U.S. Department of Justice

Office of Justice Programs

Bureau of Justice Statistics

Special Report

Celebrating

 35 years

FEBRUARY 2015 NCJ 248491

HIGHLIGHTS

 In 2011–12, an estimated 40% of state and federal prisoners 

and jail inmates reported having a current chronic medical 

condition while about half reported ever having a chronic 

medical condition.

 Twenty-one percent of prisoners and 14% of jail inmates 

reported ever having tuberculosis, hepatitis B or C, or other 

STDs (excluding HIV or AIDS).

 Both prisoners and jail inmates were more likely than 

the general population to report ever having a chronic 

condition or infectious disease. The same finding held true 

for each specific condition or infectious disease. 

 Among prisoners and jail inmates, females were more likely 

than males to report ever having a chronic condition.

 High blood pressure was the most common chronic 

condition reported by prisoners (30%) and jail inmates (26%).

 The majority of prisoners (74%) and jail inmates (62%) were 

overweight, obese, or morbidly obese.

 While female prisoners and jail inmates were less likely than 

males to be overweight, they were more likely to be obese 

or morbidly obese. 

 About 66% of prisoners and 40% of jail inmates with a current 

chronic condition reported taking prescription medication.

 The majority of prisoners reported having been tested 

for HIV (71%) and for tuberculosis (94%) since admission. 

Among jail inmates, 11% had been tested for HIV and 

54% for tuberculosis.

 Seventeen jurisdictions reported testing all inmates for HIV 

during the intake process, 11 reported opt-out testing, and 

10 reported opt-in testing.

 More than half of prisoners (56%) and jail inmates (51%) 

said that they were either very satisfied or somewhat 

satisfied with the health care services received 

since admission.

Medical Problems of State and Federal 

Prisoners and Jail Inmates, 2011–12

Laura M. Maruschak, BJS Statistician

Marcus Berzofsky, Dr.P.H., and Jennifer Unangst, RTI International

I

n 2011–12, half of state and federal prisoners and local 

jail inmates reported ever having a chronic condition 

(figure 1). Chronic conditions include cancer, high blood 

pressure, stroke-related problems, diabetes, heart-related 

problems, kidney-related problems, arthritis, asthma, and 

cirrhosis of the liver. Twenty-one percent of prisoners and 

14% of jail inmates reported ever having an infectious 

disease, including tuberculosis, hepatitis B and C, and other 

sexually transmitted diseases (STDs). About 1% of prisoners 

and jail inmates who had been tested for HIV reported being 

HIV positive.

This report uses data from the 2011–12 National Inmate 

Survey (NIS-3) to describe the health status and the 

health services and treatment received by state and federal 

prisoners and local jail inmates. Data from the 2009–2012 

National Survey on Drug Use and Health (NSDUH) were 

used to compare the incarcerated populations to the general 

population. The general population was standardized 

0

10

20

30

40

50

60

Infectious disease

Prisoners Jail inmates

Percent

Chronic condition

Figure 1

Prevalence of ever having a chronic condition or infectious 

disease among state and federal prisoners and jail inmates, 

2011–12

Source: Bureau of Justice Statistics, National Inmate Survey, 2011–12.

Revised October 4, 2016
MEDICAL PROBLEMS OF STATE AND FEDERAL PRISONERS AND JAIL INMATES, 2011–12 | FEBRUARY 2015 2

twice, once to match the prison population and once to 

match the jail population by sex, age, race, and Hispanic 

origin. Standardizing the general population to the inmate 

population controls for differences in the distributions of 

sex, age, and race, and Hispanic origin, which are important 

risk factors for medical problems. Standardization removes 

the effect of sex, age, race, and Hispanic origin when 

comparing the prevalence of medical conditions between 

the incarcerated populations and the general population. 

However, it does not remove the effect of other factors 

associated with both incarceration status and outcome. The 

report details the prevalence of specific chronic conditions 

and infectious diseases and highlights important differences 

in the rates of each by demographic characteristics. It 

examines treatment received by inmates with health 

problems and describes inmate satisfaction with health 

services received while incarcerated.

Prisoners and jail inmates were more likely than the 

general population to report ever having a chronic 

condition or an infectious disease

When compared to the general population, both prisoners 

and jail inmates were more likely to report ever having 

a chronic condition, and they were more likely to report 

each of the specific chronic conditions measured. When 

compared to the general population, the measure of ever 

having a chronic condition excludes cancer, kidney-related 

problems, and arthritis or rheumatism because data were 

not collected on these chronic conditions in the NSDUH. 

Forty-four percent of prisoners reported ever having a 

chronic condition, compared to 31% of persons in the 

general population (table 1). Prisoners were about 1.5 

times more likely than persons in the standardized general 

population to report ever having high blood pressure, 

diabetes, or asthma. About 45% of jail inmates reported 

Difference between ever having and currently having chronic medical conditions 

Estimates of chronic medical conditions among state and 

federal prisoners and jail inmates are based on self-reported 

information in the National Inmate Survey (NIS-3). Inmates 

were asked whether a doctor, nurse, or other health care 

provider ever told them they had select noninfectious medical 

conditions which were categorized as chronic conditions. 

Chronic medical conditions involve persistent health 

problems that have long-lasting effects, and include but are 

not limited to, the select conditions that were asked about in 

the NIS-3. This measure indicated a diagnosis of having the 

condition at least once in their lifetime, but does not mean 

that the inmate currently has the medical condition. As a 

measure of current medical conditions in the NIS-3, inmates 

were also asked at the time of the interview whether a doctor, 

nurse, or other health care provider had told them they 

currently had select noninfectious medical conditions. 

The data show that an estimated 50% of prisoners and jail 

inmates reported ever having a chronic condition compared 

to 40% currently having a chronic condition. The percentage 

of inmates who reported currently having a chronic condition 

was lower than those who reported ever having a chronic 

condition because over time, a past condition may have 

been resolved, gone into remission, or no longer required 

treatment. The measure of ever having a chronic medical 

condition indicates the percentage of inmates who are 

potentially at risk for future medical problems while the 

measure of current condition indicates the percentage of 

inmates who may have needed health care services at the 

time of interview.
MEDICAL PROBLEMS OF STATE AND FEDERAL PRISONERS AND JAIL INMATES, 2011–12 | FEBRUARY 2015 3

Table 1

Prevalence of ever having a chronic condition or infectious disease among state and federal prisoners and the general 

population (standardized), 2011–12

State and federal prisoners General population*a

Chronic condition/infectious disease Percent Standard error Percent Standard error

Ever had a chronic conditionb 43.9%** 1.5% 31.0% 0.3%

Cancer 3.5 0.4 / :

High blood pressure/hypertension 30.2** 1.2 18.1 0.3

Stroke-related problems 1.8** 0.3 0.7 0.1

Diabetes/high blood sugar 9.0** 0.8 6.5 0.2

Heart-related problemsc 9.8** 1.0 2.9 0.1

Kidney-related problems 6.1 0.7 / :

Arthritis/rheumatism 15.0 0.9 / :

Asthma 14.9** 0.9 10.2 0.2

Cirrhosis of the liver 1.8** 0.3 0.2 --

Ever had an infectious diseased 21.0%** 1.3% 4.8% 0.2%

Tuberculosis 6.0** 0.6 0.5 0.1

Hepatitise 10.9** 1.0 1.1 0.1

Hepatitis B 2.7 0.4 / :

Hepatitis C 9.8 1.0 / :

STDsf 6.0** 0.5 3.4 0.1

HIV/AIDS 1.3%** 0.3% 0.4% 0.1%

*Comparison group.

**Difference with comparison group is significant at the 95% confidence level.

--Less than 0.05%.

: Not calculated.

/Not collected in the NSDUH.

aGeneral population estimates were standardized to match the prison population by sex, age, race, and Hispanic origin.

bIncludes only conditions measured by both the NIS and NSDUH. In the NSDUH, persons were asked if a doctor or other medical professional had ever told them that 

they had high blood pressure, a stroke, diabetes, heart disease, asthma, or cirrhosis of the liver. 

cFor state and federal prisoners, heart-related problems could include angina; arrhythmia; arteriosclerosis; heart attack; coronary, congenital, or rheumatic heart disease; 

heart valve damage; tachycardia; or other type of heart problem.

dExcludes HIV or AIDS due to unknown or missing data. Only those tested reported results.

eIncludes hepatitis B and C for the prison population and all types of hepatitis for the general population.

f

Excludes HIV or AIDS.

