Why Canada needs healthy prisons

Canada going wrong direction on prison health, UBC physician says

Dr. Ruth Martin (left) and former inmate Mo Korchinski are fighting for improved prison conditions. Photo: Martin Dee.

Dr. Ruth Martin (left) and former inmate Mo Korchinski are fighting for improved prison conditions. Photo: Martin Dee.

Prisons represent an important opportunity to treat and prevent the spread of disease, says UBC’s Ruth Martin, a former prison physician who will speak at the UBC Prison Health Conference on Feb. 20 and 21. A public forum will also be held on Feb. 20.

What is the most pressing health concern facing Canada’s justice system?

It’s difficult to select one. The prevalence of all illnesses and diseases are higher among incarcerated populations compared to the general population, from mental illness to infectious disease. Prisoners with short sentences often have difficulty getting their basic health care needs addressed. Those with long sentences face difficulty with preventive measures for chronic illnesses, such as diabetes, heart disease and cancer screening.

Why is it important to improve prison health?

Three reasons. First, when prisoners are released, any diseases or illnesses they contracted in jail will spread to members of the general population without treatment and prevention. Second, the greater health risks facing the prison population make incarceration an important opportunity to reach a group that is otherwise difficult to reach for public health officials. Third, from a human rights point of view, to quote Dostoevsky, “One can measure the quality of a society by the quality of its prisons.”

Many people say prisoners get too many perks. What do you say to those critics?

Most people in jail have committed a crime because of unmet health and social needs. Poverty, poor education, trauma, challenging early childhoods, ethnicity and unstable housing all contribute to chronic unmet health and social needs, which can lead to addiction and crime, and to on-going health concerns. Time spent in prison should be about doing everything possible to restore a person’s health (physical, mental, emotional and spiritual) and education, so that all incarcerated people are better equipped to reintegrate into society when they leave the correctional institution.

Are Canada’s prison health policies getting better or worse?

In Nova Scotia and Alberta, the responsibility of provincial prison health care has transferred from the Ministry of Justice to the Ministry of Health. As a result, they can better assess the current quality of prison healthcare and move towards seamless continuity in health care standards between jail and the community. In contrast, B.C. is headed in the wrong direction. The Ministry of Health has no responsibility for the health care of B.C. prisoners. Instead, a private contractor provides prison health care. It’s a similar thing federally, with Correctional Services of Canada’s health care services remaining under justice instead of health.

Dr. Ruth Martin is a Clinical Professor in the Department of Family Practice.