Prison health and public health responses at a regional prison in Western Australia

Abstract

Objective: To describe the health of inmates in a Western Australian regional prison and evaluate the coverage of public health interventions. Design: Cross‐sectional audit of all paper‐based and electronic medical notes of inmates at one regional prison in Western Australia. Setting: A mixed medium‐security prison in regional Western Australia. Participants: 185 prisoners, 170 men and 15 women Main Results: The prisoners were mainly young (70% < 35 years of age) and Indigenous (84%). Fifty two percent of prisoners had at least one chronic health condition. There was a significantly higher prevalence of diabetes to that found in the general Indigenous population (15% vs 6% p=0.001), and a significantly lower prevalence hepatitis C (4.5%) compared with both national (29–61%) and State (20%) data. Screening for sexually transmitted infections and blood borne viruses within the first month of incarceration was achieved for 43% of inmates. Vaccination coverage for influenza (36%) and pneumococcal disease (12%) was low. Conclusion: This study makes visible the burden of disease and reach of public health interventions within a largely Indigenous regional prisoner population. Our study demonstrates that the additional risks associated with being Indigenous remain in a regional Australian prison but also shows that interventions can be delivered equitably to Indigenous and non‐Indigenous inmates. Implications: Ongoing monitoring of prisoner health is critical to take advantage of opportunities to improve public health interventions with timely STI and BBV screening and increased vaccinations rates.

Chronic hepatitis B prevalence among Aboriginal and Torres Strait Islander Australians since universal vaccination: a systematic review and meta-analysis

“…Three further studies involved clinical audits, with two of the three [45,47] comparing HBsAg prevalence among Indigenous and non-Indigenous prisoners. These two studies in prisoners had small samples sizes (101 and 185), and were conducted mostly in males (>80%), with one study showing a higher HBsAg prevalence among Indigenous (3%) compared with non-Indigenous prisoners (1%) and the other found a similar prevalence of 3% among Indigenous and non-Indigenous prisoners.…”

Chronic hepatitis B prevalence in Australian Aboriginal and Torres Strait Islander people before and after implementing a universal vaccination program: a systematic review and meta-analysis

“…Among the 36 studies, four were conducted in urban areas, 28,37,40,43 10 in regional, 30,34,38,41,[44][45][46][47]49,55 seven in remote, 27,33,35,42,[52][53][54] 12 were conducted in multiple geographical locations or were national analyses with no breakdown by location 29,36,39,50,51,[56][57][58][59][60][61][62] and two did not provide enough information to determine a geographical location. 32,43 There were two studies conducted in SA, 27,37 four in WA, 29,30,33,48 five in Qld, 39,41,42,44,52 nine in NSW, 28,32,34,…”

Reducing the health disparities of Indigenous Australians: time to change focus

“…In the US, ongoing disparities in income and education and the pervasiveness of poverty all impact negatively on the mental health and wellbeing of American Indian and Alaska Native peoples and lead to early morbidity and mortality [14]. Indigenous populations in Canada, the United States, Australia and Aotearoa/New Zealand are over-represented in prisons [15,16] and those with mental illness constitute some of the most vulnerable groups in society, experiencing further isolation and stigmatisation as a result of their illness and often facing additional risks from racial discrimination [17]. …”