Source: Bureau of Justice Statistics, National Inmate Survey (NIS), 2011–12; and the Substance Abuse and Mental Health Services Administration, National Survey on Drug 

Use and Health (NSDUH), 2009–2012.
MEDICAL PROBLEMS OF STATE AND FEDERAL PRISONERS AND JAIL INMATES, 2011–12 | FEBRUARY 2015 4

ever having a chronic condition, compared to 27% of the 

standardized general population (table 2). Jail inmates were 

nearly two times more likely than persons in the general 

population to report ever having high blood pressure, 

diabetes, or asthma.

An estimated 21% of prisoners and 14% of jail inmates 

reported ever having tuberculosis, hepatitis, or other STDs 

excluding HIV or AIDS, compared to 5% of the general 

population.1 For each type of infectious disease, prisoners 

and jail inmates were more likely than those in the general 

population to report ever having that infectious disease.

1In the NSDUH, hepatitis includes all types. In the NIS-3, hepatitis includes 

hepatitis B and hepatitis C.

High blood pressure was the most commonly reported 

chronic condition among prisoners and jail inmates

Similar to the standardized general population, the most 

commonly reported chronic condition reported by both 

prisoners and jail inmates was high blood pressure. Nearly 

a third (30%) of prisoners and more than a quarter (26%) 

of jail inmates reported high blood pressure. Asthma (15% 

for prisoners and 20% for jail inmates) and arthritis (15% 

for prisoners and 13% for jail inmates) were the second and 

third most common chronic conditions.

Table 2

Prevalence of ever having a chronic condition or infectious disease among jail inmates and the general population 

(standardized), 2011–12

Jail inmates General population*a

Chronic condition/infectious disease Percent Standard error Percent Standard error

Ever had a chronic conditionb 44.7%** 1.2% 26.9% 0.3%

Cancer 3.6 0.4 / :

High blood pressure/hypertension 26.3** 1.1 13.9 0.2

Stroke-related problems 2.3** 0.3 0.5 --

Diabetes/high blood sugar 7.2** 0.6 4.5 0.1

Heart-related problemsc 10.4** 0.7 1.9 0.1

Kidney-related problems 6.7 0.5 / :

Arthritis/rheumatism 12.9 0.7 / :

Asthma 20.1** 1.0 11.4 0.2

Cirrhosis of the liver 1.7** 0.3 0.1 --

Ever had an infectious diseased 14.3%** 0.7% 4.6% 0.1%

Tuberculosis 2.5** 0.3 0.4 --

Hepatitise 6.5** 0.5 0.9 --

Hepatitis B 1.7 0.2 / :

Hepatitis C 5.6 0.5 / :

STDse,f 6.1** 0.5 3.5 0.1

HIV/AIDS 1.3%** 0.2% 0.3% --

*Comparison group.

**Difference with comparison group is significant at the 95% confidence level.

--Less than 0.05%.

: Not calculated.

/Not collected in the NSDUH.

aGeneral population estimates were standardized to match the jail population by sex, age, race, and Hispanic origin.

bIncludes only conditions measured by both the NIS and NSDUH. In the NSDUH, persons were asked if a doctor or other medical professional had ever told them that 

they had high blood pressure, a stroke, diabetes, heart disease, asthma, or cirrhosis of the liver. 

cFor jail inmates, heart-related problems could include angina; arrhythmia; arteriosclerosis; heart attack; coronary, congenital, or rheumatic heart disease; heart valve 

damage; tachycardia; or other type of heart problem.

dExcludes HIV or AIDS due to unknown or missing data. Only those tested reported results.

eIncludes hepatitis B and C for the jail population and all types of hepatitis for the general population.

f

Excludes HIV or AIDS.

Source: Bureau of Justice Statistics, National Inmate Survey (NIS), 2011–12; and the Substance Abuse and Mental Health Services Administration, National Survey on 

Drug Use and Health (NSDUH), 2009–2012.
MEDICAL PROBLEMS OF STATE AND FEDERAL PRISONERS AND JAIL INMATES, 2011–12 | FEBRUARY 2015 5

Among prisoners, hepatitis C was the most commonly 

reported infectious disease (10%), followed by tuberculosis 

and STDs (6% each). Among jail inmates, nearly 6% 

reported ever having hepatitis C, 6% ever had some other 

STD, and 2% ever had tuberculosis. About 1% of both 

prisoners and jail inmates who were tested reported having 

HIV or AIDS.

Chronic conditions were more commonly reported by 

female inmates both in prisons and jails

Female prisoners and jail inmates were more likely than 

males to report ever having a chronic condition (table 3). 

About two-thirds of females in both prisons (63%) and jails 

(67%) reported ever having a chronic condition, compared 

to half of males in prisons (50%) and jails (48%). In prisons, 

25% of females and 21% of males reported ever having an 

infectious disease. In jails, 20% of females reported ever 

having an infectious disease, compared to 13% of males.

Hispanic prisoners and jail inmates were less likely than 

white and black prisoners and jail inmates to report ever 

having an infectious disease. About 57% of white, 52% of 

black, and 41% of Hispanic prisoners reported ever having a 

chronic condition. Similarly, 54% of white, 50% of black, and 

37% of Hispanic jail inmates reported ever having a chronic 

condition. White prisoners were almost 1.5 times more likely 

than black prisoners to report ever having an infectious 

disease. About 15% of both white and black jail inmates 

reported ever having an infectious disease, compared to 10% 

of Hispanic inmates.

Older prisoners were about 3 times more likely than 

younger persons to report ever having a chronic 

condition or infectious disease

Older prisoners and jail inmates were more likely than 

younger persons to report ever having a chronic condition 

or infectious disease. Prisoners age 50 or older were about 

2.5 times more likely than those ages 18 to 24 to report ever 

having a chronic condition. Similarly, jail inmates age 50 or 

older were about 2 times more likely than those ages 18 to 

24 to report ever having a chronic condition. About 1 in 10 

prisoners and jail inmates ages 18 to 24 reported ever having 

an infectious disease. Prisoners (35%) and jail inmates (30%) 

age 50 or older were about 3 times more likely to report 

having an infectious disease than those ages 18 to 24.

Table 3

Prevalence of ever having a chronic condition or infectious disease among state and federal prisoners and jail inmates, by 

demographic characteristics, 2011–12

Chronic conditiona Infectious diseaseb

Demographic characteristic State and federal prisoners* Jail inmates State and federal prisoners* Jail inmates

All inmates 50.5% 50.2% 21.0% 14.3%**

Sex

Male † 49.6% 47.8% 20.7% 13.4%**

Female 62.9 †† 66.6 †† 25.0 20.1 ††

Age

18–24 † 27.5% 37.7%** 11.0% 9.5% 

25–34 40.9 †† 45.6 †† 19.7 †† 13.1 ††**

35–49 55.5 †† 57.7 †† 18.8 †† 15.0 ††**

50 or older 72.6 †† 78.6 †† 35.1 †† 30.1 ††

Race/Hispanic originc

White 57.4% 54.3% 24.6% †† 14.9%**

Black/African American † 51.9 49.7 16.7 15.2

Hispanic/Latino 40.6 †† 37.1 †† 23.4 10.1 ††**

Otherd 49.4 61.3 †† 20.0 14.9

Note: The jail population was not standardized to match the prison population. Therefore, differences observed may be due to differences in prison and jail population 

by sex, age, race, and Hispanic origin. See appendix table 8 for standard errors.

*Comparison group. 

**Difference with comparison group is significant at the 95% confidence level.

† Comparison group.

†† Difference with comparison group is significant at the 95% confidence level.

aIncludes cancer, high blood pressure or hypertension, stroke-related problems, diabetes or high blood sugar, heart-related problems, kidney-related problems, arthritis 

or rheumatism, asthma, and cirrhosis of the liver.

bIncludes tuberculosis, hepatitis B, hepatitis C, and STDs. Excludes HIV or AIDS due to unknown or missing data.

cExcludes persons of Hispanic or Latino origin, unless specified.

dIncludes persons identified as American Indian or Alaska Native; Asian, Native Hawaiian, or other Pacific Islander; and two or more races.

Source: Bureau of Justice Statistics, National Inmate Survey, 2011–12.
MEDICAL PROBLEMS OF STATE AND FEDERAL PRISONERS AND JAIL INMATES, 2011–12 | FEBRUARY 2015 6

Rates of high blood pressure and diabetes increased among prisoners and jail 

inmates

In the Bureau of Justice Statistics’ (BJS) 2002 Survey of 

Inmates in Local Jails and 2004 Survey of Inmates in State and 

Federal Correctional Facilities, inmates were asked a series 

of questions to determine if they ever had or currently have 

a chronic condition. Inmates were also asked about specific 

chronic conditions. The 2011–12 National Inmate Survey 

(NIS-3) included a more restricted measure of ever had or 

currently having a chronic condition. In the NIS-3, inmates 

were asked if a doctor, nurse, or other health care provider 

ever told them that they had a certain chronic condition 

and, if a doctor, nurse, or health care provider told them that 

they currently had the chronic condition. Although the NIS-3 

collected a more conservative measure, prevalence estimates 

of some common chronic conditions were higher in 2011–12 

than 2002 and 2004, indicating true increases have occurred 

over time.

