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A recent study published in The Lancet has shed light on the alarming rates of death following incarceration, prompting urgent calls for comprehensive reform in prison healthcare and transitional care services worldwide. The study, conducted across eight countries including Australia, Brazil, Canada, New Zealand, Norway, Scotland, Sweden, and the U.S., revealed stark realities about the health outcomes of individuals post-release from prison.
More than 30 million people worldwide pass through prisons annually, with nearly 70,000 individuals in Australia alone. However, what follows release from prison is often a tragic tale of preventable deaths and poor health outcomes. The study highlighted that individuals who have experienced incarceration tend to face significantly poorer physical and mental health compared to those who haven’t been incarcerated. This includes higher rates of infectious diseases, mental illness, substance abuse problems, chronic diseases, and self-harm or suicide attempts.
The findings indicate a disturbing trend wherein the risk of preventable deaths dramatically escalates post-release. In the initial weeks after release, alcohol and drug overdoses were identified as the leading cause of death across all countries studied, except for Brazil, where deaths due to interpersonal violence prevailed. However, as time progressed, the burden shifted towards suicides, accidental injuries, and non-communicable diseases, including cardiovascular diseases and cancer.
Experts point out several contributing factors to this concerning trend. Firstly, incarceration often acts as a filter for poor health and marginalization, exacerbating existing health disparities. Secondly, many prisons worldwide fail to provide adequate physical and mental healthcare services, despite international standards mandating an equivalent standard of care to that available in the community. Thirdly, the lack of investment in transitional care to support individuals post-release further compounds the issue. Lastly, the stigma associated with incarceration, coupled with disruptions in healthcare, housing, employment, and social relationships, creates a ‘perfect storm’ of marginalization and exclusion for the vulnerable population.
In response to these findings, experts emphasize the need for urgent action. They stress the importance of prison healthcare providers in routinely assessing the health status of inmates upon entry, providing comprehensive healthcare during incarceration, and facilitating a smoother transition back into the community through pre-release needs assessments and coordinated transitional healthcare services.
However, addressing this issue requires a coordinated, whole-of-government response, with the World Health Organization (WHO) recommending the inclusion of prisons in all public health strategies and policies. Despite some promising initiatives, such as Aboriginal Community Controlled Health Organizations (ACCHOs) in Australia, the current actions remain insufficient to curb the alarming rates of post-incarceration deaths.
The study underscores the urgent need for routine monitoring of deaths following incarceration and coordinated efforts to prevent them. With political will and concerted efforts, there is hope for a future where individuals released from prison have an equal opportunity not only to survive but to thrive in their communities.
As the discourse around post-incarceration deaths gains momentum, there is a growing recognition that more research, particularly in low- and middle-income countries, is urgently needed to address this global health challenge and ensure a more equitable future for all.
