Affiliation:
1. SEICHE Center for Health and Justice, Department of Internal Medicine Yale University School of Medicine New Haven Connecticut
2. Department of Population Health New York University New York New York
3. School of Social Work, University of Connecticut Storrs Connecticut
4. Department of Epidemiology and Biostatistics University of California San Francisco California
5. Center for Outcomes Research and Evaluation Yale New Haven Hospital New Haven Connecticut
6. Section of Cardiology, Department of Medicine Yale School of Medicine New Haven Connecticut
Abstract
Background
Incarceration is a social determinant of cardiovascular health but is rarely addressed in clinical settings or public health prevention efforts. People who have been incarcerated are more likely to develop cardiovascular disease (CVD) at younger ages and have worse cardiovascular outcomes compared with the general population, even after controlling for traditional risk factors. This study aims to identify incarceration‐specific factors that are associated with uncontrolled CVD risk factors to identify potential targets for prevention.
Methods and Results
Using data from JUSTICE (Justice‐Involved Individuals Cardiovascular Disease Epidemiology), a prospective cohort study of individuals released from incarceration with CVD risk factors, we examine the unique association between incarceration‐specific factors and CVD risk factor control. Participants (N=471), with a mean age of 45.0±10.8 (SD) years, were disproportionately from racially minoritized groups (79%), and poor (91%). Over half (54%) had at least 1 uncontrolled CVD risk factor at baseline. People released from jail, compared with prison, had lower Life's Essential 8 scores for blood pressure and smoking. Release from jail, as compared with prison, was associated with an increased odds of having an uncontrolled CVD risk factor, even after adjusting for age, race and ethnicity, gender, perceived stress, and life adversity score (adjusted odds ratio 1.62 [95% CI, 1.02–2.57]).
Discussion
Release from jail is associated with poor CVD risk factor control and requires tailored intervention, which is informative as states design and implement the Centers of Medicare & Medicaid Services Reentry 1115 waiver, which allows Medicaid to cover services before release from correctional facilities.
Publisher
Ovid Technologies (Wolters Kluwer Health)
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