Prisoners

Prison stays are usually temporary, which means Australia’s prison population is fluid—prisoners are constantly entering and being released from prison, and their health issues and concerns are also those of the general community.

The demographic and health profiles of prisoners are different to those of the general community. Prisoners are predominately young, adult males, from lower socioeconomic groups, with an over-representation of Indigenous people.

Prisoners often arrive at prison with several health problems—their health is sufficiently poorer than in the general community that they are often considered to be geriatric at the age of 50–55.

The poor health and complex health needs of prisoners are reflected in the number and types of medications they take—they are more likely than those in the general community to be taking medication for mental health issues, addictions and chronic conditions.

All medical services to prisoners are provided by the state and territory in which they are imprisoned. For prisoners who underuse health services in the general community, prison may provide an opportunity to access treatment to improve their health; indeed, prisoners typically use health services much more extensively in prison than in the community.

The proximity of prisoners to health services is important. Every prison will have at least a nurse, and usually a minimum of weekly visits by a medical practitioner. This contrasts with the extremes found in the general community where, for example, people living in remote areas have less access to regular medical services than people living in large, urban areas. Although prisoners have close proximity to health services, they are unable to choose to visit multiple medical practitioners at the same time. In addition, the provision and operation of health services in a prison environment is not always straightforward, and the regimes and processes in place may make continuity of care between the community and prison difficult to achieve, especially upon entry.

The National Prisoner Health Data Collection (NPHDC) is the main source of national data about the health of prisoners in Australia. It gathers information from prison entrants, dischargees, prisoners visiting the prison health clinic, and prisoners taking prescribed medication.

The NPHDC was designed to monitor the National Prisoner Health Indicators, which comprise more than 100 indicators relating to socioeconomic factors, general health, risk factors, mental health, sexual behaviour, and prison health services. The indicators and data collection were developed by the AIHW, with assistance and advice from the National Prisoner Health Information Committee (NPHIC). They are aligned to the National Health Performance Framework (AIHW 2009), and help ensure that appropriate health services are in place to meet the needs of the prisoner population. The AIHW reports against the indicators in The health of Australia’s prisoners series.

Reference

Williams BA, Ahalt C & Greifinger RB 2014.The older prisoner and complex chronic medical care. In: WHO. Prisons and health. Copenhagen: WHO.