Epidemiology of Hypertension and Diabetes among Inmates in the Ashanti Region, Ghana.

Abstract

This study examined the epidemiology and risk factors associated with hypertension and diabetes among inmates in selected prisons within the Ashanti Region of Ghana. Using a cross-sectional design, data were collected through structured questionnaires and biometric screening, and logistic regression analysis was employed to identify associated factors. The results revealed a high prevalence of hypertension, with age and duration of incarceration emerging as significant predictors. Inmates aged 31- 40, 41- 50, and 51- 60 years were 1.86, 2.94, and 3.33 times more likely, respectively, to be hypertensive compared to those aged 20- 30 years. Those incarcerated for 1- 2 years and 3–5 years also had higher odds of hypertension compared to inmates imprisoned for less than a year. Although smoking history showed reduced odds of hypertension (odds ratio < 1, suggesting smokers appeared less likely to be hypertensive than non-smokers), the association was not statistically significant. Diabetes prevalence was 10.7%, occurring predominantly among males and younger inmates (20- 40 years). However, no statistically significant associations were observed between diabetes status and demographic or socioeconomic characteristics, suggesting that prison-related lifestyle and contextual factors may contribute more to diabetes risk than traditional predictors. The logistic regression model for hypertension demonstrated good adequacy, as confirmed by the Likelihood Ratio Test (p = 0.001) and the Hosmer- Lemeshow test (p = 0.069), with moderate predictive performance indicated by the Area Under the Curve (AUC = 0.673). The study concludes that both hypertension and diabetes are prevalent in Ghanaian prisons, with hypertension linked to age and incarceration duration, while diabetes appears evenly distributed across demographic categories. This study is among the first to provide empirical evidence on the dual burden of hypertension and diabetes within Ghanaian prisons, offering critical insights for policy and intervention strategies in correctional health.