Between 2004 and 2011–12, rates of high blood pressure 

and diabetes rose among prisoners (figure 2). The rate of 

diabetes in 2011–12 (899 per 10,000 prisoners) was almost 

twice the rate in 2004 (483 per 10,000). The rate of high blood 

pressure (3,020 per 10,000 prisoners) was almost 1.5 times the 

rate in 2004 (2,093 per 10,000). Similar rates were observed 

for asthma, arthritis, and heart-related problems. Although 

data suggest stability in these rates, caution should be taken 

when interpreting data, as the methodology was updated for 

2011–12.

0

500

1,000

1,500

2,000

2,500

3,000

3,500

Heart-related 

problems

Arthritis/

rheumatism

Diabetes/ Asthma

high blood 

sugar*

High blood 

pressure/

hypertension*

Rate per 10,000 prisoners

2004

2011–12

Figure 2

Rate of ever having a chronic condition among state and 

federal prisoners, 2004 and 2011–12

Note: See appendix table 9 for standard errors. 

*Differences between years are significant at the 95% confidence level. 

Source: Bureau of Justice Statistics, National Inmate Survey, 2011–12; and 

Survey of Inmates in State and Federal Correctional Facilities, 2004.

Continued on next page
MEDICAL PROBLEMS OF STATE AND FEDERAL PRISONERS AND JAIL INMATES, 2011–12 | FEBRUARY 2015 7

Similar trends were observed among jail inmates (figure 3). 

The 2011–12 rate of jail inmates who reported ever having 

diabetes (723 per 10,000 jail inmates) was twice the 2002 

rate (361 per 10,000), and the rate of high blood pressure in 

2011–12 was almost 1.5 times higher than the rate in 2002. 

The rate of asthma also rose between 2002 and 2011–12, from 

1,502 per 10,000 jail inmates to 2,012 per 10,000. Although 

data suggest that the rates of arthritis and heart-related 

problems among jail inmates were relatively stable, caution 

should be taken when interpreting data, as the methodology 

was updated for 2011–12.

Rate of HIV or AIDS in state and federal prisons 

continued to decline

Based on data from administrative records reported through 

BJS’s National Prisoner Statistics (NPS-1) data collection, 

18,945 state and federal prisoners were infected with HIV 

or had confirmed AIDS in 2012—down from 19,536 in 2011 

(appendix table 1). Between 2011 and 2012, the estimated 

rate of HIV or AIDS declined from 145 per 10,000 prisoners 

to 143 per 10,000. This decline is consistent with declines 

observed over the previous decades (figure 4).

0

500

1,000

1,500

2,000

2,500

3,000

Heart-related 

problems

Arthritis/

rheumatism

Diabetes/ Asthma*

high blood 

sugar*

High blood 

pressure/

hypertension*

Rate per 10,000 jail inmates

2002

2011–12

Figure 3

Rate of ever having a chronic condition among jail 

inmates, 2002 and 2011–12

Note: See appendix table 10 for standard errors. For comparability to the 

2011–12 rates, jail inmates age 17 or younger were excluded when calculating 

2002 rates of ever having each specific chronic condition.

*Differences between years are significant at the 95% confidence level.

Source: Bureau of Justice Statistics, National Inmate Survey, 2011–12; and 

Survey of Inmates in Local Jails, 2002.

Rate per 10,000 prisoners

0

50

100

150

200

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Figure 4

Rate of HIV or AIDS cases among state and federal 

prisoners, 2001–2012

Source: Bureau of Justice Statistics, National Prisoner Statistics Program, 

2001–2012.

Rates of high blood pressure and diabetes increased among prisoners and jail 

inmates (continued)
MEDICAL PROBLEMS OF STATE AND FEDERAL PRISONERS AND JAIL INMATES, 2011–12 | FEBRUARY 2015 8

24% of prisoners and jail inmates reported at least two 

chronic conditions

In 2012, nearly a quarter (24%) of both prisoners and jail 

inmates reported ever having multiple chronic conditions 

(table 4). About 7% of prisoners and 4% of jail inmates 

reported high blood pressure and diabetes—two chronic 

conditions that are risk factors for cardiovascular disease. 

About 12% of prisoners and 9% of jail inmates reported 

ever having a chronic condition and an infectious disease. 

Among prisoners and jail inmates who reported ever having 

hepatitis B, about 15% reported ever having cirrhosis of the 

liver. About 11% of those in both populations who ever had 

hepatitis C reported that they had cirrhosis of the liver.

Table 4

Prevalence of ever having multiple chronic conditions and 

infectious diseases among state and federal prisoners and 

jail inmates, 2011–12

State and federal 

prisoners* Jail inmates

Chronic condition/ infectious 

disease Percent

Standard 

error Percent

Standard 

error

Chronic conditions

Multiple chronic conditions 24.2% 1.3% 24.3% 1.2%

Hypertension and diabetes 6.6 0.7 4.4** 0.5

Infectious diseasesa

Multiple infectious diseases 4.1% 0.5% 2.2%** 0.3%

Chronic conditions and 

infectious diseases

Both a chronic condition 

 and infectious disease 12.3% 0.9% 9.1%** 0.6%

Among those who had

 Hepatitis B–

Had cirrhosis of the liver 14.6 2.8 15.2 4.8

Among those who had 

 Hepatitis C–

Had cirrhosis of the liver 11.3 4.8 11.0 4.6

Note: The jail population was not standardized to match the prison population. 

Therefore, differences observed may be due to differences in prison and jail 

population by sex, age, race, and Hispanic origin.

*Comparison group.

**Difference with comparison group is significant at the 95% confidence level.

aIncludes tuberculosis, hepatitis B, hepatitis C, and STDs. Excludes HIV or AIDS 

due to unknown or missing data.

Source: Bureau of Justice Statistics, National Inmate Survey, 2011–12.

Majority of prisoners and jail inmates were either overweight, obese, or 

morbidly obese2

In 2011–12, nearly three-quarters of prisoners were either 

overweight (46%), obese (26%), or morbidly obese (2%), with 

about a quarter of prisoners being either normal weight 

(26%) or underweight (1%) (table 5). Measures of overweight, 

obese, and morbidly obese were calculated using the body 

mass index (see Methodology). Female prisoners (35%) were 

less likely than males (47%) to be overweight. However, female 

(43%) prisoners were more likely than males (27%) to be either 

obese or morbidly obese (appendix table 2). Prisoners ages 

18 to 24 were less likely than all other age groups to be obese. 

About 14% of prisoners ages 18 to 24 were obese, compared 

to 20% of those ages 25 to 34, 33% of those ages 35 to 49, and 

25% of those age 50 or older. Black prisoners (29%) were more 

likely than white prisoners (23%) to be obese.

In 2011–12, more than 6 in 10 jail inmates were either 

overweight (39%), obese (20%), or morbidly obese (2%), while 

about 4 in 10 jail inmates were either normal weight (37%) or 

underweight (1%). Female (32%) jail inmates were less likely 

than males (40%) to be overweight. However, female (37%) jail 

inmates were more likely than males (20%) to be either obese 

or morbidly obese (appendix table 3). Similar to prisoners, 

jail inmates ages 18 to 24 were less likely than all other age 

groups to be obese. About 13% of jail inmates ages 18 to 24 

were obese, compared to 19% of those ages 25 to 34, 27% of 

those ages 35 to 49, and 22% of those age 50 or older. About 

44% of Hispanic jail inmates reported being overweight—the 

highest percentage among all racial or ethnic categories. 

About 1 in 5 jail inmates in each racial category was obese. 

Black jail inmates (3%) were more likely than white jail inmates 

(1%) to be morbidly obese.

Table 5

Body mass index of state and federal prisoners and local 

jail inmates, 2011–12

Body mass index State and federal prisoners Jail inmates

Total 100% 100%

Normal/underweight 26.4 38.4

Overweight 45.7 39.3

Obese 25.5 20.0

Morbidly obese 2.4 2.3

Source: Bureau of Justice Statistics, National Inmate Survey, 2011–12.

