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Prison healthcare in Australia

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Health care of prisoners in Australia is a major concern to prison institutions around Australia with prison populations increasing in both numbers and rate with a imprisonment rate of 187.3 per 100,000 adults.

Prisoners in Australia are generally from a disadvantaged socioeconomic background, and often have higher rates of tobacco smoking, illicit drug use and alcohol consumption in comparison to the general public. The disadvantages in socioeconomic background develops into a significant disparity in health between prisoners and the general public in Australia.

Prison in Gnangara, Western Australia

History

Socioeconomic factors

The lowest end of the socioeconomic group perform worse than the highest end of the socioeconomic group on almost all health measures. The prevalence of many chronic diseases are higher in lower socioeconomic groups when compared to the higher socioeconomic groups, and is a result of unhealthy lifestyles. Daily smoking is more than 3 times higher in lower socioeconomic groups at 20% than higher socioeconomic groups with 6.7%, and rates of insufficient activity also shows inequality between the two socioeconomic groups with 76% for lower socioeconomic groups and 56% for higher socioeconomic groups.

The Australian Institute of Health and Welfare states that "On average, those in the lowest spectrum were far more likely to smoke daily. In 2013, 20% of those aged 14 and over in this group smoked daily, a rate 3 times that of people in the highest spectrum at 6.7%".

Common socioeconomic factors of prisoners in Australia that reflect onto health and well-being include cultural background, education and family relationships.

Cultural Background

The majority of prisoners in custody are born in Australia, at 81%. 3% are born in New Zealand, 2% are born in Vietnam, 2% are born in the United Kingdom and the remaining 11% from other countries.

Education

In a report published by the Australian Institute of Health and Welfare in 2015, it is stated that less education generally results in lower income, leading less resources being available to disadvantaged socioeconomic groups for a healthy lifestyle. The Australian Institute of Health and Welfare proposes that "Education is one of the recognised social detriments to health, with lower levels of education being strongly associated with poorer health"., and where the majority of prisoners reside from the lower spectrum of the socioeconomic group, are exposed to unhealthy lifestyles that lead to numerous health conditions.

Family

Medical conditions

Physical Health

There are numerous physical health conditions that arise for prisoners in Australia. As the majority of prisoners are generally from a disadvantaged socioeconomic group, they are exposed to unhealthy habits such as an unbalanced diet, cigarette smoking, excessive alcohol consumption and illicit substance abuse.

Unhealthy lifestyle leads to numerous physical health conditions, and some of the most common health conditions include; asthma, arthritis, cancer, cardiovascular diseases, diabetes and complications to oral health.

Asthma

Asthma is a common respiratory disease among prisoners in Australia, and is frequently caused by contaminated prison conditions, such as airborne substances and inadequate health habits such as the smoking of tobacco, excessive alcohol consumption and illicit drug use. Nearly a quarter of male prisoners have been diagnosed with asthma at 22%, and over a quarter of female prisoners have been diagnosed with asthma at 31%. Asthma is also more prevalent in prisoners as age increases, with the exception of ages between 25 and 34, where asthma diagnosis rate is highest at 29.

There is no significant evidence of asthma being more prevalent in Indigenous Australians with 25% reported having been diagnosed with asthma in comparison to Non-Indigenous Australians reported at 23%.

Arthritis

Arthritis refers to numerous medical conditions that affect the joints, and although it is more frequent as age increases, anyone from any age group can develop a case of arthritis. Although it is one of the most common medical conditions that prisoners in Australia are diagnosed, the predominant cause of arthritis in inmates is unknown. It is instead generally determined that heredity and environmental factors both affect the likelihood of developing a type of arthritis.

Just under one-fifth of female inmates are diagnosed with arthritis at 18%, and it is twice as common in female prisoners than male inmates at 9%. Non-Indigenous prisoners (12%) are more likely than Indigenous prisoners (7%) to report having had a diagnosis of arthritis.  

Cancer

Hypertension

Hypertension, commonly known as high blood pressure is the single most common medical condition among prison inmates.

Oral Health

Oral health is a major health concern due to its incidence rate, and is more prevalent in disadvantaged socioeconomic groups. Problems of oral health in prison inmates are a recurrent condition, and Osborn M (2003) proposes that "it is important to consider the wider social determinants of health when looking at treatment options" .

Infectious Diseases

Sexually Transmissible Infections

Hepatitis C

The Hepatitis C Virus

Hepatitis C is a blood-borne disease that primarily causes inflammation to the liver, and can be passed from person to person. It considered a major global health issue, with an estimated 180 million people carrying the disease worldwide. Mokhlis (2016) states that "More than 300,000 Australians are estimated to have been exposed to Acute Hepatitis C virus (HCV), of whom around 226,700 are living with chronic infection, including 16,000 Indigenous Australians". for prison inmates, it is most frequently transmitted by illicit drug use, or specifically, needle sharing.

Mental Health

Self-harm and Suicide

Self-harm is the intentional infliction of physical stress onto body tissue. Suicide rates or self-harm of inmates in custody are a major concern for prison institutions in Australia, and is increasing in proportion of recent years. A quarter of prison inmates have been reported to have caused self-harm at 23 percent, which has increased by 16 percent since 2012. Pannell J (2003) states that "The prevention of self-harm and suicide in prisoners depends on good interaction between the individual prisoner and prison staff".

Health services

While Australian citizens and permanent residents have access to free or subsidised healthcare through a universal health care system (Medicare) , prisoners in Australia are not granted medicare and are not granted access to free or subsidised healthcare.

Generally, nurses are predominantly the first line of contact for prisoners, whereas doctors are first seen by individuals outside of a prison environment.


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References

  1. ^ The health of Australia's prisoners 2015. Canberra: Australian Institute of Health and Welfare. 2015. ISBN 978-1-74249-866-9.
  2. ^ "Australia's health 2016". Australia's Health Series. 15. 2016 – via Australian Institute of Health and Welfare.
  3. ^ Osborn, Mary (2003). "Oral health status of prison inmates - New South Wales, Australia". Australian Dental Journal. 48: 34–38.
  4. ^ Mokhlis, Michael (2016). "Hepatitis C in Australian prisons: a national needs assessment". International Journal of Prisoner Health. 12: 3–16.
  5. Pannell, Joel (2003). "Prison Officer's Beliefs Regarding Self-Harm in Prisoners: An Empirical Investigation". International Journal of Forensic Psychology. 1: 103–110.

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