Ministry Releases Prisoner Health Findings
19 December 2006
Ministry of Health Releases Prisoner Health Findings
The Ministry of Health has today released a report describing the health status of the country's prison population.
Dr Don Matheson, Deputy Director General of Public Health says the Prisoner Health Survey 2005 provides us with a 'snapshot in time' and has been a joint project between the Ministry of Health and the Department of Corrections. Staff had highlighted the need for better information on the health status of prisoners in order to make a positive impact on the future planning of prison health services.
"The aim of the survey was to improve our understanding of the health needs of prisoners. The survey provides us with a wide-ranging and diverse dataset which will be a valuable tool for planning health services for prisoners in years to come."
Dr Matheson says, "the health of prisoners is important. Prisoners are entitled to the same level of health care as the rest of New Zealanders."
He says this survey has shown us that there are numerous opportunities to improve the health of prisoners, for example in the area of tobacco smoking. Two thirds of all prisoners surveyed reported being current smokers and females were significantly more likely to be current smokers than males.
"This is in addition to the areas of concern noted in previous surveys, such as drugs, alcohol and gambling addiction as well as mental health issues such as depression."
Dr Matheson says the survey has also given us a range of information specifically related to the Maori prison population which will be vital in future prison health service planning. Previously only a limited amount of health status information for Maori prisoners has been available. Prior to the survey we didn't have information on communicable disease, chronic disease, tobacco smoking and other risk factors like blood pressure, overweight and obesity and fruit and vegetable consumption for any of the prison population, including Maori."
Don Matheson says other new information looks at the rates of chronic diseases and communicable diseases amongst prisoners, something we haven't previously had any data on.
"Over half of all prisoners reported being diagnosed with a chronic disease (58.4%) and the most common reported chronic disease was asthma (21.6%)."
He says, "another finding is that the survey found one in three prisoners had a history of being diagnosed with one or more of the communicable diseases asked about. These included hepatitis B, hepatitis C, chlamydia, sexually transmitted infections, rheumatic fever and tuberculosis. The survey also showed one in 50 prisoners had a history of tuberculosis."
"Given that less than half the prison population surveyed had any formal qualification, the findings of this survey are also relevant in terms of programmes aimed at prisoners' rehabilitation and reintegration back into the community to reduce reoffending. In particular, the high prevalence of prisoners with a history of head injury which has left cognitive effects on some prisoners, commonly experienced memory and learning disabilities, vision and hearing difficulties."
Dr Matheson says the Ministry of Health is working with the Department of Corrections to identify how to make a positive impact on the current and future health status of the New Zealand prison population and improve the planning process for prison health and disability support services.
Prisoner Health Survey - Questions and Answers
1. What was the biggest health risk facing prisoners identified in the survey?
Previous research on prisoners has identified high levels of alcohol and drug use, gambling as well as depression. In addition to this, the survey identifies that one of the biggest health risks facing prisoners is tobacco smoking. Two-thirds of all prisoners reported being current smokers (67.1%) and females were significantly more likely to be current smokers than males. MÃ¢ori male prisoners have one and a half times the prevalence of smoking as MÃ¢ori males in the general population, while non-MÃ¢ori male prisoners have nearly three times the prevalence of smoking as non-MÃ¢ori males in the general population.
2. What is the Ministry of Health doing to address tobacco smoking and other areas identified in the survey including communicable disease?
Tobacco smoking has been identified as a priority area for further work. The Ministry of Health is working with the Department of Corrections on how we might provide smoking cessation programmes for prisoners. All prisoners have access to the Quitline freephone line. The Ministry is also in the process of implementing programmes to bring all prisoners vaccination status up to date.
3. What else is the Ministry doing to address already established priority areas for prisoners, eg mental health, alcohol and drugs?
The Government launched its package of initiatives (Effective Interventions in The Criminal Justice System) in August 2006 to improve the functioning of New Zealand's criminal justice system. That is, a system which "protects our communities by punishing offenders appropriately, cutting re-offending rates, and making better use of prisons". In this context the Government identified the association between offending behaviour and mental health and/or alcohol problems.
Accordingly the Government, within the Effective Interventions package asked the Officials to undertake two major projects. The first project will provide advice to Government on offenders with a mental health and/or a drug and alcohol problems and their interaction with the criminal justice system (Police, Courts, Corrections) and the Health sector, highlighting any service gaps. Officials of Health, Justice Corrections and Police are required to report back to Government on this work by 31 May 2007.
The second project involves the Ministry of Health investigating the availability of alcohol and drug assessment and treatment programmes for those offenders in the community who may be referred to services by the Department of Corrections, such as offenders on supervision, parole or home detention. The Ministry of Health is required to report back to Government by 31 March 2007.
The Ministry of Health has been responsible for overseeing the implementation of a number of strategies to address the needs of prisoners with mental illness identified in the National Study of Psychiatric Morbidity in New Zealand Prison (1999). In the last six years, the Ministry's Forensic Framework has resulted in an increase in additional beds and FTE positions. The Ministry is reviewing the existing framework for its relevancy to the future shape of services given the increased prison muster and additional prisons.
4. What access to medical care do prisoners have whilst in prison?
Prisoners are entitled to the same level of health care as the rest of the population. As well as seeing the prison nurse and prison doctor, one in five prisoners (18.2%) had seen a medical specialist (including psychiatrists) in the last year while in prison and one in five prisoners (20.5%) had been to a public hospital in the same period. Levels of health service utilisation were higher in older age groups.
5. Do prisons have to meet nutritional requirements when providing meals to prisoners?
Prisons abide by the Ministry of Health's Nutritional Guidelines in providing prisoners with three meals a day, including the recommended servings of fruit and vegetables. The survey showed that seven out of 10 prisoners (69.5%) eat the recommended two or more servings of fruit each day and six out of 10 (63.5%) eat the recommended three or more servings of vegetables each day. However, over half of all prisoners are overweight or obese.The survey also showed a trend for prisoners to have become less physically active since entering prison.
6. Has there been a health survey of prisoners before?
The Prisoner Health Survey 2005 is the first nationwide health survey of New Zealand prisoners aged 16 years and over, and is the first time a broad exploration of the health of prisoners has been carried out. An earlier survey examined the incidence of psychiatric problems in prisoners (ie, The National Study of Psychiatric Morbidity Study in New Zealand Prisons).
7. What were the objectives of the survey?
The objectives of the survey were to improve understanding of the extent of health needs among New Zealand prisoners and to inform future prisoner health service planning, policy, processes, and programmes.
8. When was this survey conducted?
The survey was conducted from May 2005 to November 2005 by the National Research Bureau Ltd (NRB).
9. Who was responsible for the survey?
The survey was initiated and developed by the Ministry of Health and the Ministry's Public Health Intelligence (PHI) section was asked to analyse the survey. The Department of Corrections was involved in the development of the survey and Corrections staff assisted NRB interviewers during data collection in prisons.
10. How many prisoners were surveyed?
This report includes information from 423 sentenced prisoners, of which 317 were male and 106 were female, with 199 MÃ¢ori and 224 non-MÃ¢ori.
11. Did most prisoners who were approached agree to take part?
The Prisoner Health Survey 2005 was well received, with 93 percent of sentenced prisoners approached completing a questionnaire.
12. What did the survey cover?
The survey asked questions about chronic diseases, disease risk and protective factors, health service utilisation, communicable disease, oral health and general health status. Mental health was not covered in the survey, as a comprehensive survey on this issue had been previously completed (ie, The National Study of Psychiatric Morbidity Study in New Zealand Prisons).
To view the full survey online please go to www.moh.govt.nz