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It is said that no one truly knows a nation until one has been inside its jails.A nation should not be judged by how it treats its highest citizens, but its lowest ones.
Nelson Mandela
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Chronic Disease in Prison
Family Medicine Forum, 2013Vancouver, BCN. Sharifi, BSc, MD, CCFP, ABAM, CCHP
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Chronic Disease in Prison
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Chronic Disease in Prison
• Arthritis• Asthma• Hepatitis• HIV• Hypertension• Mental Illness• Obesity• Substance Use Disorders
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Chronic Disease in Prison
• Substance Use Disorder• Mental Illness• Hypertension• Obesity• Arthritis• Asthma• Hepatitis• Cancer• HIV
*Wilper et al, 2009
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Chronic Disease in Prison
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Higher odds ratio
• Substance Use Disorder• Mental Illness• Hypertension• Arthritis• Asthma• Hepatitis• Cancer• HIV
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Same odds ratio
• Diabetes• Angina• Myocardial infarction
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Lower odds ratio
• Obesity
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Chronic Disease in Prison
• Challenges/Opportunities– Data collection– Allocation of resources– Disease management– Empowering patients– Continuous quality improvement
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Chronic Disease in Prison
• National Commission on Correctional Healthcare Recommendations– Total disease management• Clinical practice guidelines
– Regular visits
• Flow sheets– Degree of control
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Crime and bad lives are the measure of a State’s failure.All crime in the end is the crime of the community.
H.G. Wells