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Health-state utilities in a prisoner population: a cross-sectional survey

Christopher AKY Chong12*, Sicong Li3, Geoffrey C Nguyen45, Andrew Sutton6, Michael H Levy7, Tony Butler78, Murray D Krahn29 and Hla-Hla Thein10

Author Affiliations

1 Section of General Internal Medicine, Lakeridge Health Oshawa, Canada

2 Faculty of Health Sciences, Queen's University, Ontario, Canada

3 Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada

4 Mount Sinai Hospital Division of Gastroenterology, University of Toronto, Toronto, Ontario, Canada

5 Johns Hopkins School of Medicine, Baltimore, Maryland, USA

6 Ecology and Epidemiology Group, Department of Biological Sciences, University of Warwick, Warwick, UK

7 Centre for Health Research in Criminal Justice, Sydney, Australia

8 School of Public Health and Community Medicine, The University of New South Wales, Sydney, Australia

9 Toronto Health Economics and Technology Assessment Collaborative, Department of Medicine Toronto, Ontario, Canada

10 National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Sydney, Australia

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Health and Quality of Life Outcomes 2009, 7:78  doi:10.1186/1477-7525-7-78

Published: 28 August 2009



Health-state utilities for prisoners have not been described.


We used data from a 1996 cross-sectional survey of Australian prisoners (n = 734). Respondent-level SF-36 data was transformed into utility scores by both the SF-6D and Nichol's method. Socio-demographic and clinical predictors of SF-6D utility were assessed in univariate analyses and a multivariate general linear model.


The overall mean SF-6D utility was 0.725 (SD 0.119). When subdivided by various medical conditions, prisoner SF-6D utilities ranged from 0.620 for angina to 0.764 for those with none/mild depressive symptoms. Utilities derived by the Nichol's method were higher than SF-6D scores, often by more than 0.1. In multivariate analysis, significant independent predictors of worse utility included female gender, increasing age, increasing number of comorbidities and more severe depressive symptoms.


The utilities presented may prove useful for future economic and decision models evaluating prison-based health programs.