Salutogenesis in Prison

This chapter concludes Part VII, with a focus on salutogenesis in prisons. In this chapter, the authors present and debate how prison health rhetoric, policy and practice are influenced by a pathogenic view of prisoner “health.” The authors comment that there is a growing recognition of a salutogenic approach to prison health policy and practice, to help tackle the root causes of health, criminality and inequality. This chapter emphasises that while the health of prisoners is influenced by material and social factors beyond their control, a salutogenic approach offers an alternative way of delivering public health and health promotion in prisons. The chapter concludes noting that the application of salutogenesis in prisons is in its infancy. They call for research, policy and practice framed by a salutogenic orientation, leading to sustained and effective measures to improve the health of people in criminal justice settings, and reducing health inequalities in prisons.

Prison health priorities in Burkina Faso: a cross-sectional study in the two largest detention environments in Burkina Faso

Purpose The purpose of this paper is to study the factors associated with the occurrence of diseases and beriberi among prisoners incarcerated in the two largest Remand and Correctional Facilities (RCF). Design/methodology/approach This was a cross-sectional descriptive and analytical study carried out from April 20 to May 19, 2017, in the RCFs of Ouagadougou and Bobo-Dioulasso. All prisoners who consulted and those referred to the health center by the health-care team were included in the study. Complaints and diagnosed diseases information were collected using the second version of the International Classification of Primary Care (ICPC-2). The authors used a logistic regression model to perform univariate and multivariate analyses. Findings Of the 1,004 prisoners from the two RCFs included in the study (32.6%), 966 (96%) were male. The median age was 31.6 years. The distribution of diseases diagnosed using the ICPC-2 showed a predominance of gastrointestinal tract, skin and respiratory tract diseases among 206 (19.3%), 188 (17.6%) and 184 (17.2%) prisoners, respectively. A total of 302 prisoners (30.1%) had clinical beriberi, and 80 prisoners (8%) were underweight. Being incarcerated for more than nine months was independently associated with a high risk of digestive and respiratory diseases as well as beriberi. Research limitations/implications This study highlighted higher frequencies of digestive, skin and respiratory complaints and diseases in the two largest detention centers in Burkina Faso. These diseases are variously related to age, penal status and length of incarceration. In addition, underweight and thiamin vitamin deficiency responsible for beriberi are more frequent in adult prisoners, those not attending school, convicted prisoners and those with a length of stay in detention of more than nine months. These concrete results should help define a strategy and priority actions needed to reduce morbidity in prisons. Practical implications The actions should include the intervention of specialists in the field of common diseases in prisons, the improvement of individual hygiene conditions and environment, the improvement of the quality and quantity of the food ration, a strategy to reduce prison overcrowding. Other actions must be planned to allow specific groups such as women and minors to have access to health care that is adapted to them. Beyond the central concern of promoting the rights of prisoners and humanizing prisons, actions to improve the health of prisoners are part of an overall public health approach with its socio-economic and environmental implications. Social implications There is a need for a strong commitment from the State to develop a prison health policy that prioritizes the prevention of communicable and non-communicable diseases that are particularly prevalent in this context, without forgetting mental health and nutrition. This requires a collaboration of stakeholders based on better intersectorial communication, the implementation of a monitoring and evaluation system for the health of prisoners, an enhancement of the status of health-care providers working in prisons and an increase in the funding allocated to the health of prisoners with the mobilization of the necessary funds. Originality/value This study uses a primary health care classification to assess the health of inmates in a prison in Africa. It contributes to the weak evidence around prison health surveillance and health profiling of prisoners in Africa.

Prison health is a public health: Management of Sars-CoV-2 outbreak in an Italian prison

The Covid-19 emergency in prisons is a public health warming due to overcrowding, poor structural conditions,and life promiscuities.Worldwide a lot of prisoners were Sars-CoV-2 positive and in Italy several outbreaks occurred in many prisons.This paper examines, using a clinical audit, a Covid-19 outbreak occurred in an Italian prison during the spring2021.The study showed that the best measures to mitigate the outbreak negative consequences both in prisoners andin the staff are the preventive actions, the hygiene and disinfection of the common detention areas; the reductionof overcrowding; the stop of the working activities during the quarantine period.Only an improvement of living conditions inside the prisons may reduce the risk of infection among inmates.

Our Relationships Carry the Movement

The radical HIV prison activist movement has always been, in practice, an abolitionist movement. Set in Philadelphia in the early 2000s, this article centers the relationships through which leaders of ACT UP Philadelphia, the Philadelphia County Coalition for Prison Health Care, TEACH Outside, and Project UNSHACKLE worked to transform the social conditions for which prisons have been posited as the solution and to create a prison-free future in real time. Its pages unfold a three-part methodological toolkit for HIV prevention justice. First, harm reduction demands that one show up and provide relief, no questions asked. Second, mutual aid grounds the forging of new social relations that are more survivable than those produced by HIV stigma, mass criminalization, and organized abandonment. Third, transformative justice offers both a vision and a practice for challenging criminalization in all its intimate, communal, and structural forms, and building a racially just and strategic HIV movement.

Undergraduate students’ perspectives on the impact of a prison health course

Objective: The stigmatisation of incarceration has significant negative effects on the health and well-being of individuals and communities. At the University of British Columbia in Canada, an undergraduate course on prison health included instruction by people with lived experience of incarceration as part of a teaching approach aimed to reduce stigma. In this study, we sought to understand the impact of this course as described by students. Design: Qualitative interviews with students who completed the course in 2017 were conducted by another former student of the course. Interviews were transcribed and interpretive descriptive methods were used to elucidate findings. Results: Nine former students participated in the study, eight (89%) were women and the median age was 23 years. Analysis yielded the following themes: (1) learning from people with lived experience, (2) de-mystifying through knowledge and understanding, (3) broadened perspectives and self-reflection, (4) future choices and actions and (5) changing views on incarceration. Conclusion: Findings suggest that approaches to address stigma in teaching prison health in an undergraduate course provided students with a deepened understanding of health inequities and determinants of health; increased feelings of compassion and interest in health equity for populations impacted by incarceration; and fostered opportunities for reflection, critical thinking and broadened perspectives.