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    Cardiovascular risk profiles and the uptake of the NHS Healthcheck programme in male prisoners in six UK prisons: An observational cross-sectional study

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    Author
    Packham, Chris
    Butcher, Elizabeth
    Williams, Marie
    Morriss, Richard K.
    Keyword
    Cardiovascular diseases
    Mental health
    Prisoners
    Prisons
    Mortality
    Health status
    Date
    2020
    
    Metadata
    Show full item record
    DOI
    10.1136/bmjopen-2019-033498
    Publisher's URL
    https://bmjopen.bmj.com/content/10/5/e033498
    Abstract
    INTRODUCTIONHalf of all deaths in custody are due to natural causes, the most common being cardiovascular disease (CVD). National Health Service Healthchecks should be available to all eligible prisoners; it is not clear who receives them. Mental health issues are common in prisoners and may affect how healthcare interventions should be delivered. Current policy is to offer Healthchecks to those serving over 2 years in prison.OBJECTIVES, METHODS, SETTING AND DESIGNAn observational cross-sectional survey in six male prisons in England between September 2017 and January 2019 in prisoners aged 35-74 to identify who was eligible for a Healthcheck and compare CVD risk data with those that were not, and factors associated with uptake.OUTCOME MEASURESCharacteristics of those accepting a Healthcheck were compared with those declining. Assessments of anxiety and depression were compared with CVD risk factors.RESULTS1207 prisoners completed a Healthcheck. 21.8% of prisoners were ineligible due to existing comorbidities. 76.4% of those invited took up a Healthcheck, and of those, 12.1% were found to have new significant CVD comorbidity. CVD risk was similar to community levels but this population was 10 years younger. Definite case-level depression or anxiety was present in 20.7% and 18.0%, respectively, of participants. An association was found between ethnicity and those invited (p=0.023, φ=0.1) and accepting (p=0.008, φ=0.1) a Healthcheck. 9.7% of prisoners serving less than 2 years had CVD risk scores of 10% or more, and had similar CVD risk profiles but much higher levels of anxiety (p<0.001, φ=0.2) or depression (p=0.009, φ=0.2) than those serving 2 years or more.CONCLUSIONCardiovascular risk was comparable with community rates and in some prisons, much higher. Rates of anxiety and depression were high. The national policy for selecting prisoners for Healthchecks may leave many high-risk prisoners without appropriate cardiovascular preventative assessments.
    Citation
    Packham, C., Butcher, E., Williams, M., Miksza, J., Morriss, R. K. & Khunti, K. (2020). Cardiovascular risk profiles and the uptake of the NHS Healthcheck programme in male prisoners in six UK prisons: an observational cross-sectional survey. BMJ Open, 10 (e033498).
    Type
    Article
    URI
    http://hdl.handle.net/20.500.12904/6915
    Note
    © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
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