From March 2020, a range of measures have been introduced in adult prisons to reduce the spread of COVID-19, including vaccinations, social distancing, virtual visits and the use of personal protective equipment such as face masks. COVID-19 outbreaks have been reported in prisons across Australia.
Given the high level of vulnerability of the prison population, COVID-19 poses a serious risk to the physical health of prisoners. Measures introduced to reduce the spread of COVID-19 are also likely to have had an impact on prisoner’s mental, emotional and social wellbeing (Department of Health 2020). However, there is currently limited data available to understand the extent to which COVID-19 has impacted prisoner health. The next NPHDC will take place in 2022 and will include items related to COVID-19. Data are scheduled for release in 2023.
For more information on active COVID-19 cases within prisons in each state and territory, see:
Mental health is fundamental to social wellbeing, and affects individuals, families, and the wider community (ABS 2019b). Mental health disorders are chronic conditions such as depression, anxiety disorders, psychotic disorders, and alcohol and other drug use disorders. These conditions can influence thoughts, feelings, behaviour, stress levels, relationships and decision making.
Of prison entrants surveyed in 2018:
-
2 in 5 (40%) reported having been told they had a mental health disorder at some point during their lives.
-
Females (28%) were almost twice as likely as males (15%) to be dispensed mental health-related medication.
-
Almost 1 in 5 (18%) were referred to mental health services for observation and further assessment (AIHW 2019).
In the NPHDC, prison dischargees were asked to rate the change in their mental health since entering prison as being a lot better, a little better, the same, a little worse, a lot worse or unknown.
Of prison dischargees surveyed in 2018:
- Almost 2 in 5 (39%) reported their mental health improved while in prison.
- Females were more likely than males to report an improvement in their mental health and wellbeing (46% compared with 38%).
- 1 in 10 males (10%) and less than 1 in 12 females (8%) reported their mental health had deteriorated during their time in prison.
For information on the mental health of Indigenous Australian prisoners, see The health of Aboriginal and Torres Strait Islander people in prison.
Chronic diseases are long-lasting conditions with persistent effects. Their social and economic consequences can affect people’s quality of life. Some risk factors associated with chronic conditions are considered preventable, including poor diet, insufficient physical activity, overweight and obesity, tobacco smoking, risky alcohol consumption and illicit drug use (AIHW 2021).
In the NPHDC, prison entrants were asked whether they had ever been told by a medical professional that they had any of the following chronic physical health conditions: arthritis, asthma, cancer, cardiovascular disease, and diabetes. Asthma was the most reported chronic condition amongst prisoners, with 22% reporting that they have been diagnosed with the condition at some point in their lives (Table 1).
Table 1: Prison entrants’ health status, 2018
|
Prison entrants ever diagnosed with a condition (%)
|
Prison entrants with a current condition (%)
|
Asthma
|
21.9
|
15.4
|
Arthritis
|
7.3
|
6.7
|
Cardiovascular diseases
|
7.3
|
4.1
|
Diabetes
|
6.5
|
5.9
|
Cancer
|
2.1
|
0.9
|
Any condition
|
30.4
|
26.3
|
Notes
1. Includes unknowns.
2. Proportions are proportions of prison entrants in this data collection only, and not the entire prison population.
3. Excludes New South Wales, which did not provide data for the 2018 NPHDC.
4. ‘Any chronic condition’ does not represent a sum of the conditions, as one prison entrant might have multiple conditions.
Source: AIHW 2019.
Existing social and health determinants put Indigenous Australians who have spent time in prison at higher risk of poor health due to an increased exposure to behavioural and environmental health risk factors (Shepherd et al. 2020). While most Indigenous Australians entering prison reported good mental health, they were more likely than non-Indigenous Australians to report having some chronic illnesses (AIHW 2019).
Of Indigenous prisoners surveyed in 2018:
- 3 in 4 (75%) entrants described their mental health as excellent, very good, or good.
- 1 in 3 (33%) had been told by a health professional that they had a mental health disorder.
- Less than 1 in 14 (7%) dischargees reported their mental health had deteriorated during their time in prison.
In 2018, asthma was the most reported chronic condition amongst Indigenous prisoners, with 13% reporting that they have been diagnosed with the condition at some point in their lives, followed by diabetes (11%) and cardiovascular disease (8%). Indigenous prisoners were less likely than non-Indigenous prisoners to report currently having asthma (11% compared with 19%) but more likely to report currently having diabetes (9% compared with 4%) and cardiovascular disease (5% compared with 3%).
Strengthening cultural safety for Indigenous Australians’ health care can improve their access to and quality of care (Australian Health Ministers’ Advisory Council 2016). Indigenous prison dischargees were asked whether they received treatment or consultation from an Aboriginal Community Controlled Health Organisation or Service (ACCHO) or Aboriginal Medical Service (AMS) while in prison. They were also asked whether they had received culturally appropriate care in prison.
Of the Indigenous prisoners surveyed upon discharge from prison:
- 4 in 5 dischargees (80%) reported they always received culturally appropriate health care in prison.
- Less than 1 in 10 (9%) reported receiving treatment or consultation from an ACCHO and/or AMS service while in prison.
- Male Indigenous dischargees were more likely to report always receiving culturally appropriate health care (81%) than female Indigenous dischargees (68%).
For more information on the health of people in prison, see:
Visit Prisoners for more on this topic.
References
ABS (Australian Bureau of Statistics) (2019a) Estimates and Projections, Aboriginal and Torres Strait Islander Australians, 2006 to 2031, ABS, Australian Government, accessed 28 March 2022.
ABS (2019b) National Health Survey: first results, 2017–18, ABS, Australian Government, accessed 28 March 2022.
ABS (2021) Prisoners in Australia, 2021, ABS, Australian Government, accessed 28 March 2022.
ABS (2022) Corrective Services, Australia, ABS, Australian Government, accessed 4 April 2022.
Australian Health Ministers’ Advisory Council (2016) Cultural Respect Framework 2016–26 for Aboriginal and Torres Strait Islander health: a national approach to building a culturally respectful health system, Australian Health Ministers' Advisory Council, Australian Government, accessed 28 March 2022.
AIHW (Australian Institute of Health and Welfare) (2019) The health of Australia’s prisoners 2018, AIHW, Australian Government, accessed 17 March 2022,
AIHW (2021) Australian Burden of Disease Study: Impact and causes of illness and death in Australia 2018 – Summary report, AIHW, Australian Government, accessed 17 March 2022.
Department of Health (2020) CDNA National Guidelines for COVID-19 Outbreaks in Correctional and Detention Facilities, Department of Health, Australian Government, accessed 23 March 2022.
Shepherd SM, Spivak B, Ashford LJ, Williams I, Trounson J and Paradies Y (2020) ‘Closing the (incarceration) gap: assessing the socio-economic and clinical indicators of Indigenous males by lifetime incarceration status’, BMC Public Health, 20(710):1–14, doi:10.1186/s12889-020-08794-3.