The Need to Improve the Health of Prisoners

There are currently around 10 million people incarcerated worldwide and over the past decade this number has increased by a million.  Research indicates that mental disorders, infectious diseases, higher suicide rates and increased mortality are more prevalent in prisons than in the general population.  Prisoners are often from the poorest sectors of society and as a result already suffer from greater health inequalities.

A review published today in The Lancet examining "The Health of Prisoners" reports that there is insufficient health care in prisons.  The evidence suggests that more needs to be done to help improve the health of millions of young, marginalised individuals, who are often beyond the reach of community health services.     

It is argued that reforming the medical service within prisons could improve public health, because as prisoners are released and return to their communities, they will be in a better sate, both mentally and physically, to contribute to society.   Seena Fazel from the University of Oxford, UK, and Jacques Baillargeon from the University of Texas Medical Branch, USA, argue that the importance of prison health care to public health needs to be recognised: "Prisoners act as reservoirs of infection and chronic disease, increasing the public health burden of poor communities."
They add: "For these individuals, prison provides an opportunity for diagnosis, disease management education, counselling, and treatment that they would not receive in the general community."

The authors of the review propose that there should be a universal screening of prisoners for physical and mental illness by trained individuals along with community-based aftercare for released prisoners.  Additionally, they call for national prison-specific policies and guidelines incorporating minimum standards and goals for improvement in the health care of women, older adult prisoners, and juveniles.

RSPH - Supporting Offenders on a Pathway to Health

At present, the RSPH is working with the National Offender Management service as part of the South East Innovation Project - Health and Physical Education.  The project focuses on improving the health and well-being of offenders, through the expansion of the Health Trainer model within the prison and community settings.  The RSPH also offers the Level 2 Award in Understanding Health Improvement course, which can be undertaken in communities, local authorities and prisons. 

Our recent sucess stories include the Sheppey cluster of prisons, initiated by Gary Lyttle and Brian Greig.  These events have been commissioned by the Sheppy Cluster of prisons to support the further roll out to other offender units and interested organisations locally.  The project was also undertaken by theYorkshire and Humberside cluster of prisons, led by Geof Dart.  A recent end of year report published by Yorkshire and Humber Improvement Partnership, Offender, Health and Social Care: Health Trainers in the Criminal Justice System, highlights the many benefits of training and empowering prisoners about health 

In addition, NHS Devon's health promotion team in partnership with Age Concern (now Age UK) created the Age Concern Older Offenders' Project, with the aim of improving the health of older offenders within Devon prisons.  NHS Devon's story can be viewed in the October archive of the blog.


To view a copy of the Yorkshire and Humberside report please contact Gina Mohajer email: gmohajer@rsph.org.uk.
For more information on the RSPH Level 2 Award in Understanding Health Improvement please contact Nicolette Smith email: nsmith@rsph.org.uk.