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Rockey N, Cervantes L, LeMasters K, Rizzolo K. Challenging Health Inequities in Incarceration: a Call for Equitable Care for Kidney Disease and Hypertension. Curr Hypertens Rep 2023; 25:437-445. [PMID: 37773248 DOI: 10.1007/s11906-023-01267-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2023] [Indexed: 10/01/2023]
Abstract
PURPOSE OF REVIEW To review the current literature on care of hypertension and chronic kidney disease for people who are currently and formerly incarcerated, and to make recommendations for improving outcomes. RECENT FINDINGS There is a growing body of literature describing care for kidney disease and hypertension for incarcerated and formerly incarcerated individuals that documents the provision of care itself, notably that many jails contract with private companies; the system is not designed to provide sustained, chronic disease care; and the transition from incarceration to community is fraught with gaps in care. However, deficiencies in data collection and regulation still limit our understanding of the quality of care provided in jails and prisons. Furthermore, more data is needed to understand the impact of structural racism in the criminal legal system on overall disparities in care for hypertension and kidney disease. Insurance coverage rates for people who were formerly incarcerated continue to be lower than the general population despite Medicaid expansion in many states. There is little recent data regarding kidney replacement therapy for this population despite known variation in dialysis modalities and transplant programs by state. Transitions clinics, which connect people who were formerly incarcerated with care in the community upon release, are growing and are important avenues by which to deliver care. People who are incarcerated are disproportionately affected by hypertension and kidney disease, yet data regarding the extent of these inequities and availability of quality care is lacking. More work is needed to understand the care of individuals with kidney disease and hypertension in prisons and to improve outcomes for these common chronic conditions. Both providing effective treatment of kidney disease and hypertension in prisons and jails and providing coordinated, quality transition to community care upon release represents an important opportunity for reform in care for a marginalized population.
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Affiliation(s)
- Nathan Rockey
- Department of Medicine, University of Colorado School of Medicine, Aurora, USA
| | - Lilia Cervantes
- Department of Medicine, University of Colorado School of Medicine, Aurora, USA
- Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Katherine LeMasters
- Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Katherine Rizzolo
- Section of Nephrology, Boston University Chobanian & Avedisian School of Medicine and Boston Medical Center, 650 Albany Street, EBRC508, Boston, Massachusetts, 02118, USA.
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Elumn JE, Saeed GJ, Aminawung J, Horton N, Lin HJ, Yaggi HK, Wang EA. The sleep justice study - a prospective cohort study assessing sleep as a cardiometabolic risk factor after incarceration: a protocol paper. BMC Public Health 2023; 23:2107. [PMID: 37884957 PMCID: PMC10605958 DOI: 10.1186/s12889-023-16985-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/13/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND An estimated 11 million individuals are released from U.S. jails and prisons each year. Individuals with a history of incarceration have higher rates of cardiovascular disease (CVD) events and mortality compared to the general population, especially in the weeks following release from carceral facilities. Healthy sleep, associated with cardiovascular health, is an underexplored factor in the epidemiology of CVD in this population. Incarcerated people may have unique individual, environmental, and institutional policy-level reasons for being sleep deficient. The social and physical environment within carceral facilities and post-release housing may synergistically affect sleep, creating disparities in sleep and cardiovascular health. Since carceral facilities disproportionately house poor and minoritized groups, population-specific risk factors that impact sleep may also contribute to inequities in cardiovascular outcomes. METHODS This study is ancillary to an ongoing prospective cohort recruiting 500 individuals with known cardiovascular risk factors within three months of release from incarceration, the Justice-Involved Individuals Cardiovascular Disease Epidemiology (JUSTICE) study. The Sleep Justice study will measure sleep health among participants at baseline and six months using three validated surveys: the Pittsburgh Sleep Quality Index (PSQI), the STOP-Bang, and the Brief Index of Sleep Control. In a subsample of 100 individuals, we will assess sleep over the course of one week using wrist actigraphy, a validated objective measure of sleep that collects data on rest-activity patterns, sleep, and ambient light levels. Using this data, we will estimate and compare sleep health and its association with CVD risk factor control in individuals recently released from carceral facilities. DISCUSSION The incarceration of millions of poor and minoritized groups presents an urgent need to understand how incarceration affects CVD epidemiology. This study will improve our understanding of sleep health among people released from carceral facilities and its potential relationship to CVD risk factor control. Using subjective and objective measures of sleep will allow us to identify unique targets to improve sleep health and mitigate cardiovascular risk in an otherwise understudied population.
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Affiliation(s)
- Johanna E Elumn
- SEICHE Center for Health and Justice, Yale School of Medicine, New Haven, CT, USA.