2This finding is consistent with the general population of adults age 20 

or older (Health, United States, 2013, Centers for Disease Control and 

Prevention).
MEDICAL PROBLEMS OF STATE AND FEDERAL PRISONERS AND JAIL INMATES, 2011–12 | FEBRUARY 2015 9

Most prisoners and jail inmates received medical 

assessments or exams since admission

Prisoners were more likely than jail inmates to report 

being assessed and questioned about medical issues at 

time of admission; to have seen a doctor, nurse, or health 

care professional for any medical reason; or to have been 

tested for infectious diseases (table 6). An estimated 85% 

of prisoners were questioned by staff about their health or 

medical history, compared to 82% of jail inmates. About 

two-thirds of prisoners (64%) and half (50%) of jail inmates 

reported being assessed by staff to see if they were sick, 

injured, or intoxicated.

An estimated 80% of prisoners and 47% of jail inmates 

reported seeing a health care professional for a medical 

reason since admission. Prisoners (71%) were about 

6.5 times more likely than jail inmates (11%) to be tested for 

HIV. Among prisoners, 57% were tested for hepatitis B and 

54% were tested for hepatitis C, compared to 6% for both 

among jail inmates. Almost all prisoners (94%) reported 

being tested for tuberculosis since admission, compared to 

about half (54%) of jail inmates.

About a third of jurisdictions reported testing all inmates on entry

In 2012, as part of the prison intake process, 17 jurisdictions 

reported that they test all inmates for HIV, 11 reported that 

they offer opt-out HIV testing (i.e., all inmates are offered the 

test, and the test is given unless the inmate declines the test), 

and 10 reported opt-in HIV testing (i.e., all inmates are offered 

the test, and the test is given if the inmate wants to be tested). 

The remaining jurisdictions either had some other practice for 

testing, did not test, or did not report the testing practice in 

their jurisdiction (appendix table 4).

Thirty-two percent of prisoners were held in the jurisdictions 

that reported testing all inmates for HIV, 26% were held in the 

jurisdictions reporting opt-out testing, and 15% were held in 

the jurisdictions that reported opt-in testing. The remaining 

quarter of prisoners were held in jurisdictions that either 

reported other testing circumstances or did not report their 

testing practices.

Among the 10 jurisdictions offering opt-in testing, consent 

specifically for HIV testing was obtained in 9 jurisdictions, 

and general consent for medical services was obtained in 

1 jurisdiction. For jurisdictions with opt-out testing, type of 

consent for testing was not consistent. Three jurisdictions 

obtained consent specifically for HIV testing, six jurisdictions 

obtained consent for medical services, one jurisdiction did not 

obtain any consent, and one jurisdiction did not report type 

of consent.

In 2012, the majority of jurisdictions reported testing inmates 

in custody who requested an HIV test (42), if there was clinical 

indication (39), who were involved in an incident (34), and 

who were under court order (32) (appendix table 5). Twenty 

jurisdictions reported offering HIV testing during routine 

medical exams, and 19 offered testing to high-risk inmates.

On discharge, most jurisdictions (24) provided inmates with 

an HIV test, if requested (appendix table 6). Seven jurisdictions 

offered an HIV test to all inmates being released, three offered 

an HIV test to some inmates, and six reported that they did 

not provide HIV testing on discharge.

Table 6

Health care services and medical tests received by state and federal prisoners and jail inmates while incarcerated, 2011–12

State and federal prisoners* Jail inmates

Health care services provided Percent Standard error Percent Standard error

At time of admission

Assessed by staff for sickness, injury, or intoxication 63.6% 1.2% 49.4%** 1.6%

Questioned by staff about health or medical history 85.0 1.0 81.8** 1.1

Since admission

Seen a doctor, nurse, or other health care professional for any reason 79.9% 1.2% 46.5%** 1.3%

Tested for—

HIV 71.4 1.4 10.8** 0.8

Tuberculosis 93.6 0.7 53.9** 2.5

Hepatitis B 57.4 1.6 6.0** 0.6

Hepatitis C 54.4 1.7 5.7** 0.5

STDsa 32.6 1.2 5.4** 0.5

Note: The jail population was not standardized to match the prison population. Therefore, differences observed may be due to differences in prison and jail population 

by sex, age, race, and Hispanic origin.

*Comparison group.

**Difference with comparison group is significant at the 95% confidence level.

aExcludes HIV or AIDS.

Source: Bureau of Justice Statistics, National Inmate Survey, 2011–12.
MEDICAL PROBLEMS OF STATE AND FEDERAL PRISONERS AND JAIL INMATES, 2011–12 | FEBRUARY 2015 10

Among prisoners and jail inmates who reported ever 

having a chronic condition, about three-quarters 

reported having a chronic condition at admission

Among those who reported ever having a chronic condition, 

73% of prisoners and 77% of jail inmates reported that they 

had a condition at admission (figure 5). Both prisoners and 

jail inmates were more likely to report a chronic condition 

at admission than since admission. Among those who 

reported ever having a chronic condition, about a quarter 

(27%) of prisoners and a tenth (8%) of jail inmates did not 

report a chronic condition at admission, but were told that 

they had the condition since admission. Prisoners and jail 

inmates who had a chronic condition at admission were 

equally likely to report taking prescription medication or 

receiving some other type of treatment in the 30 days prior 

to admission (table 7). In both populations, about 6 in 10 

reported taking prescription medication and more than 3 in 

10 reported receiving some other type of treatment.

Table 7

Prevalence of prescription medication use and other treatment among prisoners and jail inmates with a current chronic 

condition or infectious disease, 2011–12

State and federal prisoners* Jail inmates

Health care services provided Percent Standard error Percent Standard error

Chronic condition at admissiona

In 30 days prior to admission—

Taking prescription medication 60.9% 2.5% 58.8% 2.1%

Receiving medical treatment other than prescription medication 34.4 1.9 32.6 1.6

Current chronic conditiona

Currently taking prescription medication 66.1% 2.3% 39.8%** 1.8%

Reasons for not taking prescription medicationb

Inmate had not seen a doctor 20.0 1.7 38.7** 2.2

Inmate did not like taking medication 10.9 1.2 16.0** 1.6

Doctor did not think it was necessary or facility would not provide it 36.3 2.3 36.3 1.6

Inmate did not think medication was necessary 19.4 1.8 30.5** 1.8

Other 35.0 2.4 50.9** 2.0

Currently receiving medical treatment other than prescription medication 19.9 1.7 13.8** 1.4

HIV-positive inmates

Taking prescription medication 84.0% 8.6% 65.9% 9.6%

Note: The jail population was not standardized to match the prison population. Therefore, differences observed may be due to differences in prison and jail population 

by sex, age, race, and Hispanic origin.

*Comparison group.

**Difference with comparison group is significant at the 95% confidence level.

aIncludes cancer, high blood pressure or hypertension, stroke-related problems, diabetes or high blood sugar, heart-related problems, kidney-related problems, arthritis 

or rheumatism, asthma, and cirrhosis of the liver.

bDetail does not sum to 100% because inmates could select more than one reason.

Source: Bureau of Justice Statistics, National Inmate Survey, 2011–12.

Percent

0

25

50

75

100

Prisoners Jail inmates

Chronic condition 

reported at admission

Chronic condition 

reported since 

admission

Figure 5

Prevalence of any chronic condition at admission and 

since admission among state and federal prisoners and jail 

inmates who reported ever having a condition, 2011–12

Note: An inmate may have reported ever having multiple conditions. As a result, 

one inmate may be in both categories because one condition may have been 

reported at admission and another condition could have been reported since 

admission. 

Source: Bureau of Justice Statistics, National Inmate Survey, 2011–12.
MEDICAL PROBLEMS OF STATE AND FEDERAL PRISONERS AND JAIL INMATES, 2011–12 | FEBRUARY 2015 11

66% of prisoners and 40% of jail inmates with a 

current chronic condition reported taking prescription 

medication

In 2011–12, about 4 in 10 prisoners (41%) and jail inmates 

(40%) reported having a current chronic condition 

(appendix table 7). Among prisoners with a current chronic 

condition, 66% reported that they were taking prescription 

medication, and 20% said they were receiving some other 

type of medical treatment. Although inmates could report 

multiple reasons for not taking prescription medication, 

prisoners most commonly cited reasons related to lack 

of health services or doctor’s provision of a prescription. 

More than a third (36%) of prisoners who were not taking 

prescription medication said that the doctor did not think 

medication was necessary or that the facility would not 

provide the medication, while about 20% reported that they 

had not seen a doctor. About 19% of prisoners reported that 

they did not think the medication was necessary, and about 

11% reported that they did not like taking the medication. 

Among prisoners who were HIV positive, 84% reported 

taking prescription medication.

