Epidemiological research on the physical health status of police detainees is scarce. The present study fills this gap by first studying the somatic reasons for consultation (n = 4396) and related prescriptions (n = 4912) as assessed by the forensic medical service during police detainment. Secondly, a health interview survey was conducted among randomly selected police detainees (n = 264) to collect information regarding their recent disease history and use of health care. Somatic health problems, medical consumption and health risk measures of the detainees were compared with those seen in the general population using general practitioner records and community health survey data. The study showed that, in police detainment, several chronic health conditions more often were the reason for consultation than in the general practice setting. In addition, the health interview survey data demonstrated that after adjustment for age and gender, the police detainees were 1.6 times more likely to suffer from one or more of the studied chronic diseases than the members from the general population. Furthermore, differences in several health risk measures, including body mass index, smoking and alcohol habits and health-care use were observed between the interviewed police detainees and the general population. These results provide insight into the variety of physical health problems of police detainees and are essential to develop optimal treatment strategies in police custody.
BackgroundAs in many European countries, access to care is decreased for undocumented migrants in the Netherlands due to legislation. Studies on the health of undocumented migrants in Europe are scarce and focus on care-seeking migrants. Not much is known on those who do not seek care.MethodsThis cross-sectional study includes both respondents who did and did not seek care, namely undocumented migrants who have been incarcerated in a detention centre while awaiting expulsion to their country of origin. A consecutive sample of all new arrivals was studied. Data were collected through structured interviews and reviews of medical records.ResultsAmong the 224 male migrants who arrived at the detention centre between May and July 2008, 173 persons were interviewed. 122 respondents met inclusion criteria. Only half of the undocumented migrants in this study knew how to get access to medical care in the Netherlands if in need. Forty-six percent of respondents reported to have sought medical help during their stay in the Netherlands while having no health insurance (n = 57). Care was sought most frequently for injuries and dental problems. About 25% of these care seekers reported to have been denied care by a health care provider. Asian migrants were significantly less likely to seek care when compared to other ethnic groups, independent from age, chronic health problems and length of stay in the Netherlands.ConclusionThe study underlines the need for a better education of undocumented patients and providers concerning the opportunities for health care in the Netherlands. Moreover, there is a need to further clarify the reasons for the denial of care to undocumented patients, as well as the barriers to health care as perceived by undocumented migrants.
This study evaluated standard toxicology screening by forensic physicians during external post-mortem examination. Collected urine samples of decedents were screened on-site for the presence of 10 commonly used drugs by means of a rapid multidrug test. Urine samples of 53% of the cases appeared to be positive for one or more compounds. Importantly, several cases were revealed which were positive for toxicology screening without indications for use of these drugs at the scene of death or from medical history. Based on these (preliminary) results, further action to incorporate routine post-mortem toxicology as a tool in forensic death investigation is recommended.
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