- Department of Internal Medicine, Section of General Internal Medicine, Yale School of Medicine, New Haven, CT, USA.
| | - Gul Jana Saeed
- Department of Internal Medicine, Roger Williams Medical Center, Providence, RI, USA
| | - Jenerius Aminawung
- SEICHE Center for Health and Justice, Yale School of Medicine, New Haven, CT, USA
- Department of Internal Medicine, Section of General Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Nadine Horton
- SEICHE Center for Health and Justice, Yale School of Medicine, New Haven, CT, USA
- Department of Internal Medicine, Section of General Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Hsiu-Ju Lin
- Department of Social Work, University of Connecticut, Storrs, CT, USA
| | - H Klar Yaggi
- Section Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
- VA CT Clinical Epidemiology Research Center (CERC), West Haven, CT, USA
| | - Emily A Wang
- SEICHE Center for Health and Justice, Yale School of Medicine, New Haven, CT, USA
- Department of Internal Medicine, Section of General Internal Medicine, Yale School of Medicine, New Haven, CT, USA
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Brinkley-Rubinstein L, Cloud DH. Invited Perspective: Uncovering Harmful Exposures in Carceral Environments. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:91305. [PMID: 36129296 PMCID: PMC9491217 DOI: 10.1289/ehp11653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 08/14/2022] [Accepted: 08/17/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Lauren Brinkley-Rubinstein
- Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Center for Health Equity Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - David H. Cloud
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
- Amend at University of San Francisco School of Medicine, San Francisco, California, USA
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Howell BA, Puglisi LB, Aminawung J, Domingo KB, Elumn J, Gallagher C, Horton N, Kazi DS, Krumholz HM, Lin HJ, Roy B, Wang EA. A prospective cohort study examining exposure to incarceration and cardiovascular disease (Justice-Involved Individuals Cardiovascular Disease Epidemiology - JUSTICE study): a protocol paper. BMC Public Health 2022; 22:331. [PMID: 35172807 PMCID: PMC8848673 DOI: 10.1186/s12889-022-12688-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 02/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND People who have been incarcerated have high rates of cardiovascular risk factors, such as hypertension and smoking, and cardiovascular disease (CVD) is a leading cause of hospitalizations and mortality in this population. Despite this, little is known regarding what pathways mediate the association between incarceration exposure and increased rates of CVD morbidity and especially what incarceration specific factors are associated with this risk. The objective of this study is to better understand CVD risk in people exposed to incarceration and the pathways by which accumulate cardiovascular risk over time. METHODS AND ANALYSIS The Justice-Involved Individuals Cardiovascular Disease Epidemiology (JUSTICE) study is a prospective cohort study of individuals released from incarceration with known cardiovascular risk factors. We are recruiting 500 individuals within three months after release from jail/prison. At baseline we are assessing traditional risk factors for CVD, including diet, exercise, and smoking, and exposure to incarceration-related policies, psychosocial stress, and self-efficacy. Cardiovascular risk factors are measured at baseline through point of care testing. We are following these individuals for the 12 months following the index release from incarceration with re-evaluation of psychosocial factors and clinical risk factors every 6 months. Using these data, we will estimate the direct and indirect latent effects of incarceration on cardiovascular risk factors and the paths via which these effects are mediated. We will also model the anticipated 10-year burden of CVD incidence, health care use, and mortality associated with incarceration. DISCUSSION Our study will identify factors associated with CVD risk factor control among people released from incarceration. Our measurement of incarceration-related exposures, psychosocial factors, and clinical measures of cardiovascular risk will allow for identification of unique targets for intervention to modify CVD risk in this vulnerable population.
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Affiliation(s)
- Benjamin A Howell
- SEICHE Center for Health and Justice, Yale School of Medicine, New Haven, CT, USA. .,Section of General Internal Medicine, Yale School of Medicine, New Haven, CT, USA.
