Health-related quality of life measures in incarcerated populations: a scoping review.
Talaat H, Raymakers A, et al. • Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation • 2026
Incarcerated populations generally report lower health-related quality of life (HRQoL) scores than the general population, with those having mental health issues, women, and Indigenous inmates demonstrating the poorest HRQoL scores.
Key Findings
Methods
Twenty-two articles met inclusion criteria for this scoping review of preference-based HRQoL instruments in incarcerated populations.
Six electronic databases and three health technology assessment agencies were searched.
Review followed PRISMA-ScR guidelines with eligibility and data extraction performed by two independent researchers.
Studies primarily focused on male and white populations, indicating significant demographic gaps in the literature.
Ten of the 22 studies targeted disease-specific populations.
Results
Mental health disorders were the most prevalent condition studied among disease-specific incarcerated populations.
Seven of the ten disease-specific studies focused on mental health disorders (n=7).
Inmates with mental health issues reported the lowest HRQoL scores across studies.
Mental health disorders represented the single largest disease category examined in the included studies.
Results
Inmates generally reported lower HRQoL scores than the general population across studies.
The finding was consistent across the reviewed literature regardless of the HRQoL instrument used.
Those with mental health issues reported especially low HRQoL scores compared to both the general population and other incarcerated individuals.
A variety of HRQoL instruments were used across studies, each assessing different domains, which hindered direct comparisons between studies.
Results
Female inmates had lower HRQoL scores than male inmates.
The review identified sex-based disparities in HRQoL within incarcerated populations.
The existing literature primarily focused on male populations, leaving female inmates underrepresented.
The authors call for more diverse, inclusive studies to address these gaps.
Results
Indigenous inmates had lower HRQoL scores than non-Indigenous inmates.
Indigenous incarcerated individuals were identified as a particularly vulnerable subgroup with poorer HRQoL.
Indigenous inmates represented an underrepresented group in the existing literature.
The authors highlight the need for more studies specifically targeting Indigenous incarcerated populations.
Results
The variety of HRQoL instruments used across studies hinders direct comparisons, and existing instruments may not be adequately validated for incarcerated populations.
Different instruments assess different domains of HRQoL, making cross-study comparison difficult.
The authors suggest that validating instruments specific to incarcerated populations may be needed for future research.
Preference-based HRQoL instruments were the focus, as these can be used to derive utility scores relevant to health economic evaluations.
The lack of standardized, validated tools tailored to incarcerated populations was identified as a key knowledge gap.
Background
Traditional health measures such as disease prevalence and life expectancy do not fully capture the physical, mental, emotional, and social well-being of incarcerated populations.
Incarcerated populations face higher rates of communicable and mental diseases compared to the general population.
HRQoL was identified as providing a more comprehensive view of well-being in this population.
The review aimed to provide insights for health policies and economic evaluations through summarizing HRQoL outcomes.
What This Means
This research examined how incarcerated people rate their own health and quality of life compared to the general public. The researchers reviewed 22 scientific studies that used standardized tools to measure health-related quality of life (HRQoL) — a concept that captures not just physical health but also mental, emotional, and social well-being — in people who are imprisoned. They found that, consistently across studies, incarcerated individuals reported worse quality of life than people living in the general community, with those who had mental health conditions faring the worst of all. Within prisons, women and Indigenous people reported even lower quality of life than male and non-Indigenous inmates, highlighting that some groups face compounding disadvantages.
The review also identified important gaps and limitations in the existing research. Most studies focused on white male populations, leaving women, Indigenous people, and other groups significantly underrepresented. Additionally, different studies used different measurement tools that assess different aspects of well-being, making it very difficult to directly compare results or draw broad conclusions. The authors suggest that tools specifically designed and validated for incarcerated populations may be needed to produce more accurate and useful data in the future.
This research matters because traditional health statistics — like how common a disease is or average life expectancy — don't tell the full story of how incarcerated people experience their health day-to-day. This research suggests that quality-of-life data can reveal deeper inequalities within prison systems, particularly for women and Indigenous inmates, and could help policymakers design better health programs and allocate resources more effectively within correctional settings. More diverse and inclusive studies are needed to ensure that the needs of all incarcerated people are understood and addressed.
Talaat H, Raymakers A, Bayoumi A, Papatheodorou S, Khawaja A, Hanna C, et al.. (2026). Health-related quality of life measures in incarcerated populations: a scoping review.. Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation. https://doi.org/10.1007/s11136-026-04217-9