Summary
The health of Australia's prisoners 2015 is the 4th report on the National Prison Health Indicators, which were developed to help monitor the health of prisoners, and to inform and evaluate the planning, delivery and quality of prison health services. It includes data from 1,011 prison entrants, 437 prison dischargees, over 9,500 prisoners who visited a prison health clinic and about 9,400 prisoners who took medications. These data were provided by prisons in all states and territories in Australia except New South Wales, which provided data on prison entrants only. Participation was not complete-84% of prisons participated, with about 49% of prison entrants and 42% of sentenced dischargees in those prisons taking part. Accordingly, the information in this report needs to be interpreted with some caution. AIHW is working with the states and territories to improve the coverage of this collection.
This report includes, for the first time, data on the smoke-free status of prisons, disabilities and long-term health conditions experienced by prisoners, and self-assessed health status. Mental health issues and risky health behaviours, including tobacco smoking, excessive alcohol consumption and illicit use of drugs, continue to be the main areas of concern. The health of Indigenous prisoners (over-represented at 27% of the prison population) is also a continuing concern.
Tobacco smoking
Prisoners in Australia continue to have high smoking rates compared with the general population. Almost three-quarters (74%) of prison entrants were current smokers, with 69% of entrants indicating they smoked daily. One-half (50%) of entrants who smoked on entry to prison reported that they would like to quit.
Smoking bans are in varying stages of implementation in Australian prisons. Almost three-quarters (74%) of prison dischargees in prisons allowing smoking currently smoked, with one-in-six (16%) indicating that they smoked more now than they did on entry to prison. Dischargees from prisons with smoking bans were more likely to use quit smoking assistance in prison. Of those who smoked on entry to prison, dischargees from prisons with smoking bans were less likely to intend to smoke after release (59%) than those from prisons in which smoking is allowed (73%).
Disability
Almost one-third (30%) of entrants reported a long-term health condition or disability that limited their daily activities and/or affected their participation in education or employment. Limitations to daily activities were the most common (24%), followed by restrictions in employment (16%) and education (12%). About 2% of prison entrants needed help and/or supervision in the areas of self-care, mobility and/or communication. Entrants aged between 35 and 54 years were more likely to have some form of limitation or restriction than their general community counterparts.
Self-assessed physical and mental health
Prisoners being discharged from prison were more likely than those entering prison to report their mental health as generally good or better (78% compared with 67% respectively) and less likely to report it as poor (4% compared with 8%). A similar pattern was seen in self-reported physical health, with dischargees slightly more likely to report their physical health as generally good or better than entrants (78% compared with 73%).
Preliminary material: Acknowledgments; Abbreviations; Symbols; Summary
1 Introduction
- Background
- Prisoner health services in Australia
- Healthcare in the prison environment
- Method
- Report structure
2 Demographic information
- Australia's prisoners
- Prison dischargees
- Profiles of different prison populations
3 Socioeconomic factors
- Cultural background
- Detention history
- Education level
- Employment and government support
- Homelessness
- Family
4 Mental health before and while in prison
- Mental health history
- Changes to mental health while in prison
- Recent psychological distress
- Self-assessed mental health status
- Mental health medication
- Prison entrants referred to prison mental health services
5 Self-harm
- Self-harm behaviour
- Identification of self-harm or suicide risk
6 Communicable diseases
- Sexually transmissible infections
- Bloodborne viruses
- Surveillance
- Medication for Hepatitis C
7 Chronic conditions
- Asthma
- Arthritis
- Cardiovascular disease
- Diabetes
- Cancer
- Self-assessed physical health
8 Activity and health changes
- Activity and weight changes
- Health changes
9 Aspects of women's health
- Pregnancies
- Cancer screenings
10 Disability
11 Tobacco smoking
- Smoking status prior to prison
- Smoking in prison
- Quitting smoking
12 Illicit drug use and needle sharing
- Drug use prior to prison
- Drug use in prison
- Needle sharing
- Opioid substitution treatment (OST)
- Tattooing and body piercing
13 Risky alcohol consumption
- Alcohol consumption prior to prison
- Alcohol consumption in prison
- Alcohol treatment in prison
14 Injuries, assaults and unprotected sex
- Head injury
- Accidents or injuries
- Assault and sexual assault
- Unprotected sex
15 General health services
- Consulting health services in the community and in prison
- Barriers to use of health services
16 Prison clinic
- Use of prison clinics
- Problems managed in clinic visits
- Services received in prison clinic visits
- Initiator of clinic visits
- Type of health professional seen
- Satisfaction with health services
17 Medication
18 Prison health services
- Full-time equivalent staffing
- Immunisation
- Use of health services outside prison
- Indigenous health services
19 Release procedures
- Health-related discharge planning
- Continuing care
- Medicare card
- Preparedness for release
20 Deaths
- Deaths in custody
- Deaths following release from prison
Appendixes
- Appendix A: Specifications of indicators
- Appendix B: Data quality statement-National Prisoner Health Data Collection
- Appendix C, E to H (PDF 1.2MB)
- Appendix C: Tables
- Appendix D: Data sources
- Appendix E: Prisoner health services in Australia
- Appendix F: Key policy directions
- Appendix G: Prisoner health legislation in Australia
- Appendix H: List of prisons in Australia
End matter: Glossary; References; List of tables; List of figures