Cardiovascular Disease in Incarcerated Populations

Abstract

Currently, 2.2 million individuals are incarcerated, and more than 11 million have been released from U.S. correctional facilities. Individuals with a history of incarceration are more likely to be of racial and ethnic minority populations, poor, and have higher rates of cardiovascular risk factors, especially smoking and hypertension. Cardiovascular disease is a leading cause of death among incarcerated individuals, and those recently released have a higher risk of being hospitalized and dying of cardiovascular disease compared with the general population, even after accounting for differences in racial identity and socioeconomic status. In this review, the authors: 1) present information on the cardiovascular health of justice-involved populations, and unique prevention and care conditions in correctional facilities; 2) identify knowledge gaps; and 3) propose promising areas for research to improve the cardiovascular health of this population. An Executive Summary of a National Heart, Lung, and Blood Institute workshop on this topic is available.

Keywords: National Heart, Lung, and Blood Institute; correctional health care; epidemiology; jails; prisons; risk factors.

Central Illustration. Possible Individual-Level Effects of Incarceration on Cardiovascular Disease

Incarceration may influence cardiovascular disease through multiple pathways. Socioeconomic position, neighborhood and family conditions, and some comorbid conditions (e.g., substance use) also may influence the likelihood of incarceration, and thus a bidirectional relationship is illustrated. *Sociodemographic and neighborhood factors affect behavioral and psychosocial factors, cardiovascular disease risk factors, and cardiovascular disease morbidity and mortality, but their relationships were not depicted for the sake of clarity. HIV = human immunodeficiency virus.