title: Disease profiles of detainees in the Canton of Vaud in Switzerland: gender and age differences in substance abuse, mental health and chronic health conditions.
abstract: BACKGROUND
  Literature on the disease profile of prisoners that differentiates by age and gender remains sparse. This study aimed to describe the health of correctional inmates in terms of substance abuse problems and mental and somatic health conditions, and compare it by gender and age.
  
  
  METHODS
  This study examined cross-sectional data from the Canton of Vaud in Switzerland on the health conditions of detainees who were in prison on January 1, 2011 or entered prison in 2011. Health conditions validated by physician examination were reported using the International Classification of Diseases (ICD) version 10. The analyses were descriptive by groups of prisoners: the entire sample (All), Men, Older adults and Women.
  
  
  RESULTS
  A total of 1,664 individuals were included in the analysis. Men comprised 91.5 % of the sample and had a mean age of 33 years. The other 8.5 % were women and had an average age of 39. Older adults (i.e., age 50 and older) represented 7 % of the total sample. Overall, 80 % of inmates were non-Swiss citizens, but the proportion of Swiss prisoners was higher among the older adults (51 %) and women (29 %). Overall, 41 % of inmates self-reported substance abuse problems. Of those, 27 % were being treated by psychiatrists for behavioral disorders related to substance abuse. Chronic infectious diseases were found in 9 % of the prison population. In addition, 27 % of detainees suffered from serious mental health conditions. Gender and age had an influence on the disease profile of this sample: compared to the entire prison population, the older inmates were less likely to misuse illegal drugs and to suffer from communicable infections but exhibited more problems with alcohol and a higher burden of chronic health conditions. Female prisoners were more disposed to mental health problems (including drug abuse) and infectious diseases. In terms of chronic diseases, women suffered from the same conditions as men, but the diseases were more prevalent in women.
  
  
  CONCLUSIONS
  It is important to understand the different disease profiles of prisoners by gender and age, as it helps identify the needs of different groups and tailor age-and gender-specific interventions.
authors.affiliation: Institut universitaire de médecine sociale et préventive, Unité d'evaluation des soins, University Hospital of Lausanne (CHUV), Route de la Corniche 10, 1010, Lausanne, Switzerland. karine.moschetti@chuv.ch.|Technology Assessment Unit (UET), University Hospital of Lausanne (CHUV), Lausanne, 1011, Switzerland. karine.moschetti@chuv.ch.|IEMS - Plateforme interfacultaire en économie et management de la santé, University of Lausanne CH, Internef Building, Lausanne, 1015, Switzerland. karine.moschetti@chuv.ch.
authors.forename: Karine
authors.initials: K
authors.lastname: Moschetti
authors.affiliation: Institut universitaire de médecine sociale et préventive, Unité d'evaluation des soins, University Hospital of Lausanne (CHUV), Route de la Corniche 10, 1010, Lausanne, Switzerland. stadelmann.pierre@gmail.com.|IEMS - Plateforme interfacultaire en économie et management de la santé, University of Lausanne CH, Internef Building, Lausanne, 1015, Switzerland. stadelmann.pierre@gmail.com.
authors.forename: Pierre
authors.initials: P
authors.lastname: Stadelmann
authors.affiliation: Institute for Biomedical Ethics, Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, Basel, 4056, Switzerland. tenzin.wangmo@unibas.ch.
authors.forename: Tenzin
authors.initials: T
authors.lastname: Wangmo
authors.affiliation: Institut d'économie et management de la santé (IEMS), HEC Lausanne and Département d'économétrie et d'économie politique (DEEP), University of Lausanne, Internef Building, Lausanne, 1015, Switzerland. alberto.holly@unil.ch.
authors.forename: Alberto
authors.initials: A
authors.lastname: Holly
authors.affiliation: Vulnerable Population Center, Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, 1011, Switzerland. Patrick.Bodenmann@hospvd.ch.
authors.forename: Patrick
authors.initials: P
authors.lastname: Bodenmann
authors.affiliation: Technology Assessment Unit (UET), University Hospital of Lausanne (CHUV), Lausanne, 1011, Switzerland. Jean-Blaise.Wasserfallen@chuv.ch.
authors.forename: Jean-Blaise
authors.initials: JB
authors.lastname: Wasserfallen
authors.affiliation: Institute for Biomedical Ethics, Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, Basel, 4056, Switzerland. b.elger@unibas.ch.|Centre universitaire romand de médecine légale, University of Geneva, Geneva, Switzerland. b.elger@unibas.ch.
authors.forename: Bernice S
authors.initials: BS
authors.lastname: Elger
authors.affiliation: Service of Correctional Medicine and Psychiatry (SMPP), University Hospital of Lausanne (CHUV), Prilly-Lausanne, 1008, Switzerland. bruno.gravier@chuv.ch.
authors.forename: Bruno
authors.initials: B
authors.lastname: Gravier
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002908:Chronic Disease / Q000453:epidemiology*; D003141:Communicable Diseases / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D008603:Mental Health / Q000706:statistics & numerical data*; D008875:Middle Aged; D015995:Prevalence; D011329:Prisoners / Q000523:psychology* / Q000706:statistics & numerical data; D011330:Prisons; D019966:Substance-Related Disorders / Q000453:epidemiology*; D013557:Switzerland / Q000453:epidemiology