| | - Lisa B Puglisi
- SEICHE Center for Health and Justice, Yale School of Medicine, New Haven, CT, USA.,Section of General Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Jenerius Aminawung
- SEICHE Center for Health and Justice, Yale School of Medicine, New Haven, CT, USA.,Section of General Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | | | - Johanna Elumn
- SEICHE Center for Health and Justice, Yale School of Medicine, New Haven, CT, USA.,Section of General Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | | | - Nadine Horton
- SEICHE Center for Health and Justice, Yale School of Medicine, New Haven, CT, USA
| | - Dhruv S Kazi
- Richard A. and Susan F. Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Harlan M Krumholz
- Center for Outcomes Research and Evaluation, New Haven, CT, USA.,Section of Cardiology, Department of Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Hsiu-Ju Lin
- Department of Social Work, University of Connecticut, Storrs, CT, USA
| | - Brita Roy
- SEICHE Center for Health and Justice, Yale School of Medicine, New Haven, CT, USA.,Section of General Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Emily A Wang
- SEICHE Center for Health and Justice, Yale School of Medicine, New Haven, CT, USA.,Section of General Internal Medicine, Yale School of Medicine, New Haven, CT, USA
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Javed Z, Haisum Maqsood M, Yahya T, Amin Z, Acquah I, Valero-Elizondo J, Andrieni J, Dubey P, Jackson RK, Daffin MA, Cainzos-Achirica M, Hyder AA, Nasir K. Race, Racism, and Cardiovascular Health: Applying a Social Determinants of Health Framework to Racial/Ethnic Disparities in Cardiovascular Disease. Circ Cardiovasc Qual Outcomes 2022; 15:e007917. [PMID: 35041484 DOI: 10.1161/circoutcomes.121.007917] [Citation(s) in RCA: 109] [Impact Index Per Article: 54.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Health care in the United States has seen many great innovations and successes in the past decades. However, to this day, the color of a person's skin determines-to a considerable degree-his/her prospects of wellness; risk of disease, and death; and the quality of care received. Disparities in cardiovascular disease (CVD)-the leading cause of morbidity and mortality globally-are one of the starkest reminders of social injustices, and racial inequities, which continue to plague our society. People of color-including Black, Hispanic, American Indian, Asian, and others-experience varying degrees of social disadvantage that puts these groups at increased risk of CVD and poor disease outcomes, including mortality. Racial/ethnic disparities in CVD, while documented extensively, have not been examined from a broad, upstream, social determinants of health lens. In this review, we apply a comprehensive social determinants of health framework to better understand how structural racism increases individual and cumulative social determinants of health burden for historically underserved racial and ethnic groups, and increases their risk of CVD. We analyze the link between race, racism, and CVD, including major pathways and structural barriers to cardiovascular health, using 5 distinct social determinants of health domains: economic stability; neighborhood and physical environment; education; community and social context; and healthcare system. We conclude with a set of research and policy recommendations to inform future work in the field, and move a step closer to health equity.
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Affiliation(s)
- Zulqarnain Javed
- Division of Health Equity & Disparities Research, Center for Outcomes Research, Houston Methodist, TX (Z.J., M.C.-A., K.N.)
| | | | - Tamer Yahya
- Center for Outcomes Research, Houston Methodist, TX (T.Y., I.A., J.V.-E., M.C.-A., K.N.)
| | | | - Isaac Acquah
- Center for Outcomes Research, Houston Methodist, TX (T.Y., I.A., J.V.-E., M.C.-A., K.N.)
| | - Javier Valero-Elizondo
- Center for Outcomes Research, Houston Methodist, TX (T.Y., I.A., J.V.-E., M.C.-A., K.N.).,Division of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart and Vascular Center, TX (J.V.-E., M.C.-A., K.N.).,Center for Cardiovascular Computational Health & Precision Medicine (C3-PH), Houston Methodist, TX (J.V.-E., M.C.-A., K.N.)
| | - Julia Andrieni
- Population Health and Primary Care (J.A.), Houston Methodist Hospital, TX
| | - Prachi Dubey
- Houston Methodist Hospital, Houston Methodist Research Institute, TX (P.D.)
| | - Ryane K Jackson
- Office of Community Benefits (R.K.J.), Houston Methodist Hospital, TX
| | - Mary A Daffin
- Barrett Daffin Frappier Turner & Engel, L.L.P., Houston, TX (M.A.D.)
| | - Miguel Cainzos-Achirica
- Division of Health Equity & Disparities Research, Center for Outcomes Research, Houston Methodist, TX (Z.J., M.C.-A., K.N.).,Center for Outcomes Research, Houston Methodist, TX (T.Y., I.A., J.V.-E., M.C.-A., K.N.).,Division of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart and Vascular Center, TX (J.V.-E., M.C.-A., K.N.).,Center for Cardiovascular Computational Health & Precision Medicine (C3-PH), Houston Methodist, TX (J.V.-E., M.C.-A., K.N.)
| | - Adnan A Hyder
- Milken Institute School of Public Health, George Washington University, DC (A.A.H.)
| | - Khurram Nasir
- Division of Health Equity & Disparities Research, Center for Outcomes Research, Houston Methodist, TX (Z.J., M.C.-A., K.N.).,Division of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart and Vascular Center, TX (J.V.-E., M.C.-A., K.N.).,Center for Cardiovascular Computational Health & Precision Medicine (C3-PH), Houston Methodist, TX (J.V.-E., M.C.-A., K.N.)
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Waters DD. Notes From Cardiology Clinic: You Can't Ride With the Cops, But Cheer for the Robbers. Can J Cardiol 2021; 37:1151-1152. [PMID: 33933607 DOI: 10.1016/j.cjca.2021.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 04/22/2021] [Indexed: 11/24/2022] Open
Affiliation(s)
- David D Waters
- Division of Cardiology, San Francisco General Hospital, and Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
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