The prevalence of non-communicable disease in older people in prison: A systematic review and meta-analysis

David Munday*, Jane Leaman, Eamonn O'Moore, Emma Plugge

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

19 Citations (Scopus)


Background people in prison often experience poor health. Those aged 50 and over are the fastest growing age-group in prison and present particular challenges to criminal justice systems around the world. Non-communicable diseases (NCDs) account for two-thirds of deaths globally and no estimate of the prevalence of NCDs in this vulnerable population exists. Methods we searched PubMed, Medline, CINAHL, EMBASE and Global Health databases to identify original research papers that met our pre-defined inclusion criteria. No date or language restrictions were applied. Two authors undertook full-text screening as well as quality assessment and data extraction for all included studies. A random effects model was used to calculate pooled prevalence of any disease that was reported in two or more articles. Results the initial search identified 2,712 articles. 119 underwent full-text screening with 26 meeting the inclusion criteria. This provided prevalence data on 28 NCDs in 93,862 individuals from prisons in 11 countries. Pooled prevalence for the most significant NCDs was a follows; cancer 8% (95% CI 6-10%), cardiovascular disease 38% (95% CI 33-42%), hypertension 39% (95% CI 32-47%), diabetes 14% (95% CI 12-16%), COPD prevalence estimates ranged from 4% to 18%. Heterogeneity across studies was high. Conclusions those in prison over 50 years of age experience a high burden of NCDs which is often higher than younger prison and age-matched community peers. This health inequality is influenced by lifestyle, environmental and societal factors. Prison services should be adapted to serve the needs of this growing population.

Original languageEnglish
Pages (from-to)204-212
Number of pages9
JournalAge and Ageing
Issue number2
Publication statusPublished - 1 Mar 2019

Bibliographical note

Publisher Copyright:
© The Author(s) 2018. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.


  • non-communicable Disease (NCDs)
  • older people
  • prevalence
  • prison
  • systematic review


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