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Health outcomes for people released from incarceration are often poor, but it is unclear to what extent these poor outcomes are caused by incarceration or a consequence of pre-existing morbidity and health risk. We synthesised published evidence regarding the impact of incarceration on physical and mental health. We searched five electronic databases (PsycINFO, CINAHL Complete, Medline, EMBASE, and Campbell Collaboration) for primary research articles measuring at least one health outcome both before and after an episode of incarceration. We screened articles published in any country and with no restrictions on publication date. We assessed risk of bias using the MethodologicAl STandards for Epidemiological Research (MASTER) scale and conducted a narrative synthesis. Nine studies met the inclusion criteria, seven of which were from the United States. Compared to pre-incarceration, post-incarceration health measures generally indicated reduced substance dependence and increased HIV viral suppression. Changes in mental health-related measures after incarceration were mixed: one study reported an increase in depressive symptoms and another study reported no change in the prevalence of depression, anxiety, psychotic disorders, or personality disorders. The prevalence of physical health conditions did not change substantially from before to after incarceration. The evidence base remains sparse and lacks global representation. Our synthesis of the available evidence nevertheless suggests that incarceration can have both positive and negative impacts on health. Further rigorous research is required, in multiple countries and world regions, to identify modifiable factors that mediate the impacts of incarceration on specific health outcomes. • Systematic review of studies assessing the impact of incarceration on health • Nine studies reported modest and variable impacts on health • Positive impacts reported for HIV and addiction, mixed for mental health, no difference for physical health • There are missed opportunities for incarceration to improve health • Better living conditions, healthcare, and transitional supports needed in prisons • Ethics approval was not required for this systematic review and meta-analysis.
Pearce et al. (Fri,) studied this question.