Implementation of Screening Programs in Incarcerated Populations

Rebecca Peisah and Anisha Gandhi

Background

The health of incarcerated persons is poorer than that of the general population (Australian Institute of Health and Welfare, 2013). High rates of mental illness, substance use disorder and chronic disease are identified risk factors that place incarcerated persons at an increased risk of morbidity and mortality from an array of preventable diseases, including cancer (Hesse, Sarah, et al., 2023). Australia has three national population-based screening programs that are widely available in the general community, however, screening programs in prisons are poorly established and often provided on an ad hoc basis (Hesse, Sarah, et al., 2023). This research aims to identify the health issues within incarcerated populations that may be a barrier to screening provision, while also identifying current and previous interventions to overcome these health issues. 

Methods

This data was collected through a public health analysis of screening programs in the adult prison population, specific to Australia.

Results

The literature revealed three important public health issues impacting screening in prison, including the over-representation of marginalised adult populations, low rates of participation in screening programs, and low health literacy. Key public health initiatives implemented to overcome these health issues fell into the brackets of restorative justice programs, pilot prison screening programs and social media campaigns. The principle clinical interventions were directed at continuity of care arrangements between prison and community health, reducing modifiable risk factors, and improving access to specialist services.

Conclusion

It is well established that people in prison are one of the most vulnerable and disadvantaged groups in Australia (RACGP, 2023). Recommendations to improve the health of incarcerated populations should focus on 1) implementing a standardised screening program in Australian prisons, 2) strengthening continuity of care between prison and community health services, and 3) improving health literacy.