There’s a health care crisis in Canada’s federal prisons, says Global Health grad

The United Nations states that prisoners should enjoy the same health care standards that are available in the community, yet incarcerated persons face barriers to care, in addition to unique health challenges, and a higher risk of disease. The result is a global health crisis – one that impacts Canada’s federal prisons.

An article on legislation governing the provision of health care in prisons, authored by Eilish Scallan, was published this month in the journal Health. Scallan is medical student at McMaster and a graduate of the MSc Global Health program.

“In order to meet UN standards, governments and communities need to pay more attention to the ways in which laws and other governing practices result in health care inequities for prisoners,” explains Scallan.

Given the ways in which prisons shape health outcomes for incarcerated persons, she has focused her research on how health care provision is governed in prisons here in Canada.  Three key themes emerge from her findings:

1. In the context of federal prisons, what constitutes “essential” health care services is more limited compared with the broader community. For example, the exclusion of key resources such as needle exchange programs and accessible mental health services is an issue in many locations.
2. The dichotomy between the rights of prisoners versus the protection of society has a significant bearing on their treatment. For example, the legislation suggests that mental health services are considered mainly for inmates who will be reintegrated into the general community.
3. The representation of health – which is limited to concepts of “essential” care or “non-essential mental health” – has negative effects on the health of persons in prison.

While the Canada Health Act (CHA) sets the standard for health across most Canadian populations, health in federal prisons is governed by the Corrections and Conditional Release Act (CCRA). Scallan’s research examines how the specific representation of “health” in this legislation impacts persons in federal prison.

“The representation of health reiterates that prisons are places of punishment, rather than rehabilitation,” says Scallan.

“Prisons have an opportunity to serve as intervention sites for underserved populations, but factors including overcrowding and inadequate harm reduction programs work to deepen existing inequities,” she says.

Scallan’s work builds on a body of scholarship which has brought to light the ways in which laws and policies produce meanings around social “problems,” including the “problem of health.”

“The way in which policies and laws are written inherently shape problems,” Scallan explains. By examining how ‘health’ is represented as a particular kind of problem in the legislation, she identifies the effect this has on the lives of those in federal prisons.

“There’s an implicit acceptance of lower standards of care for those behind bars. It’s our responsibility to hold our governments accountable to ensure positive change.”

Read the full paper

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