Exploring barriers to and enablers of adequate healthcare for Indigenous Australian prisoners with cancer: a scoping review drawing on evidence from Australia, Canada and the United States

Abstract

BackgroundInternational frameworks supported by national principles in Australia stipulate that prisoners should be provided with health services equivalent to those provided in the general community. However, a number of barriers unique to the prison system may hinder the provision of equitable healthcare for this population. In Australia, Indigenous people carry a greater burden of cancer mortality, which the Cancer Data and Aboriginal Disparities (CanDAD) project is seeking to address. During the course of recruiting participants to the CanDAD study, Indigenous Australian prisoners with cancer emerged as an important, under-researched but difficult to access sub-group.MethodsThis scoping review sought to identify barriers and facilitators of access to adequate and equitable healthcare for Indigenous Australian prisoners with cancer in Australia. This review demonstrated a lack of research and, as such, the scoping review was extended to prisoners with cancer in Australia, New Zealand, the United States and Canada. This approach was taken in order to summarise the existing body of evidence regarding the barriers and facilitators of access to adequate and equitable healthcare for those who are incarcerated and suffering from cancer, and highlight areas that may require further investigation.ResultsEight studies or commentaries were found to meet the inclusion criteria. This limited set of findings pointed to a range of possible barriers faced by prisoners with cancer, including a tension between the prisons’ concern with security versus the need for timely access to medical care.ConclusionFindings identified here offer potential starting points for research and policy development. Further research is needed to better elucidate how barriers to adequate cancer care for prisoners may be identified and overcome, in Australia and internationally. Furthermore, given Indigenous Australians’ over-burden of cancer mortality and over-representation in the prison system, further research is needed to identify whether there are a unique set of barriers for this group.

Motherhood as a double-edged sword: A phenomenological exploration into the lived experiences of incarcerated pregnant women

“…Based on Olds et al (2016), motherhood is de ned as "having a feminine sense of self "and this identity is created when mothers' feelings are respected, valued and understood. He believes that motherhood is the result of one's own feeling and that feeling is inseparable from the living world which one experiences (10). In the interviews with mothers in prison in the western United States, many women talked about their maternal worries and anxieties in prison; include: tolerating the stresses of lack of proper care and welfare facilities for their children, inappropriate treatment of prison staff, being chained and handcuffed in front of their children or while they are in their arms, complications which result from childbirth and breastfeeding (11), compliance with strict prison rules (12) and most importantly, fear of separation from the child and concern about the effect of prison on his/her health and future.…”

Invisible women: correctional facilities for women across Canada and proximity to maternity services

“…Like most facilities in which women are incarcerated are co-located with men, and approximately 10 times as many men are incarcerated as women, prison health services are unlikely to be operationalized to provide gender-specific services including reproductive health care. For people in prisons, access to care can be hampered by security concerns (Olds et al, 2016) staffing issues (Morgan et al, 2007) and communication barriers between corrections and health-care providers [World Health Organization (WHO), 2014]. Poor access to reproductive health services can result in disease transmission, unwanted fertility, inadequate prenatal care, as well as maternal and neonatal complications (Stover et al, 2016).…”

The impacts of and outcomes from telehealth delivered in prisons: A systematic review

“…Factors contributing to limited access to healthcare services during incarceration are complex and multifaceted. These include individual-related barriers such as lack of understanding about the disease and the effects associated with treatment [ 15 ] and lack of knowledge regarding existing health services in prison [ 15 , 16 ]; organisation-related issues such as delays in approval of healthcare [ 15 , 16 ] and limited patient-centred approach due to security restrictions [ 17 ]; and social/cultural factors such as stigma and concerns about confidentiality [ 15 ]. Costs associated with transportation as well as potential risk of prison escapes further hinder the provision of timely and optimal healthcare services [ 2 , 18 ].…”