: 12% versus 7.9%). There are also higher levels of inaccessibility of drinking water (females: 27% versus 3.5%; males: 18% versus 3.1%) and flushing toilets (females: 42% versus 29%; males: 48% versus 26%). Among incarcerated females, there is higher prevalence of smoking (37% versus 11%) and hypertension (17% versus 10%). Incarcerated people face less food insecurity (females: 7.4% versus 20%; males: 9.2% versus 18%) and higher proportions receive breast and Papanicolau exams. Targeted policies should address health inequalities faced by the Mexican incarcerated population, both by improving carceral living conditions and connecting incarcerated people with necessary public services upon release.