The Health of Australia's Prisoners 2010
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The health of Australia’s prisoners 2010 Australian Institute of Health and Welfare Cat. no. PHE 149 The Australian Institute of Health and Welfare is a major national agency which provides reliable, regular and relevant information and statistics on Australia’s health and welfare. The Institute’s mission is authoritative information and statistics to promote better health and wellbeing. © Australian Institute of Health and Welfare 2011 This product, excluding the AIHW logo, Commonwealth Coat of Arms and any material including artwork owned by a third party or protected by a trademark, has been released under a Creative Commons BY 3.0 (CC‑BY 3.0) licence. Excluded material owned by third parties may include, for example, design and layout, images obtained under licence from third parties and signatures. We have made all reasonable efforts to identify and label material owned by third parties. You may distribute, remix and build upon this work. However, you must attribute the AIHW as the copyright holder of the work in compliance with our attribution policy available at <www. aihw.gov.au/copyright/>. The full terms and conditions of this licence are available at <http:// creativecommons.org/licenses/by/3.0/au/>. Enquiries relating to copyright should be addressed to the Head of the Communications, Media and Marketing Unit, Australian Institute of Health and Welfare, GPO Box 570, Canberra ACT 2601. A complete list of the Institute’s publications is available from the Institute’s website <www.aihw.gov.au>. ISBN 978‑1‑74249‑195‑0 Suggested citation Australian Institute of Health and Welfare 2011. The health of Australia’s prisoners 2010. Cat. no. PHE 149. Canberra: AIHW. Australian Institute of Health and Welfare Board Chair Dr Andrew Refshauge Director David Kalisch Any enquiries about or comments on this publication should be directed to: Communications, Media and Marketing Unit Australian Institute of Health and Welfare GPO Box 570 Canberra ACT 2601 Tel: (02) 6244 1032 Email: [email protected] Published by the Australian Institute of Health and Welfare Cover image: detail from artwork by an Indigenous offender. Printed by Bytes 'n Colours Please note that there is the potential for minor revisions of data in this report. Please check the online version at <www.aihw.gov.au> for any amendments. Contents Contents Acknowledgments ........................................................................v Abbreviations.............................................................................vi Symbols...................................................................................vi Summary ................................................................................vii Overview ................................................................................viii Snapshot of the health of Australia’s prisoners...........................................xi 1 Introduction ...........................................................................2 1.1 Background......................................................................3 1.2 Prisoner health services in Australia ..............................................3 1.3 National Prisoner Health Census method ........................................4 1.4 Report structure .................................................................6 2 Overview..............................................................................10 2.1 Prison environment.............................................................10 2.2 Australia’s prisoners .............................................................12 2.3 Prison entrants..................................................................13 3 Health conditions.....................................................................26 3.1 Mental health...................................................................26 3.2 Head injury . 37 3.3 Communicable diseases ........................................................39 3.4 Chronic conditions .............................................................43 3.5 Women’s health ................................................................49 4 Health behaviours ....................................................................54 4.1 Tobacco smoking ...............................................................54 4.2 Risky alcohol consumption .....................................................57 4.3 Illicit drug use...................................................................60 4.4 Unprotected sex................................................................68 4.5 Health service use...............................................................68 The health of Australia’s prisoners 2010 iii 5 Prison health services.................................................................78 5.1 Visits by Aboriginal Community Controlled Health Organisations ..............78 5.2 Referrals to prison mental health services .......................................80 5.3 Identification of suicide or self‑harm risk ........................................82 5.4 Transfers from prison clinic to public hospitals..................................83 s 5.5 Immunisation...................................................................83 5.6 Discharge planning .............................................................84 5.7 Use of prison clinic..............................................................86 5.8 Problems managed in prison clinics.............................................90 Content 5.9 Initiator of clinic visits...........................................................95 5.10 Type of health professional seen in clinic visits ..................................97 5.11 Opioid pharmacotherapy treatment............................................99 5.12 Medication ....................................................................102 5.13 Full‑time equivalent staffing ratios . 112 6 Deaths ...............................................................................116 6.1 Deaths in custody..............................................................116 6.2 Deaths following release from prison...........................................117 7 Comparisons with the general community..........................................120 7.1 Indigenous and non‑Indigenous populations ..................................120 7.2 The general Australian population .............................................130 8 Data gaps and future directions .....................................................134 8.1 Missing information and unavailable data......................................134 8.2 Indicators not included in this report ..........................................135 8.3 Future directions for the Census ...............................................135 Appendix A 2009–2010 comparisons .................................................136 Appendix B List of indicators ..........................................................146 Appendix C Data sources..............................................................149 Appendix D Prisoner health services in Australia .....................................151 Appendix E Key policy directions .....................................................155 Appendix F Prisoner health legislation in Australia ...................................159 Appendix G Prisons in Australia.......................................................161 Appendix H Prisoner health Census forms ............................................163 Glossary ................................................................................174 References . 178 List of tables ............................................................................186 List of figures ...........................................................................190 iv The health of Australia’s prisoners 2010 Acknowledgments Acknowledgments The author of this report was Ingrid Johnston. Ellen Connell and Jenna Pickles helped to produce the report, with valuable input from Dr Fadwa Al‑Yaman and Tim Beard. Dr Al‑Yaman has provided support and leadership to this project since its inception. Other people at the Australian Institute of Health and Welfare (AIHW) have also provided important assistance to this project: John Steggall for the census forms, Melita Lee for the database, and Jan Watson for data entry. Special thanks go to all the prisoners and service providers who participated in the Census and to the states and territories for their support in coordinating this work with prisons in their jurisdiction. This report would not have been possible without them. The AIHW would like to acknowledge the valuable contribution provided by members of the Prisoner Health Information Group in the preparation of this report. Funding for this report was provided by the participating jurisdictions, with support from the AIHW. Queensland Health Dr Alun Richards Department of Corrective Services, Western Australia Dr Fraser Moss South Australian Prison Health Service Dr Peter Frost Department of Health and Human Services, Tasmania Dr Chris Wake Justice Health, Australian Capital Territory Professor Michael Levy Department of Health, Northern Territory Harry McSherry Justice Health, New South Wales Dr Devon Indig Department of Justice, Victoria Michele Gardner Australian Bureau of Statistics Jane Griffin‑Warwicke, Michelle Marquardt Burnet Institute Dr Stuart Kinner Kirby Institute Dr Tony Butler The health of Australia’s prisoners 2010 v Abbreviations ABS Australian Bureau of Statistics ACCHO Aboriginal Community Controlled