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Challenging Health Inequities in Incarceration: a Call for Equitable Care for Kidney Disease and Hypertension

  • Hypertension and Obesity (E Reisin, Section Editor)
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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.

Summary

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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Funding

Dr. Rizzolo was funded by National Institutes of Health grant 5T32DK007135-46 during the drafting of this manuscript. The remaining authors have nothing to disclose.

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  1. Department of Medicine, University of Colorado School of Medicine, Aurora, USA

    Nathan Rockey & Lilia Cervantes

  2. Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA

    Lilia Cervantes & Katherine LeMasters

  3. Section of Nephrology, Boston University Chobanian & Avedisian School of Medicine and Boston Medical Center, 650 Albany Street, EBRC508, Boston, Massachusetts, 02118, USA

    Katherine Rizzolo

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Rockey, N., Cervantes, L., LeMasters, K. et al. Challenging Health Inequities in Incarceration: a Call for Equitable Care for Kidney Disease and Hypertension. Curr Hypertens Rep 25, 437–445 (2023). https://doi.org/10.1007/s11906-023-01267-z

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  • DOI: https://doi.org/10.1007/s11906-023-01267-z

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