Effects of the COVID-19 pandemic on people experiencing incarceration: a systematic review

Williams, Darius Benedict, Spinks, Bethany, Williams, Denitza ORCID: https://orcid.org/0000-0002-2874-9270, Lewis, Ruth, Bull, Francesca and Edwards, Adrian ORCID: https://orcid.org/0000-0002-6228-4446 2024. Effects of the COVID-19 pandemic on people experiencing incarceration: a systematic review. BMJ Open 14 , e076451. 10.1136/bmjopen-2023-076451

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Abstract

Objective: To assess the effect of the COVID-19 pandemic on people experiencing incarceration (PEI), focusing particularly on clinical outcomes compared with the general population. Design: Systematic review with narrative synthesis in accordance with the Centre for Reviews and Dissemination’s good practice guidelines. Data sources: Medline, Social Policy and Practice, Criminology Connection, ASSIA, EMBASE, SCOPUS, Web Of Science, CINAHL, Cochrane Library, Cochrane COVID-19 reviews, COVID-19 Evidence Reviews and L*OVE COVID-19 Evidence databases were searched up to 21 October 2022. Eligibility criteria for selecting studies: We included studies presenting data specific to adults ≥18 years experiencing incarceration, with exposure to SARS-CoV-2 infection. All studies with a comparison group, regardless of study design and country were included. Studies with no comparison group data or not measuring clinical outcomes/health inequalities were excluded. Studies focussing on detained migrants, forensic hospitals, prison staff and those not in English were also excluded. Data extraction and synthesis: Two reviewers extracted data and assessed risk of bias. Data underwent narrative synthesis using a framework analysis based on the objectives, for infection rates, testing, hospitalisation, mortality, vaccine uptake rates and mental health outcomes. There was no scope for meta-analysis, due to the heterogeneity of evidence available. Results: 4516 references were exported from the databases and grey literature searched, of which 55 met the inclusion criteria. Most were from the USA and were retrospective analyses. Compared with the general population, PEI were usually found to have higher rates of SARS-CoV-2 infection and poorer clinical outcomes. Conflicting data were found regarding vaccine uptake and testing rates compared with the general population. The mental health of PEI declined during the pandemic. Certain subgroups were more adversely affected by the COVID-19 pandemic, such as ethnic minorities and older PEI. Conclusion: PEI have poorer COVID-19 clinical outcomes than the general public, as shown by largely low-quality heterogenous evidence. Further high-quality research of continuing clinical outcomes and appropriate mitigating interventions is required to assess downstream effects of the pandemic on PEI. However, performing such research in the context of incarceration facilities is highly complex and potentially challenging. Prioritisation of resources for this vulnerable group should be a focus of national policy in the event of future pandemics. PROSPERO registration number: CRD42022296968.

Item Type:	Article
Date Type:	Published Online
Status:	Published
Schools:	Medicine
Additional Information:	License information from Publisher: LICENSE 1: URL: http://creativecommons.org/licenses/by-nc/4.0/, Start Date: 2024-04-05, Type: open-access
Publisher:	BMJ Publishing Group
Date of First Compliant Deposit:	16 April 2024
Date of Acceptance:	1 March 2024
Last Modified:	16 Apr 2024 16:38
URI:	https://orca.cardiff.ac.uk/id/eprint/168010

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