The health of prisoners in Tuscany 10 years after the reform. Results of the fourth survey in 2018
Dealing with the health of prisoners and their health care is crucial for many reasons. In the first place it is equivalent to implementing public health interventions in the broadest sense of the term.
Many international studies have shown, in fact, that the detained population, although young, is characterized by a high prevalence of people with serious health conditions, significantly higher than that of the general population. This concerns in particular psychiatric disorders, dependence on psychotropic substances, infectious diseases and some chronic pathologies, above all of the gastrointestinal system. We also know that most of the detainees will return to freedom, bringing with them diseases that can potentially pose a risk to the health of the whole community, adding to the burden of disease already present. There is therefore a compelling interest in this section of the population receiving appropriate treatment and care for any manifested ailment, discomfort or illness.
For almost 10 years, ARS Toscana has been monitoring the state of health of the detained population through an ad hoc survey. In the epidemiological panorama, the ARS survey is still the only investigation that detects the pathologies present in prison.
In addition, in 2018 a computerized clinical card was introduced, which has a sociodemographic section and a health section.
The first, in addition to containing information of a general nature, also records where the prisoner has come from (from freedom, from another institute, from a diagnostic therapeutic centre, from community orders or house arrest) and whether this is their first detention. This latter information is very interesting in order to assess the health status of people who are entering the penitentiary system for the first time.
The second section includes the recording of: diagnoses, both internal and psychiatric, coded according to the International Classification of Diseases, Ninth Revision, Clinical Modification; the pharmacological treatments provided within the facilities, registered by trade name; the consumption of tobacco and cigarettes smoked daily (ex-smokers were assigned to the non-smoking category); weight and height values that can determine the body mass index; and specific information regarding attempted suicide and acts of self-harm.
The survey, carried out thanks to the active collaboration of medical personnel employed at Tuscany penitentiary facilities, took place between 1 November 2017 and 28 February 2018, and involved all inmates surveyed on 24 October 2017 at all Tuscany detention facilities.