Jail inmates who reported having a current chronic 

condition were less likely than prisoners to report taking 

prescription medication or receiving some other type 

of medical treatment. About 40% of jail inmates with a 

current chronic condition reported that they were receiving 

prescription medication, and 14% reported receiving some 

other type of medical treatment. More than a third (39%) of 

jail inmates who were not taking prescription medication 

reported that they had not seen a doctor and 36% said the 

doctor did not think medication was necessary or the facility 

would not provide the medication. Nearly a third (31%) of 

jail inmates said that they did not think the medication was 

necessary, and 16% reported that they did not like taking 

the medication. Among jail inmates who were HIV positive, 

66% reported taking prescription medication.

More than half of prisoners and jail inmates reported 

being somewhat or very satisfied with health care 

services received since admission

In 2011–12, 13% of prisoners were very satisfied with the 

health services received since admission and 44% were 

somewhat satisfied (table 8). Among jail inmates, 14% 

were very satisfied with the health services received since 

admission and 37% were somewhat satisfied. Jail inmates 

(49%) were more likely than prisoners (44%) to report 

not being satisfied with the health care services received 

since admission.

Nearly half (48%) of prisoners and 43% of jail inmates 

reported that the health care received while incarcerated was 

better than or about the same as the care they received in the 

12 months prior to admission.

Table 8

Satisfaction with health care services received by state and federal prisoners and jail inmates, 2011–12

State and federal prisoners* Jail inmates

Health care services provided Percent Standard error Percent Standard error

Since admission

Very satisfied 12.6% 0.9% 14.3% 0.8%

Somewhat satisfied 43.8 1.4 36.9** 1.4

Not at all satisfied 43.6 1.6 48.8** 1.5

Compared to those received 12 months 

 prior to admission

Better 12.4% 1.0% 11.0% 0.7%

About the same 35.8 1.6 32.0 1.1

Worse 51.8 1.8 57.0** 1.3

Note: The jail population was not standardized to match the prison population. Therefore, differences observed may be due to differences in prison and jail population 

by sex, age, race, and Hispanic origin.

*Comparison group.

**Difference with comparison group is significant at the 95%-confidence level.

Source: Bureau of Justice Statistics, National Inmate Survey, 2011–12.
MEDICAL PROBLEMS OF STATE AND FEDERAL PRISONERS AND JAIL INMATES, 2011–12 | FEBRUARY 2015 12

Methodology

National Inmate Survey

The 2011–12 National Inmate Survey (NIS-3) was conducted 

in 233 state and federal prisons, 358 local jails, and 15 special 

facilities (i.e., military facilities, Indian country jails, and 

Immigration and Customs Enforcement (ICE) facilities) 

between February 2011 and May 2012. Data were collected 

by RTI International under a cooperative agreement with the 

Bureau of Justice Statistics (BJS).

The NIS-3 administered two questionnaires to inmates—a 

survey about sexual victimization and a survey about 

mental and physical health, past drug and alcohol use, and 

treatment for substance abuse. Inmates were randomly 

assigned to receive one of two questionnaires to ensure that 

the content of the survey remained unknown to facility staff 

and the interviewers at the time of the interview.

A total of 106,532 inmates participated in the NIS-3, 

receiving either the sexual victimization survey or the 

randomly assigned companion survey. Combined, the 

surveys were administered to 43,721 inmates in state and 

federal prisons, 61,351 inmates in jails, 605 inmates in 

military facilities, 192 inmates in Indian country jails, and 

663 inmates in ICE facilities.

The interviews, which averaged 35 minutes in length, 

used computer-assisted personal interviewing (CAPI) and 

audio computer-assisted self-interviewing (ACASI) data 

collection methods. For approximately the first 2 minutes, 

interviewers conducted a personal interview using CAPI 

to obtain background information and date of admission 

to the facility. For the remainder of the interview, inmates 

interacted with a computer-administered questionnaire 

using a touchscreen and synchronized audio instructions 

delivered via headphones. Respondents completed the 

ACASI portion of the interview in private, with the 

interviewer either leaving the room or moving away from 

the computer.

A shorter paper questionnaire was made available for 

inmates who were unable to come to the private interviewing 

room or interact with the computer. The paper form was 

completed by 751 state and federal prisoners (1.9% of all 

prisoner interviews) and 264 jail inmates (0.5% of all jail 

inmate interviews). Inmates who completed the paper form 

were not asked about their physical health, mental health, 

past drug and alcohol use, or treatment for substance abuse.

Additional information on the methodology for sample 

selection of facilities and inmates can be found in the report, 

Sexual Victimization in Prisons and Jails Reported by Inmates, 

2011–12 (NCJ 241399, BJS web, May 2013).

In this report, the analysis of the physical health module was 

restricted to adult inmates in prisons or jails. Therefore, this 

report excludes juvenile inmates ages 16 or 17 and inmates 

in military facilities, Indian country jails, or ICE facilities. 

Administration of the physical health module

The physical health module was administered to 

participating inmates in the NIS-3 for one of two reasons—

1. to ensure the sexual victimization survey length was 

similar for all participating inmates

2. as part of the alternative survey on mental and physical 

health, past drug and alcohol use, and treatment for 

substance abuse.

Among inmates who received the sexual victimization 

survey (90% of inmates surveyed), a brief physical health 

module was randomly assigned to half of the inmates 

who participated. Among those inmates, respondents 

who completed the core sexual victimization survey 

in 33 minutes or less received the brief physical health 

module. Based on the time criteria, 11,671 state and federal 

prisoners (67% of the prisoners who would have been 

randomly assigned the brief physical health module) and 

17,130 jail inmates (69% of the jail inmates who would have 

been randomly assigned the brief physical health module) 

completed the brief physical health module.

Among inmates who received the alternative survey on 

mental and physical health, past drug and alcohol use, and 

treatment for substance abuse (10% of inmates surveyed), 

the full physical health module was administered to those 

who completed the mental health and disabilities modules 

in 30 minutes or less. Of the 4,304 inmates randomized to 

the alternative survey, 3,833 (89%) inmates received and 

completed the full physical health module. Among the 

6,704 jail inmates randomized to the alternative survey, 

5,494 inmates (90%) received and completed the full 

physical health module.

The module on physical health, which was administered 

through ACASI, relied on inmates reporting their direct 

experiences. The brief physical health module asked the 

inmate about the types of medical services received at 

the time of admission and about any medical conditions 

(i.e., chronic diseases and infectious diseases) the inmate 

ever had, had at the time of admission, and had developed 

since admission. The full physical health module asked the 

same questions contained in the brief physical module, plus 

additional items on the types of services and treatments 

received by inmates with a medical condition and when 

those services and treatments were received. The entire 

ACASI questionnaire (listed as the National Inmate 

Survey-3) is available on the BJS website.
MEDICAL PROBLEMS OF STATE AND FEDERAL PRISONERS AND JAIL INMATES, 2011–12 | FEBRUARY 2015 13

Nonresponse bias analysis to assess feasibility of using 

the 90% or 10% sample in the NIS-3

To produce reliable national-level statistics, a nonresponse 

bias analysis was needed to assess the feasibility of using 

data in the physical health module from the sexual 

victimization survey (90% sample) and the alternative 

survey (10% sample). Bias arises when subjects with 

characteristics associated with the outcome of interest are 

either overrepresented or underrepresented, resulting in the 

estimated prevalence of an outcome being different from the 

actual prevalence of the outcome. Because not everybody 

responded to the physical health module, it might be that 

respondents differ from nonrespondents in significant ways. 

Because the time to complete earlier modules in the survey 

was a major factor in determining whether the respondent 

was administered the physical health module, those who did 

not receive the physical health module may be different than 

those who did. The time requirements may have biased the 

physical health estimates, making them no longer nationally 

representative of all inmates.

To assess the potential bias in both the sexual victimization 

survey (90%) and alternative survey (10%) administered in 

the NIS-3, a nonresponse bias analysis was conducted for 

those who received the physical health module and those 

who did not. For the sexual victimization survey, differences 

in response status to the physical health module were 

assessed by whether or not an inmate had been sexually 

victimized, language of the interview (i.e., English or 

Spanish), whether or not an inmate reported a mental health 

problem and the interaction of victimization and mental 

health status. For the alternative survey, differences in 

response status to the physical health module were assessed 

by language of the interview (i.e., English or Spanish), 

whether an inmate reported a mental health problem, 

and the interaction of language of interview and mental 

health status.

Key findings from the nonresponse bias analysis for 

respondents to the sexual victimization survey include—

 For both prisons and jails, inmates who reported a sexual 

victimization were significantly less likely than inmates 

who did not report a sexual victimization to receive and 

complete the brief physical health module (p-value less 

than 0.0001 for prisoners and jail inmates).

