Risk of death increases for prisoners after release

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Risk of death for prisoners increases significantly after being released, according to a study of over 20,000 persons imprisoned in the state of Georgia. Six causes (HIV infection, cancer, cirrhosis, homicide, transportation and accidental poisoning) accounted for 62 percent of the excess mortality following release.

“Health care planning for prisoners should not ignore long-term health needs,” the study said.

Interventions such as treatment for hepatitis C could result in an appreciable number of years of life gained for persons who pass through a correctional institution.

1. Spaulding AC, Seals RM, McCallum VA, et al. Prisoner survival inside and outside of the institution: implications for health-care planning. American Journal of Epidemiology, published online 14 Jan 2011. (open access)

Lack of health care among rural Appalachian residents

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People living in rural communities in Appalachian counties in Virginia are not receiving adequate health care, even among those with health insurance, a study has found. More than 30 percent of Appalachian residents rated their health status as poor/fair, compared to less than 18% of non-Appalachian residents.

The study researchers say that it may be that Appalachian residents wait longer to seek health care than do those from other counties due to a cultural tendency to be “self-reliant,” and perhaps “fatalistic,” which may result in cancer and other conditions being diagnosed and treated at later stages. Other barriers to adequately managing these conditions (economic hardships, co-occurring undiagnosed depression) and may also affect one’s perception of health.

Research has shown that communities in the Appalachian Mountain region of the United States have higher rates of unemployment and poverty and lower rates of high school and college graduation compared to other parts of the country. The majority of Appalachian residents are white, while five percent are black. They tend to have strong family support systems and are very religious, but strongly distrust outsiders and formalized medical systems.

1. McGarvey EL, Leon-Verdin M, Killos LF. Health disparities between Appalachian and non-Appalachian counties in Virginia USA. Journal of Community Health 2010, published online 23 Sep 2010. (open access)