Health Promotion

In The Prisons

Created by:
Stacy-Ann David , Ayden Flemming, Destiny Walcott, Chimika
Prescott, Naomi Villifana and Nakita Hernandez
Introduction

• The prison is a confine space in a

building where persons are legally
held as a punishment for a crime they
have committed or awaiting trial. In
Trinidad there are six prisons which
are Port of Spain, Carrera convict
prison, remand prison, maximum
security prison, eastern correctional
and rehabilitation center and one
convict depot in Tobago. The prison
service in T&T is an arm of the
criminal justice system and a division
of the Ministry of National Security.
Area

• The international committee of prisons recommends

that cells be at least 58 square feet in size for single
accommodation, however in shared dormitory it
recommends 37square feet per person including
bunkbeds being used. The cell has one bucket for all
inmates to use to pass stool and urine. When
overcrowded inmates sleep on the floor. Prisoners
usually spend most of there time in the cell, but to
eat, shower, wash clothes, worship, go to school or
to learn a trade they are removed from the cell, even
for recreational activities they go in open space for.
Characteristics

• Prisons are staffed with security correctional officers

who maintain order among inmates. They are
equipped with security features like high walls,
security lights, and powerful alarms. These are used
to keep inmates inside and monitor their behavior. In
Trinidad and Tobago, poisoners don’t have the luxury
of cell phones, television and radios in cells. Prison is
a rogue life with a lot of limitations and schedule for
every activity. They also reward bad behavior, and
they reward good behavior. The loss of a prisoner
sense of autonomy and capacity to control his or her
own will is taken away. The inculcation of a carceral
identity are reinforced by strict social arrangements
and the power of imbalance between officers and
prisoners. The perimeter fencing and security is to
prevent any escape. Not all convicted are sent to
prison some pay a fine or are place on a bond.
Health promotion strengths
in the prisons
• The strength-based approach in the prison is recognizing, mobilizing and
developing a person holistically to promote health and facilitate healing. Although
they are confined to a secured space with limitations health within an individual
must be met. Some strengths within the prison can be met by:

1.Healthy diet which includes foods from the six food groups and lots of water.
2.Vaccination to prevent communicable disease.
3.Routine doctor visits and dental checkups.
4.Exercising at least twice a week for one hour max and or getting fresh air.
5.Running water in cells or hand sanitizers, for inmates to cleanse hands after
passing stool and urine for inmates serving time.
6.Do laundry twice per week.
7.Include supervise social activities eg school, church, playing board games,
watching television or even having their family members visits often.
8.Encourage family members to bring fruits, healthy snacks and lots of water.
9.Limit the number of inmates in a cell.
10.For prisoners doing hard labor can plant vegetables and ground provisions to add
to the healthy diet and they will get a proper body workout.
Actual and potential
Health issues/concerns
• The prison population has overall poorer health. Many come from a
• background of social deprivation and economic disadvantage and, as a result, have
• significant health needs. Many of these needs are related to unhealthy lifestyles but
• most people in prison smoke and over half are dependent on alcohol and/or drugs
• and many have health issues associated with HIV, viral hepatitis, sexually
• transmitted infections (STIs), and tuberculosis.
• WHO states that the primary duty of healthcare staff is to protect and
• promote the health of prisoners by ensuring that they receive the best care possible.
• Supporting interventions in a prison environment is complex, due to the limitations
• of facilities. Across the prison estate, health promotion activities and interventions
• are variable, joint working is required to weave health promotion opportunities in
• activities within the prison
• . This is part of the prison and NHS partnership working to promote
• an entire prison approach to health promotion and they focus on 5 key areas such as healthy eating
• and nutrition, smoking, healthy lifestyles, including sex and relationships and active living, mental
• health promotion and wellbeing and drug and other substance misuses.
• Healthcare staff routinely provide information about what health services are
• available and how to access these. Health promotion information is available on
• notice boards and staff can provide information for specific illnesses/conditions.
• Health promotion activity is generally carried out by healthcare staff; physical
• education instructors can support this activity in the gym setting, but generally the
• focus sits with healthcare where physical health issues are identified. These health
• promotion activities need to be tailored to the educational abilities of prisoners to
• improve outcomes and support lifestyle changes.

Continued…..
Current Policies that Promote Health
Promotion In Prisons
• The promotion of health within prison systems is an essential but challenging endeavor. In recent
• years, various policies have been implemented globally to address the unique healthcare needs of
• incarcerated individuals. One prominent example is the adoption of harm reduction strategies,
• emphasizing access to substance abuse treatment and needle exchange programs. Such initiatives
• aim to reduce the spread of diseases like HIV and Hepatitis C among the prison population.

• Moreover, mental health support has gained recognition as a critical component of inmate well-
• being. Policies focusing on mental health intervention and counseling services aim to mitigate
• the impact of incarceration on individuals’ psychological health.