 For both prisons and jails, inmates who responded to the 

survey in Spanish were significantly less likely than those 

who responded in English to receive and complete the 

brief physical health module (p-value less than 0.0001 for 

prisoners and jail inmates).

 For both prisons and jails, inmates who reported a mental 

health condition were significantly less likely than those 

who did not report a mental health condition to receive 

and complete the brief physical health module (p-value 

less than 0.0001 for prisoners and jail inmates).

 Among prisoners and jail inmates who reported a sexual 

victimization, inmates who reported a mental health 

condition were significantly less likely than inmates who 

did not report a mental health condition to receive and 

complete the brief physical health module (p-value less 

than 0.0001 for prisoners and jail inmates).

 Among prisoners, 1.5% (177 of 11,671 respondents) 

reported a sexual victimization, reported a mental health 

condition, and received and completed the brief physical 

health module.

 Among jail inmates, 1.1% (190 of 17,130 respondents) 

reported a sexual victimization, reported a mental health 

condition, and received and completed the brief physical 

health module.

Key findings from the nonresponse bias analysis for 

respondents to the alternative survey include—

 For both prisons and jails, inmates who reported a 

mental health condition were significantly less likely than 

inmates who did not report a mental health condition 

to receive and complete the full physical health module 

(p-value less than 0.0001 for prisoners and jail inmates). 

However, among those with a mental health condition, 

92.0% of prisoners and 86.5% of jail inmates received and 

completed the physical health module.

 In prisons, 225 inmates (5.2% of respondents) responded 

to the alternative survey in Spanish.

 In jails, 321 inmates (5.3% of respondents) responded to 

the alternative survey in Spanish.

 Among prisoners and jail inmates who responded in 

Spanish, inmates who reported a mental health condition 

were not significantly less likely than inmates who did not 

report a mental health condition to receive and complete 

the full physical health module (p-values of 0.3989 and 

0.0678 for prisoners and jail inmates).

For the alternative survey, based on the results of the 

nonresponse bias analyses, it was determined that a weight 

adjustment could properly correct for potential bias among 

respondents to the full physical health module. However, 

based on the results of the nonresponse bias analyses for the 

sexual victimization survey, it was determined that a weight 

adjustment might not fully compensate for the potential 

bias among those who responded to the brief physical 

health module. Therefore, the analyses of the physical 

health data were restricted to inmates who completed the 

alternative survey.
MEDICAL PROBLEMS OF STATE AND FEDERAL PRISONERS AND JAIL INMATES, 2011–12 | FEBRUARY 2015 14

Weighting and nonresponse adjustments

Responses from interviewed inmates were weighted to 

produce national-level estimates. Each interviewed inmate 

was assigned an initial weight corresponding to the inverse 

of the probability of selection within each sampled facility. 

A series of adjustment factors was applied to the initial 

weight to minimize potential bias due to nonresponse and 

to provide national estimates. For the analysis of the physical 

health module, these adjustments were one of two types:

1. adjustments to account for survey nonresponse

2. adjustments to account for module nonresponse due to 

time constraints.

Methods to adjust for survey nonresponse are detailed 

in the report, Sexual Victimization in Prisons and Jails 

Reported by Inmates, 2011–12 (NCJ 241399, BJS web, 

May 2013). Once adjusted weights were developed to 

account for survey nonresponse, an additional weighting 

adjustment was conducted to account for the potential 

bias induced by nonresponse due to time constraints. Bias 

could result if the module nonrespondents were different 

from the module respondents. The adjustment for module 

nonresponse included a calibration of the weights to 

ensure that the weight from a nonresponding inmate was 

assigned to a responding inmate with similar characteristics. 

Because both respondents and nonrespondents to the 

physical health module completed part of the alternative 

survey, the adjustment used data from modules that both 

groups completed. These data included demographic, 

criminal history, mental health, and interview debriefing 

characteristics. This adjustment ensured that the estimates 

accurately reflected the full sample, rather than only the 

inmates who responded to the physical health module. For 

each inmate, these adjustments were based on a generalized 

exponential model, developed by Folsom and Singh (2002), 

and applied to the sexual victimization survey respondents.3

The module nonresponse adjustment maintained the 

benchmark totals designed to make national-level estimates 

for the total number of inmates age 18 or older who were 

held in jails at midyear 2011 or in prisons at yearend 2011. 

These benchmark totals represented the estimated number 

of inmates by sex (from BJS’s 2011 Annual Survey of 

Jails and 2011 National Prisoner Statistics). The national 

estimates for state prisons were 1,154,600 adult males and 

83,400 adult females; for federal prisons, 190,600 adult males 

and 13,200 adult females; and for jails (with an average daily 

population of 6 or more inmates), 628,620 adult males and 

91,551 adult females.

Standard errors and tests of significance

As with any survey, the NIS-3 estimates are subject to 

error arising from sampling rather than using a complete 

enumeration of the population of adult inmates in prisons 

and jails. For each physical health outcome, the estimated 

sampling error varies by the size of the estimate, the number 

of completed interviews, and the intra-cluster correlation of 

the outcome within facilities.

A common way to express this sampling variability is to 

construct a 95% confidence interval around each survey 

estimate. Typically, multiplying the standard error by 1.96 

and then adding or subtracting the result from the estimate 

produces the confidence interval. This interval expresses the 

range of values that could result among 95% of the different 

samples that could be drawn.

Chronic conditions and infectious disease in the 

general population

Prevalence rates of chronic conditions and infectious 

diseases in the general population included in this report 

come from the National Survey on Drug Use and Health 

(NSDUH). To be most comparable to the inmate population 

included in the NIS-3, the survey years from 2009 to 

2012 of NSDUH were used in this analysis. Statistical 

tests comparing the prevalence of chronic conditions and 

infectious diseases measured in the NIS-3 and NSDUH are 

presented in tables 1 and 2. NSDUH collects information 

on six chronic conditions (i.e., high blood pressure, strokerelated problems, diabetes, heart disease, asthma, and 

cirrhosis of the liver) and four infectious diseases (i.e., HIV 

or AIDS, tuberculosis, hepatitis, and STDs). 

Because the demographic makeup of the general population 

is different than that of the inmate population (i.e., the 

general population is older, more white, and more female), 

general population rates were standardized to the inmate 

population (i.e., the prison population for table 1 and the 

jail population for table 2) to assess the differences between 

comparable populations. Standardization calibrates the 

weights of one of the populations to the distribution 

of the other based on a set of specified characteristics. 

Standardized estimates were computed in SUDAAN using 

its standardization options in PROC DESCRIPT. For this 

analysis, the general population was standardized to inmate 

population based on sex, age, race, and Hispanic origin. The 

standardized general population estimates for disease can 

be interpreted as the estimate of disease among the general 

population, if the general population had the same sex, age, 

race, and Hispanic origin distribution as the prisoner and 

jail inmate populations. 3Folsom, Jr., R.E. & Singh, A.C. (2000). The Generalized Exponential Model 

for Sampling Weight Calibration for Extreme Values, Nonresponse, and 

Poststratification. Proceedings of the American Statistical Association, Survey 

Research Methods Section, pp. 598–603.
MEDICAL PROBLEMS OF STATE AND FEDERAL PRISONERS AND JAIL INMATES, 2011–12 | FEBRUARY 2015 15

Calculation of body mass index (BMI)

BMI is a measurement of body fat, based on height and 

weight, that applies to both men and women ages 18 to 65. 

