Prison Health as Public Health in Ontario Corrections

Murphy, Yoko; Sapers, Howard

doi:10.35502/jcswb.122

Cited by 5 publications

(6 citation statements)

References 33 publications

(41 reference statements)

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“…The consequences of incarceration and infection by HIV and HCV are vast and well-documented, having a cascading effect on multiple levels. For individuals, synergistic deficits increase the susceptibility for disease progression, multimorbidity, psychiatric suffering, and death [12,13]. For prison health and management, the duty of properly caring for serious physical and mental needs, coupled with efficient integration with external health services, are certainly challenging [14].…”

Section: Introductionmentioning

confidence: 99%

“…For prison health and management, the duty of properly caring for serious physical and mental needs, coupled with efficient integration with external health services, are certainly challenging [14]. Lastly, societal implications must be considered, including public health concerns as former prisoners might not seek specialized and early care due to untreated conditions, notwithstanding the higher chances of recidivism and difficulties in resocialization commonly seen [13,15].…”

Section: Introductionmentioning

confidence: 99%

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Seroprevalence and associated factors of HIV and Hepatitis C in Brazilian high-security prisons: A state-wide epidemiological study

et al. 2021

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The prevalence of hepatitis C virus (HCV) and the acquired immunodeficiency virus (HIV) is much higher in prisons than in community settings. Some explanatory factors for this burden include putative aspects of the prison environment, such as unprotected sexual relations and sexual violence, use of injectable drugs and syringe sharing. Nonetheless, efforts in better understanding the dynamics of both HCV and HIV are scarce in developing countries such as Brazil, which poses a risk not only to the inmates but to the community as well. In this investigation, we sought to determine the seroprevalence and sociodemographic and behavioral risk factors associated with HIV and anti-HCV antibodies among men detained at high-security institutions. This is an epidemiological, proportionally stratified observational study including 1,132 inmates aged 18 to 79 years-old (Mage = 32.58±10.18) from eleven high-security prisons located in the State of Paraná, Brazil. We found that HIV and anti-HCV prevalence were 1.6% (95% CI: 1.0–2.5) and 2.7% (95% CI: 1.0–2.5), respectively. Risk factors associated with HIV included not receiving intimate visits (OR = 8.80, 95% CI: 1.15–66.88), already having another sexually transmitted infection (OR = 3.89, 95% CI: 1.47–10.29), and reporting attendance in HIV preventive campaigns (OR = 4.24, 95% CI: 1.58–11.36). Moreover, anti-HCV seroprevalence was associated with higher age (OR = 4.03, 95% CI: 1.61–10.07), criminal recidivism (OR = 2.58, 95% CI 1.02–6.52), and the use of injectable drugs (OR = 7.32, 95% CI 3.36–15.92). Although prisons might increase the risk for acquiring and transmitting HIV and HCV, the adoption of permanent epidemiological surveillance programs could help reducing the circulation of viruses, involving strategies focusing on screening, treating, and preventing infections to assure proper prisoner health. Moreover, these policies need to take place inside and outside the prison environment to offer continued assistance to former prisoners once they leave the institution.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Seroprevalence and associated factors of HIV and Hepatitis C in Brazilian high-security prisons: A state-wide epidemiological study

et al. 2021

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“…All residents of Haley House are individuals on conditional release but remain under the supervision of CSC. Beyond this supervisory role, Haley House caters to older men with complex care needs [ 22 ], including individuals with dementia, individuals seeking palliative and end-of-life care, and individuals with mobility, and speech issues. In addition, Haley House employs a dignity-centred model of care for residents, which aims to improve the support provided across the care continuum [ 26 ].…”

Section: Methodsmentioning

confidence: 99%

“…This absence is particularly pronounced in studies on previously incarcerated older adults reintegrating back into the community. This marginalized population face barriers to health care access during community reintegration [ 19 , 20 ] which is further complicated by the prominence of accelerated health decline, poor social determinants of health and complex multi-morbidities [ 21 , 22 ]. Despite these recognized challenges, recent increases in incarceration rates [ 23 ] has focused research on the compromised health profiles of aging populations inside correctional facilities [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Lost in transition? Community residential facility staff and stakeholder perspectives on previously incarcerated older adults’ transitions into long-term care

