Imprisonment and health: Issues and concerns

Prison health is an inevitable part of public health as there is intensive interaction between prisons and society. Prisoners do not represent a homogeneous segment of society. Many have lived at the margins of society, are poorly educated and come from socio-economically disadvantaged groups. They often have unhealthy lifestyles and addictions such as alcoholism, smoking and drug use, which contribute to poor general health and put them at risk of disease. The prevalence of mental health problems is very high and some prisoners are seriously mentally ill and should be in psychiatric facility rather than in prison. The rise in prison population has resulted in overcrowding and communicable diseases, such as HIV and Tuberculosis are more prevalent in prisons than in the community. Many prisoners have had no contact, or very limited contact, with health services in the community before they were detained in prison. The situation is further more pathetic among women prisoners. Women who enter prison usually come from marginalized and disadvantaged backgrounds and are often characterized by histories of violence, physical and sexual abuse. In comparison to their free world female and incarcerated male counterparts, female prisoners suffer more frequent and serious diseases and injuries and tend to place a greater demand on the prison health service than men do. Health care in women prisons received little attention because female prisoners are a small percentage. Correctional institutions have struggled to provide adequate health care to women prisoners; however, a close look at the needs of women in prison and related health aspects raises issues of gender insensitivity and inequity, of human rights neglect and general lack of public health concern. Prisoners are from our community and they return to our community. Rehabilitation of prisoners is one of the most important goals of incarceration and the correctional system might be the last best chance of change and improvement. The period of incarceration no matter how long or short provides the window of opportunity to improve the health care of prisoners as well as to arrange for follow-up in the community upon their release. Access to, as well as quality of, health services in prison is of vital importance. The present paper thus attempts to increase the visibility of health status and access to health care of prisoners in general and women prisoners in particular. Addressing health in prisons is essential in any public health initiative that aims to improve overall public health.