Prevalence of risk factors for non-communicable diseases in prison populations worldwide: a systematic review
Prevalence of risk factors for non-communicable diseases in prison populations worldwide: a systematic review
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DOI：
10.1016/s0140-6736(12)60319-5
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发表时间：
2012-05-26
期刊：
影响因子：
168.9
通讯作者：
Doll, Helen
中科院分区：
文献类型：
--
作者：
Herbert, Katharine;Plugge, Emma;Doll, Helen
低收入和中等收入国家以及囚犯等社会弱势群体不成比例地承担着非传染性疾病（NCD）的负担。没有进行系统的分析来评估囚犯中饮食不良、体育活动不足以及超重和肥胖的普遍程度。我们的目标是综合目前的证据，并强调行动和进一步的research.Methods领域，我们系统地搜索在线数据库1948年和2011年5月之间发表的报告。根据合格性标准筛选研究;然后两位作者独立提取先前商定的形式数据。采用基于领域的评估对每项研究的偏倚风险进行评估。关于体重指数和体力活动的数据以森林图表示;由于数据的异质性，没有计算总体估计数。从人口亚组的年龄和性别方面最相似的可用数据被用来计算年龄调整和性别调整的患病率比，估计活动不足和肥胖患病率的可能性，在囚犯与全国population.Findings相比，31个合格的研究报告在29个出版物，其中包括超过60 000名囚犯在15个国家的884个机构。男性囚犯比一般人群中的男性更不容易肥胖（患病率范围为0.33至0.87），除一项研究外，（1.02，0.92-1.07），而在美国，女性囚犯比非监禁女性更容易肥胖（1.18，1.08-1.30）和澳大利亚（流行率为1.15 - 1.20）。与英国的囚犯相比，澳大利亚的囚犯比一般人群更有可能达到足够的活动水平。（2009年澳大利亚女性的患病率为1.19，95% CI为1.04-1.37，英国女性为0.32，95% CI为0.21-0.47;澳大利亚男性的患病率为1.37 - 1.59，英国男性为0.71，0.34-0.78）。女性的平均能量摄入量超过了建议的水平，钠的摄入量约为所有囚犯建议摄入量的两到三倍。解释与刑事司法系统接触是促进这一弱势群体健康的公共卫生机会;如果不这样做，个人和社会的代价可能是巨大的。改进监测和进一步研究对于适当确定公共卫生干预措施的目标至关重要。
Background The burden of non-communicable diseases (NCDs) is disproportionately carried by low-income and middle-income countries and disadvantaged sectors of society such as prisoners. No systematic analysis has been done to assess the prevalence of poor diet, inadequate physical activity, and overweight and obesity in prisoners. We aim to synthesise current evidence and to highlight areas for action and further research.Methods We systematically searched online databases for reports published between 1948 and May, 2011. Studies were screened against eligibility criteria; two authors then independently extracted data with previously agreed proformas. The risk of bias was assessed for each study with a domain-based assessment. Data on body-mass index and physical activity were presented in forest plots; no overall estimates were calculated on account of data heterogeneity. Available data from the population subgroup most similar in terms of age and sex were used to calculate age-adjusted and sex-adjusted prevalence ratios, which estimate the likelihood of insufficient activity and obesity prevalence in prisoners compared with the national population.Findings 31 eligible studies were reported in 29 publications, including more than 60 000 prisoners in 884 institutions in 15 countries. Male prisoners were less likely to be obese than males in the general population (prevalence ratios ranged from 0.33 to 0.87) in all but one study (1.02, 0.92-1.07), whereas female prisoners were more likely to be obese than non-imprisoned women in the USA (1.18, 1.08-1.30) and Australia (prevalence ratios ranged from 1.15 to 1.20). Australian prisoners were more likely to achieve sufficient activity levels than the general population compared with prisoners in the UK (prevalence ratio 1.19, 95% CI 1.04-1.37, for women in Australia in 2009 vs 0.32, 0.21-0.47, for women in the UK; prevalence ratios ranged from 1.37 to 1.59 for men in Australia vs 0.71, 0.34-0.78, for men in the UK). Female mean energy intake exceeded recommended levels and sodium intake was about two to three times the recommended intake for all prisoners.Interpretation Contact with the criminal justice system is a public-health opportunity to promote health in this vulnerable population; the costs to the individual and to society of failing to do so are likely to be substantial. Improved monitoring and further research is essential to inform appropriate targeting of public health interventions.