et al. 2023

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Background Establishing an effective continuum of care is a pivotal part of providing support for older populations. In contemporary practice; however, a subset of older adults experience delayed entry and/or are denied access to appropriate care. While previously incarcerated older adults often face barriers to accessing health care services to support community reintegration, there has been limited research on their transitions into long-term care. Exploring these transitions, we aim to highlight the challenges of securing long-term care services for previously incarcerated older adults and shed light on the contextual landscape that reinforces the inequitable care of marginalized older populations across the care continuum. Methods We performed a case study of a Community Residential Facility (CRF) for previously incarcerated older adults which leverages best practices in transitional care interventions. Semi-structured interviews were conducted with CRF staff and community stakeholders to determine the challenges and barriers of this population when reintegrating back into the community. A secondary thematic analysis was conducted to specifically examine the challenges of accessing long-term care. A code manual representing the project themes (e.g., access to care, long-term care, inequitable experiences) was tested and revised, following an iterative collaborative qualitative analysis (ICQA) process. Results The findings indicate that previously incarcerated older adults experience delayed access and/or are denied entry into long-term care due to stigma and a culture of risk that overshadow the admissions process. These circumstances combined with few available long-term care options and the prominence of complex populations already in long-term care contribute to the inequitable access barriers of previously incarcerated older adults seeking entry into long-term care. Conclusions We emphasize the many strengths of utilizing transitional care interventions to support previously incarcerated older adults as they transition into long-term care including: 1) education & training, 2) advocacy, and 3) a shared responsibility of care. On the other hand, we underscore that more work is needed to redress the layered bureaucracy of long-term care admissions processes, the lack of long-term care options and the barriers imposed by restrictive long-term care eligibility criteria that sustain the inequitable care of marginalized older populations.

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“…Confirmatory data on these benefits for Canadian-specific correctional populations also exist (Farrell-Macdonald et al, 2014 ; MacSwain et al, 2013 ; Russolillo, Moniruzzaman, McCandless et al, 2018 ; Russolillo, Moniruzzaman, Somers et al, 2018 ). The initiation of OAT within Canadian federal correctional institutions, combined with continuous linkage to OAT treatment upon release, is therefore essential to support the health and well-being of this underserved population with complex needs (Binswanger et al, 2011 ; Larney & Dolan, 2009 ; McKenzie et al, 2009 ; Murphy & Sapers, 2020 ; Nunn et al, 2009 ).…”

Section: Introductionmentioning

confidence: 99%

Barriers and facilitators to opioid agonist treatment (OAT) engagement among individuals released from federal incarceration into the community in Ontario, Canada

Russell

Pang

Nafeh

et al. 2022

International Journal of Qualitative Studies on Health and Well

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Introduction Correctional populations with opioid use disorder experience increased health risks during community transition periods. Opioid Agonist Treatment (OAT) can reduce these risks, but retention is a key challenge. This study addresses a knowledge gap by describing facilitators and barriers to OAT engagement among federal correctional populations released into the community in Ontario, Canada. Methods This article describes results from a longitudinal mixed-methods study examining OAT transition experiences among thirty-five individuals released from federal incarceration in Ontario, Canada. Assessments were completed within one year of participants’ release. Data were thematically analyzed. Results The majority (77%) of participants remained engaged in OAT, however, 69% had their release suspended and 49% returned to custody. Key facilitators for OAT engagement included flexibility, positive staff rapport, and structure. Fragmented OAT transitions, financial OAT coverage, balancing reintegration requirements, logistical challenges, and inaccessibility of ‘take-home’ OAT medications were common barriers. Conclusions Post-incarceration transition periods are critical for OAT retention, yet individuals in Ontario experience barriers to OAT engagement that contribute to treatment disruptions and related risks such as relapse and/or re-incarceration. Additional measures to support community OAT transitions are required, including improved discharge planning, amendments to OAT and financial coverage policies, and an expansion of OAT options.

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Prison Health as Public Health in Ontario Corrections

Cited by 5 publications

References 33 publications

Seroprevalence and associated factors of HIV and Hepatitis C in Brazilian high-security prisons: A state-wide epidemiological study

Seroprevalence and associated factors of HIV and Hepatitis C in Brazilian high-security prisons: A state-wide epidemiological study

Lost in transition? Community residential facility staff and stakeholder perspectives on previously incarcerated older adults’ transitions into long-term care

Barriers and facilitators to opioid agonist treatment (OAT) engagement among individuals released from federal incarceration into the community in Ontario, Canada

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