BMI can be used to determine if a person is underweight 

(18.5 or less), normal weight (18.5 to 24.9), overweight 

(25.0 to 29.9), obese (30.0 to 39.9), or morbidly obese (40 or 

greater). In the NIS-3, BMI was based on the following 

formula provided by the Centers for Disease Control 

and Prevention:

BMI = weight (pounds) / (height (inches))2 x 703.
MEDICAL PROBLEMS OF STATE AND FEDERAL PRISONERS AND JAIL INMATES, 2011–12 

| FEBRUARY 2015 16

Appendix table 1

State and federal prisoners with HIV or AIDS, by jurisdiction, 

yearend 2010, 2011, and 2012

Jurisdiction 2010 2011 2012

U.S. total 20,093 19,536 18,945*

Federal 1,578 1,610 1,601

State 18,515 17,926 17,344*

Alabama 252 274 266

Alaska ///

Arizona 164 165 181

Arkansas 128 110 105

California 1,098 1,165 1,089

Colorado 181 198 201

Connecticut 301 301 249

Delaware 73 76 81

Florida 2,920 2,679 2,583

Georgia 912 903 891

Hawaii 18 21 13

Idaho 20/ 14

Illinois 487 457/

Indiana///

Iowa 36 37 37

Kansas 33 615

Kentucky 87 62 91

Louisiana 665 536 532

Maine 153 11

Maryland 722 572 485

Massachusetts 206 208 186

Michigan 233 428 370

Minnesota 47 50 70

Mississippi 254 255 287

Missouri 273 292 295

Montana7 18 11

Nebraska 20 20 22

Nevada 133 123 115

New Hampshire 1245

New Jersey 420 372 303

New Mexico 27 37 29

New York 3,080 3,010 2,950

North Carolina 720 692 718

North Dakota912

Ohio 381 376 405

Oklahoma 155 137 131

Oregon 63 60 63

Pennsylvania 703 706 695

Rhode Island 47 32 35

South Carolina 412 387 328

South Dakota 11 12 11

Tennessee 219 213 226

Texas 2,394 2,320 2,200

Utah 35 24 24

Vermont376

Virginia 306 307 279

Washington 75 71 75

West Virginia 25 18 29

Wisconsin 128 120 135

Wyoming562

Note: Excludes inmates in jurisdictions that did not report data on HIV or AIDS. 

*U.S. and state totals include an estimated number of prisoners with HIV or AIDS in Illinois.

/Not reported.

Source: Bureau of Justice Statistics, National Prisoner Statistics Program, 2010, 2011, and 2012.
MEDICAL PROBLEMS OF STATE AND FEDERAL PRISONERS AND JAIL INMATES, 2011–12 | FEBRUARY 2015 17

Appendix table 2

Body mass index of prisoners, by demographic characteristics, 2011–12

Underweight Normal Overweight Obese Morbidly obese

Demographic characteristic Percent

Standard 

error Percent

Standard 

error Percent

Standard 

error Percent

Standard 

error Percent

Standard 

error

All inmates 0.8% 0.3% 25.6% 1.1% 45.7% 1.1% 25.5% 1.0% 2.4% 0.4%

Sex

Male* 0.8% 0.3% 25.8% 1.1% 46.5% 1.2% 24.7% 1.0% 2.2% 0.5%

Female 1.0 0.7 21.6** 1.7 34.7** 2.2 37.2** 2.9 5.6** 1.1

Age

18–24* 1.4% 0.6% 42.2% 3.1% 41.2% 2.7% 14.2% 2.1% 1.1% 0.8%

25–34 0.3 0.2 29.7** 2.6 47.3 2.5 20.3** 1.7 2.3 1.1

35–49 1.3 0.6 18.9** 1.5 43.6 1.6 33.3** 2.3 3.0** 0.5

50 or older 0.5 0.2 21.6** 2.5 50.7** 3.2 25.3** 2.2 1.9 0.7

Race/Hispanic origina

White 0.3% 0.1% 28.0% 1.8% 47.2% 1.8% 22.6%** 1.7% 1.9% 0.5%

Black/African American* 1.3 0.5 25.2 1.9 42.7 2.1 28.7 1.5 2.1 0.5

Hispanic/Latino 1.0 0.7 22.0 1.9 47.4 3.8 26.4 2.8 3.3 1.4

Otherb 0.7 0.4 27.6 3.6 47.0 4.3 23.1 4.1 1.7 0.6

*Comparison group.

**Difference with comparison group is significant at the 95% confidence level.

aExcludes persons of Hispanic or Latino origin, unless specified.

bIncludes persons identified as American Indian or Alaska Native; Asian, Native Hawaiian, or other Pacific Islander; and two or more races.

Source: Bureau of Justice Statistics, National Inmate Survey, 2011–12.

Appendix table 3

Body mass index of jail inmates, by demographic characteristics, 2011–12

Underweight Normal Overweight Obese Morbidly obese

Demographic characteristic Percent

Standard 

error Percent

Standard 

error Percent

Standard 

error Percent

Standard 

error Percent

Standard 

error

All inmates 1.2% 0.2% 37.2% 1.2% 39.3% 1.1% 20.0% 0.9% 2.3% 0.3%

Sex

Male* 1.2% 0.2% 38.3% 1.3% 40.3% 1.1% 18.8% 1.0% 1.4% 0.2%

Female 1.8 0.7 29.7** 2.6 31.8** 2.7 28.6** 2.6 8.0** 2.3

Age

18–24* 1.0% 0.4% 52.9% 2.0% 32.1% 2.1% 13.2% 1.4% 0.8% 0.2%

25–34 1.3 0.5 34.9** 1.6 42.3** 2.1 18.6** 1.6 3.0** 0.9

35–49 0.9 0.3 27.5** 2.1 41.7** 2.1 27.1** 1.9 2.9** 0.5

50 or older 3.1 1.1 33.5** 3.1 39.6 3.4 22.2** 3.4 1.6 0.6

Race/Hispanic origina

White 1.0% 0.3% 40.3% 2.0% 38.7% 2.0% 18.7% 1.7% 1.3%** 0.3%

Black/African American* 1.2 0.4 38.1 1.9 36.6 1.9 21.4 1.5 2.7 0.5

Hispanic/Latino 1.7 0.8 30.7** 2.0 44.2** 2.2 20.5 2.0 2.9 0.6

Otherb 1.3 0.6 35.7 3.5 39.0 3.5 20.4 3.3 3.6 2.3

*Comparison group.

**Difference with comparison group is significant at the 95% confidence level.

aExcludes persons of Hispanic or Latino origin, unless specified.

bIncludes persons identified as American Indian or Alaska Native; Asian, Native Hawaiian, or other Pacific Islander; and two or more races.

Source: Bureau of Justice Statistics, National Inmate Survey, 2011–12.
MEDICAL PROBLEMS OF STATE AND FEDERAL PRISONERS AND JAIL INMATES, 2011–12 | FEBRUARY 2015 18

Appendix table 4

HIV testing practices and consent received for state and federal prisoners during the intake process, by jurisdiction, 2012

Testing practices Consent obtained

Jurisdiction Mandatory Opt-out Opt-in

On 

assessment

On inmate 

request Other

Do not 

provide General HIV test None

Federala X X

Alabama X X

Arizona X X

Arkansas X X

California X X

Colorado X X

Connecticut X ~ ~ ~

Delaware X X

Florida X X

Georgia X X

Hawaii X X

Idaho X X

Indiana X X

Iowa X X

Kansasb X X

Kentucky X X

Louisiana X X

Maine X X

Maryland X X

Massachusetts X X

Michigan X / / /

Minnesota X X

Mississippi X X

Missouri X X

Montana X / / /

Nebraska X X

Nevada X X

New Hampshire X X

New Jersey X X

New Mexico X X

New Yorkc X X

North Carolina X X

North Dakota X X

Ohio X X

Oklahoma X X

Oregond X X

Pennsylvania X X

Rhode Island X X

South Carolina X X

South Dakota X X

Tennessee X X

Texas X X

Utah X X

Vermont X X

Virginia X X

Washington X X

West Virginia X X X

Wisconsin X X

Wyoming X X

Note: Alaska and Illinois did not report data on testing practices during the intake process.

~Not applicable.

/Not reported.

aHIV testing was only offered to sentenced inmates.

bInmates were only tested for HIV if blood exposure occurred with staff or inmate volunteers.

cAll inmates were offered HIV testing.

dInmates were only tested for HIV on court order.

Source: Bureau of Justice Statistics, National Prisoner Statistics Program, 2012.
MEDICAL PROBLEMS OF STATE AND FEDERAL PRISONERS AND JAIL INMATES, 2011–12 | FEBRUARY 2015 19

Appendix table 5 

HIV testing practices for state and federal prisoners while in custody, by jurisdiction, 2012

Jurisdiction

Offered during 

routine exam High-risk Inmate request Clinical indication Court order

Involved in 

an incident

Federal X X X X X X

Alabama X X X X X

Arizona X X X X X X

Arkansas X X X X X X

California X X X X X

Colorado X X X X X X

Connecticut X X X X X

Delaware X X X X X

Floridaa X

Georgia X X X

Hawaii X X X

Idaho X

Indiana X X X X X

Iowa X X X X

Kansasb X X X X X

Kentucky X X X X X X

Louisiana X X X X X

Maine X X X X

Maryland X X X X X

Massachusetts X X X

Michiganc

Minnesota X X X X

Mississippi X X X X X

Missouri X X X X

Montana

Nebraska X X X X

Nevada X X X X

New Hampshire X X X

New Jersey X X X X X

New Mexico X

New Yorkd X X X X X X

North Carolina X X X X X

North Dakota X X X

Ohio X X X X

Oklahoma X X X

Oregon X X

Pennsylvania X

Rhode Island X X X X X

South Carolina X X X X

South Dakota X X X X X X

Tennessee X X X

Texas X X X X X

Utah X X X X

Vermont X

Virginia X X X X X

Washington X X X

West Virginia X

Wisconsin X X X X

Wyoming X X

Note: Alaska and Illinois did not report data on testing practices while in custody. 

aInmates could be tested for HIV at any time during incarceration.

bAll pregnant inmates were tested for HIV.

cInmates were tested for HIV on request yearly and if blood exposure occurred. 

dTesting for HIV was offered on a voluntary basis when transferring between facilities and participating in the Family Reunion Program.

