Abstract
BackgroundInternational frameworks supported by national principles in Australia stipulate that prisoners should be provided with health services equivalent to those provided in the general community. However, a number of barriers unique to the prison system may hinder the provision of equitable healthcare for this population. In Australia, Indigenous people carry a greater burden of cancer mortality, which the Cancer Data and Aboriginal Disparities (CanDAD) project is seeking to address. During the course of recruiting participants to the CanDAD study, Indigenous Australian prisoners with cancer emerged as an important, under-researched but difficult to access sub-group.MethodsThis scoping review sought to identify barriers and facilitators of access to adequate and equitable healthcare for Indigenous Australian prisoners with cancer in Australia. This review demonstrated a lack of research and, as such, the scoping review was extended to prisoners with cancer in Australia, New Zealand, the United States and Canada. This approach was taken in order to summarise the existing body of evidence regarding the barriers and facilitators of access to adequate and equitable healthcare for those who are incarcerated and suffering from cancer, and highlight areas that may require further investigation.ResultsEight studies or commentaries were found to meet the inclusion criteria. This limited set of findings pointed to a range of possible barriers faced by prisoners with cancer, including a tension between the prisons’ concern with security versus the need for timely access to medical care.ConclusionFindings identified here offer potential starting points for research and policy development. Further research is needed to better elucidate how barriers to adequate cancer care for prisoners may be identified and overcome, in Australia and internationally. Furthermore, given Indigenous Australians’ over-burden of cancer mortality and over-representation in the prison system, further research is needed to identify whether there are a unique set of barriers for this group.
Highlights
International frameworks supported by national principles in Australia stipulate that prisoners should be provided with health services equivalent to those provided in the general community
Chronic illness is of particular concern for this population, with one third of prisoners identified as having a chronic health condition and 2 % ever being diagnosed with cancer (Australian Institute of Health and Welfare 2013)
Research question The questions addressed by the review were: ‘What do the experiences of male and female prisoners with cancer tell us about the adequacy of care for prisoners with cancer in Australia, New Zealand, the United States and Canada?’ and ‘What does the available evidence reveal about gaps in care, and barriers and facilitators of access to healthcare for prisoners with cancer in Australia, New Zealand, the United States and Canada?’
Summary
International frameworks supported by national principles in Australia stipulate that prisoners should be provided with health services equivalent to those provided in the general community. The relative social disadvantage of the Australian prison population as a whole, compared to the general population, is well documented. This includes disadvantage in areas such as housing, employment, education and health (Alan et al 2011; Australian Institute of Health and Welfare 2013). Chronic illness is of particular concern for this population, with one third of prisoners identified as having a chronic health condition and 2 % ever being diagnosed with cancer (Australian Institute of Health and Welfare 2013).
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