The WHO status report on prison health in the WHO European Region presents an analysis of data collected on the health status of people in prison and prison health systems for 39 countries in the Region. The WHO survey collected data from Member States between 2016 and 2017 to enable monitoring and surveillance of health in prisons.
The report reveals that the general state of monitoring and surveillance systems for health in prisons is poor. This affects the development of evidence-based policies that effectively target the needs of the prison population.
“We only have data from 39 countries, but the data that we have indicate an enormous difference in the general health of people in prison compared to those in the outside world. Collecting this data is essential to enable the integration of prison health policies into the broader public health agenda benefiting the entire society,” says Dr Carina Ferreira-Borges, Programme Manager for Alcohol and Illicit Drugs at the WHO Regional Office for Europe.
An estimated 6 million people are incarcerated each year in the Region. After release, rates of reoffending and returning to prison are high. The report points out that this cycle between prison and community often leads to disjointed and ineffective health care outside of prison.
During the early days of a person’s release, the risk of suicide, self-harm and drug overdose is increased. This means that continuity of care during this transition is critical. Gaps in care during this period have significant negative public health implications and can constrain a country’s ability to address inequalities.
“A large proportion of people in prison return to the community every year, so viewing prison as a setting for public health opens an opportunity for public health actions and for improving health literacy to support and protect vulnerable populations,” says Dr Bente Mikkelsen, Director of the Division of Noncommunicable Diseases and Promoting Health through the Life-course at the WHO Regional Office for Europe.
“A prison sentence takes away a person’s liberty; it should not also take away their health and their right to health,” she adds.
Prisons and other places of detention have an opportunity to deliver preventive and risk-reduction interventions and treatments to a population that previously may have lacked or had limited access to health care and a healthy lifestyle.
According to the report, prisons must be seen as settings in which health interventions can address existing health conditions and contribute to positive lifestyles and behaviour changes. Time in prison can also be used to improve people’s skills to help them find a job after release and reintegrate into society.
“The prison population, with its disproportionate disease burden, is one that cannot be forgotten in WHO’s pursuit of the United Nations Sustainable Development Goals. To achieve universal health coverage and better health and well-being for all, as in WHO’s vision, it is vital that prisons are seen as a window of opportunity to change lifestyles and ensure that no one is left behind,” emphasizes Dr Mikkelsen.