• Additionally, several countries have embraced the concept of rehabilitative justice, incorporating
• educational and vocational programs within correctional facilities. These programs contribute to
• the overall health and well-being of prisoners by preparing them for successful reintegration into
• society upon release.
Health Promotion Barriers
In The Prisons
• Initiatives for health promotion in prison environments face a number of challenges that limit
• their efficacy and reach. The paucity of funding allotted to assist health promotion initiatives in
• jails is a major obstacle (Smith, 2018).Prisons frequently struggle to offer appropriate money for
• health promotion programs due to budgetary constraints and conflicting priorities, which limits
• access to crucial resources including instructional materials, equipment, and experienced staff.
• Furthermore, one of the biggest obstacles to conducting health promotion programs in prisons is
• security concerns. The implementation of stringent security regulations and control measures
• may impede the mobility of both personnel and inmates, hence impeding the planning of health
• promotion events or workshops in correctional facilities. Furthermore, the power dynamics and
• hierarchical structure found in jails can have an effect on the attitudes of employees toward
• initiatives to promote health. Initiatives to promote health can be hampered by unfavorable
• attitudes or a lack of support from the prison staff, which can also put up obstacles to efficient
• cooperation and communication.
Continued……
• Moreover, a major obstacle to advancing health and wellness in jails is inmate resistance. For a
• variety of reasons, including a lack of knowledge about the advantages of healthy behaviors or a
• suspicion of authority, some people who are incarcerated may be hesitant or dubious to engage in
• health promotion initiatives. Building relationships, establishing trust, and customizing health
• promotion programs to the unique requirements and preferences of the prison population are all
• necessary to overcome inmate opposition (Smith, 2018).
• Improving the health and well-being of inmates in correctional facilities requires addressing
• these complex obstacles. Prison officials and healthcare professionals can create a supportive
• environment which promotes health, prevents diseases, and gives prisoners the power to make
• positive lifestyle decisions by acknowledging these obstacles and actively working to overcome
• them.
Recommendations

Promoting and maintaining a healthy lifestyle in this vulnerable

population is therefore a key challenge for prison staff, prison healthcare
staff and visiting healthcare professionals. WHO state that the primary
duty of healthcare staff is to protect and promote the health of prisoners
The prison population, although younger than the general population, has
and to ensure that they receive the best care possible. Supporting
overall poorer health. Many come from a background of social
interventions in a prison environment is complex, due to the limitations
deprivation and economic disadvantage and, as a result, have significant
of the regime and facilities. Across the prison estate health promotion
health needs. Many of these needs are related to unhealthy lifestyles;
activities and interventions are variable, joint working is required to
most people in prison smoke and over half are dependent on alcohol
weave health promotion opportunities in activities within the prison. This
and/or drugs, and previous engagement with health services has usually
is part of the prison and NHS partnership working to promote a whole
been minimal.
prison approach to health promotion; they focus on 5 key areas: healthy
eating and nutrition, smoking, healthy lifestyles, including sex and
relationships and active living, mental health promotion and wellbeing
and drug and other substance misuse
Continued…

Healthcare staff routinely provides information about what

health services are available and how to access these. Health
Prisons offer a unique opportunity to educate and encourage
promotion information is available on wing notice boards and
prisoners to better understand their own health; stopping
staff can provide information for specific illnesses/conditions.
smoking, nutrition, exercise and how to use health services are
Health promotion activity is generally carried out by
all activities that take place in the wider prison. A wide range
healthcare staff; physical education instructors can support
of tools can be used to support prisoners, including peer
this activity in the gym setting, but generally the focus sits
support and the questions asked in this chapter intend to
with healthcare where physical health issues are identified.
identify the most effective interventions and how to deliver
These health promotion activities need to be tailored to the
them.
educational abilities of prisoners to improve outcomes and
support lifestyle changes.
Conclusions

•The promotion of health within prison systems is an essential but challenging endeavor. In
recent years, various policies have been implemented globally to address the unique
healthcare needs of incarcerated individuals. One prominent example is the adoption of harm
reduction strategies, emphasizing access to substance abuse treatment and needle exchange
programs. Such initiatives aim to reduce the spread of diseases like HIV and Hepatitis C
among the prison population.

•Moreover, mental health support has gained recognition as a critical component of inmate
well-being. Policies focusing on mental health intervention and counseling services aim to
mitigate the impact of incarceration on individuals' psychological health.

•Additionally, several countries have embraced the concept of rehabilitative justice,

incorporating educational and vocational programs within correctional facilities. These
programs contribute to the overall health and well-being of prisoners by preparing them for
successful reintegration into society upon release.
References

• (Promoting Health and Wellbeing - Physical

Health of People in Prison: Assessment,
Diagnosis and Management of Physical Health
Problems, n.d.)

1. James, D. J., & Glaze, L. E. (2006). Mental

health problems of prison and jail inmates.
Bureau of Justice Statistics.
2. Dolan, K., Wirtz, A. L., Moazen, B., Ndeffo-
Mbah, M., Galvani, A., Kinner, S. A., &
Courtney, R. (2016). Global burden of HIV,
viral hepatitis, and tuberculosis in prisoners
and detainees. The Lancet, 388(10049), 1089-
1102.
•
• Smith, J. (2018). Health Promotion Barriers in
Prisons. Journal of Correctional Health Care,
• 45(2), 78-92.
THANK
YOU FOR
LISTENING