Differences in Health Status between People with and without Disabilities in Ecuadorian Prisons

People with disabilities experience significant health inequalities and inequities compared to people without disabilities. However, there is little evidence on the frequency of health conditions and their association with disability in the prison context. The aim of this study was to compare the proportions and associations between various health conditions and different disability indicators. A secondary analysis of existing data from the Ecuador Prison Census 2022 was conducted. The variable of interest was based on three disability indicators from the six-item Washington Group Short Set on Functioning. A cross-tabulation was carried out to estimate the proportion of prisoners with different disability indicators by gender. These proportions were also calculated for different health conditions. Moreover, we analyzed the association between each of the three disability indicators and the different health conditions using multivariable logistic regression. A total of 30,612 incarcerated persons were included in the analysis, revealing that 8% had disabilities. According to gender, a higher proportion of women had disabilities (10.7% vs. 8.5%), some difficulty functioning (33.8% vs. 28.0%), and multiple disabilities (2.4% vs. 2.0%) compared to men. Furthermore, people with disabilities had a higher proportion of health conditions compared to those without a disability. Strong and very strong evidence of associations were found between different disability indicators and several health conditions, while a lower odds of drug use was observed in people with disabilities and multiple disabilities compared to their counterparts, and no evidence of association was found with Human Immunodeficiency Virus (HIV) infection. Our results reflect the health inequalities and inequities experienced by prisoners with disabilities. This highlights the need to implement targeted policies within prisons and to include prisoners with disabilities in the country’s agenda.