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.