TORONTO - Federal inmates are far more likely to suffer chronic and mental illnesses, contract infectious disease and die prematurely than other Canadians, a comprehensive new report said.

The 65-page report commissioned by Correctional Service Canada also said the government department lacks an overall plan to prevent, treat and monitor illness in prison, where public health services are sorely lacking.

The report assessed the overall health needs of federal prisoners based on 20 years of studies and reviews on the physical and mental health of inmates.

On average, inmates are younger than the population as a whole but:
* Male prisoners are 40 per cent more likely to be treated for diabetes and 68 per cent more likely to be treated for heart conditions.
* Inmates are 20 times more likely to have hepatitis C and 10 times more likely to be infected with HIV.
* Inmates are twice as likely to smoke and 10 times more likely to have drug or alcohol problems.

Mental health disorders, substance abuse problems, fetal alcohol syndrome and some infectious diseases may predate incarceration.

The risk of being murdered is eight times higher than in the non-prison population. Inmates are four times more likely to commit suicide.

The report noted when inmates return to the community, they bring any untreated diseases they've acquired with them.

"Addressing their health needs will contribute to the inmate's rehabilitation and successful reintegration into the community," said the report, which was published as a supplement to the March/April issue of the Canadian Journal of Public Health.

The report is a "striking portrait" of health care in prison that points out problems and suggests ways to solve them, said Dr. Françoise Bouchard, director general of health services for Correctional Service Canada.

"The challenge is, we have to become more proactive in terms of reaching out and identifying these problems so that we can put in place some intervention," she said.

Bouchard said the Corrections Department has already acted on the report, setting aside $14 million over the next few years for a comprehensive surveillance system to monitor the care and treatment of inmates.

Source: www.cbc.ca

Inmates in poorer health, report suggests
Apr. 7, 2004.
FROM CANADIAN PRESS

A comprehensive new report on the health of inmates in federal prisons paints a grim picture of disease rates that vastly outstrip those in the general population.

Despite being younger, on average, than the population as a whole, inmates appear to be in markedly poorer health, with significantly higher rates of chronic and infectious diseases and mental health disorders, according to the report, published today in a special supplement to the Canadian Journal of Public Health.

Commissioned by Correctional Service Canada, the report contains several pointed reminders of why Canadians outside prison walls ought to care, noting that when inmates return to the community, they bring with them any diseases they acquired while behind bars, if they go untreated.

"Inmates come from the community and return to the community," it notes in the closing paragraph. "Addressing their health needs will contribute to the inmate's rehabilitation and successful reintegration into the community."

The report was greeted as an impressive feat by the executive director of the St. Leonard's Society of Canada, which provides services to and advocates for people in conflict with the law.

"To get all of this material in one place gives a far clearer picture of where we're at with federal prisoners than we have had," Elizabeth White said in an interview.

"And I think that can only bode well for future treatment opportunities and better understanding, in the health services field, of the needs."

The director general of health services for Correctional Services Canada agreed.

"It gives us, you know, a good benchmark and milestone to say, `OK, in the next years these are the issues that we should be addressing and prioritizing in our work,' " Dr. Francoise Bouchard, a community medicine specialist, said in an interview.

"We already have started that."

The report was compiled under the leadership of consultant Dr. Brent Moloughney, a specialist in public health and epidemiology.

The harsh portrait it paints comes as no surprise to those familiar with prisons and the health issues of people who end up in them, Bouchard admitted. Still, she believes it can serve as a useful reminder.

"For me, it's a good tool to raise the awareness of people about the situation we have, in the public as well as in our own community within CSC," she said.

This is a small portion of the reality the report captures:

-Roughly 70 per cent of inmates are identified as needing treatment for a substance abuse problem when they are first incarcerated.

-Aboriginals, who make up a hugely disproportionate part of the male and female prison population, are a high risk group with high rates of physical and sexual abuse, early drug and alcohol use and emotional problems.

-Inmates are more than twice as likely to smoke and are 30 times more likely to inject drugs.

-They are 20 times more likely to have hepatitis C and 10 times more likely to be infected with HIV.

-Their risk of being murdered is eight-fold higher than the non-prison population. They are four times more likely to commit suicide.

-Males are 40 per cent more likely to be treated for diabetes and 68 per cent more likely to be treated for heart conditions.

-HIV infection rates among female inmates are dramatically higher than the rest of the population. It's estimated 0.13 per cent of Canadians are HIV positive but at least 4.7 per cent of female inmate s carry the virus. Female inmates also have much higher rates of hepatitis C infection.

Many inmate health problems predate incarceration, the report suggests, including mental health disorders, substance abuse problems, fetal alcohol syndrome and some infectious diseases.

Others are acquired behind bars, where the risk of catching tuberculosis and diseases transmitted through sex or in blood - during needle sharing or tattooing - is high. In fact, the report makes a thinly veiled pitch for a needle exchange program for prisons.

Bouchard said Correctional Service Canada is taking a more activist approach, trying through programs and interventions to improve the health of inmates. She thinks the efforts will pay off.

"The outcomes eventually - hopefully - will be reflected. The results of any health services interventions are not always immediate," she said. "You're thinking long term."