Source: Bureau of Justice Statistics, National Prisoner Statistics Program, 2012.
MEDICAL PROBLEMS OF STATE AND FEDERAL PRISONERS AND JAIL INMATES, 2011–12 | FEBRUARY 2015 20

Appendix table 6

HIV testing practices for state and federal prisoners during discharge planning, by jurisdiction, 2012

Jurisdiction

All inmates

offered

Some inmates

offered

Only on

inmate request Other

Do not

provide

Federal X

Alabamaa X

Arizona X

Arkansas X

California X

Colorado X

Connecticut X

Delaware X

Florida X

Georgia X

Hawaii X

Idaho X

Indiana X

Iowa X

Kansas X

Kentucky X

Louisiana X

Maine X

Marylandb X

Massachusetts X

Michigan X

Minnesota X

Mississippi X

Missouric X

Nebraska X

Nevadaa X

New Hampshire X

New Jersey X

New Mexico X

New York X

North Carolina X

North Dakota X

Ohio X

Oklahoma X

Oregon X

Pennsylvania X

Rhode Island X

South Carolina X

South Dakotad X

Tennessee X

Texasa X

Utahe X

Vermont X

Virginia X

Washington X

West Virginia X

Wisconsin X

Wyoming X

Note: Alaska, Illinois, and Montana did not report data on testing practices during discharge planning.

aAll inmates tested for HIV on discharge.

bInmates were tested for HIV on request and offered HIV testing for upcoming releases.

cHIV testing was mandatory for all offenders not already HIV positive.

dAll inmates were offered HIV testing at Mike Durfee State Prison. At South Dakota State Prison and South Dakota Women’s Prison, inmates were only tested on inmate 

request.

eUtah State Health Department tested all inmates for HIV on day of parole.

Source: Bureau of Justice Statistics, National Prisoner Statistics Program, 2012.
MEDICAL PROBLEMS OF STATE AND FEDERAL PRISONERS AND JAIL INMATES, 2011–12 | FEBRUARY 2015 21

Appendix table 7

Prevalence of a current chronic condition among state and federal prisoners and jail inmates, 2011–12

State and federal prisoners* Jail inmates

Current chronic condition Percent Standard error Percent Standard error

Total 41.0% 1.4% 39.8% 1.3%

Cancer 1.1 0.2 1.5 0.3

High blood pressure/hypertension 23.0 1.3 20.2 1.0

Stroke-related problems 0.9 0.2 1.0 0.2

Diabetes/high blood sugar 7.4 0.7 5.3** 0.5

Heart-related problems 5.1 0.7 6.0 0.5

Kidney-related problems 3.4 0.5 3.8 0.4

Arthritis/rheumatism 12.4 1.0 10.5 0.7

Asthma 11.9 0.8 15.6** 1.0

Cirrhosis of the liver 1.3 0.3 1.3 0.3

*Comparison group.

**Difference with comparison group is significant at the 95% confidence level.

Source: Bureau of Justice Statistics, National Inmate Survey, 2011–12.

Appendix table 8

Standard errors for table 3: Prevalence of ever having a chronic condition or infectious disease among state and federal 

prisoners and jail inmates, by demographic characteristics, 2011–12

Chronic condition Infectious disease

Demographic characteristic State and federal prisoners Jail inmates State and federal prisoners Jail inmates

All inmates 1.5% 1.3% 1.3% 0.7%

Sex

Male 1.6% 1.3% 1.4% 0.7%

Female 2.1 2.7 2.0 2.4

Age

18–24 2.7% 2.0% 2.0% 1.0%

25–34 2.7 1.9 2.5 1.2

35–49 1.9 2.1 1.5 1.2

50 or older 4.3 2.5 3.1 4.2

Race/Hispanic origin

White 2.1% 1.9% 1.8% 1.2%

Black/African American 2.9 1.7 1.5 1.4

Hispanic/Latino 2.8 2.3 3.4 1.2

Other 5.4 3.4 2.6 2.1

Source: Bureau of Justice Statistics, National Inmate Survey, 2011–12.

Appendix table 9

Standard errors for figure 2: Rates of ever having a chronic 

condition among state and federal prisoners, 2004 and 

2011–12

State and federal prisoners

Ever had a chronic condition 2004 2011–12

Chronic condition

High blood pressure/hypertension 0.4% 1.2%

Diabetes/high blood sugar 0.2 0.8

Asthma 0.3 0.9

Arthritis/rheumatism 0.4 0.9

Heart-related problems 0.3 1.0

Source: Bureau of Justice Statistics, National Inmate Survey, 2011–12; and Survey 

of Inmates in State and Federal Correctional Facilities, 2004.

Appendix table 10

Standard errors for figure 3: Rate of ever having a chronic 

condition among jail inmates, 2002 and 2011–12

Jail inmates

Ever had a chronic condition 2002 2011–12

Chronic condition

High blood pressure/hypertension 0.5% 1.1%

Diabetes/high blood sugar 0.3 0.6

Asthma 0.5 1.0

Arthritis/rheumatism 0.5 0.7

Heart-related problems 0.4 0.7

Source: Bureau of Justice Statistics, National Inmate Survey, 2011–12; and Survey 

of Inmates in Local Jails, 2002.
MEDICAL PROBLEMS OF STATE AND FEDERAL PRISONERS AND JAIL INMATES, 2011–12 | FEBRUARY 2015 22

Appendix table 11

State and federal prisoners and jail inmates, by demographic characteristics, 2011–12

State and federal prisoners* Jail inmates

Demographic characteristic Number Percent Standard error Number Percent Standard error

All inmates 1,441,800 100% ~ 720,200 100% ~

Sex

Male 1,345,200 93.3% 0.9% 628,600 87.3%** 0.9%

Female 96,600 6.7 0.9 91,600 12.7** 0.9

Race/Hispanic origina

White 427,100 29.9% 1.5% 261,800 36.7%** 1.6%

Black/African American 489,900 34.3 2.3 222,500 31.2 1.8

Hispanic/Latino 356,100 24.9 2.6 146,400 20.5 1.6

Otherb 156,000 10.9 1.0 82,800 11.6 0.8

Age

18–24 166,200 11.5% 0.9% 188,200 26.1%** 1.0%

25–34 471,700 32.7 1.4 255,100 35.4 1.1

35–49 559,500 38.8 1.5 210,400 29.2** 1.1

50 or older 244,500 17.0 1.0 66,500 9.2** 0.7

*Comparison group.

**Difference with comparison group is significant at the 95% confidence level.

~Not applicable.

aExcludes persons of Hispanic or Latino origin, unless specified.

bIncludes persons identified as American Indian or Alaska Native; Asian, Native Hawaiian, or other Pacific Islander; and two or more races.

Source: Bureau of Justice Statistics, National Inmate Survey, 2011–12.
Office of Justice Programs

Innovation • Partnerships • Safer Neighborhoods

www.ojp.usdoj.gov

Celebrating

 35 years

The Bureau of Justice Statistics of the U.S. Department of Justice is the principal federal 

agency responsible for measuring crime, criminal victimization, criminal offenders, victims 

of crime, correlates of crime, and the operation of criminal and civil justice systems at the 

federal, state, tribal, and local levels. BJS collects, analyzes, and disseminates reliable and 

valid statistics on crime and justice systems in the United States, supports improvements 

to state and local criminal justice information systems, and participates with national and 

international organizations to develop and recommend national standards for justice statistics. 

William J. Sabol is acting director.

This report was written by Laura M. Maruschak, BJS Statistician, and Marcus Berzofsky, 

Dr.P.H., and Jennifer Unangst, RTI International. E. Ann Carson and Jennifer Bronson, Ph.D., 

BJS Statisticians, and Jennifer Unangst, RTI International, provided statistical verification 

and review.

Morgan Young, Irene Cooperman, and Jill Thomas edited the report. Barbara Quinn produced 

the report.

February 2015, NCJ 248491