Medical and social health problems of convicted and health care delivery to this category

Abstract

An overview of the literature of domestic and foreign authors concerning the prisoners incarceration conditions and the health status, the most important disease groups and the medical support organization is presented. The prisoners health status significantly differs from the nationwide values, what is related to the maladgusted population stratum concentration, the prison conditions that facilitate some infectious diseases spread, and other factors. These problems are not isolated, as the majority of persons who are in prison, sooner or later return to the community. In the second half of the 1990s in Russia the leading in morbidity structure of convicted were respiratory diseases - 23.5% (respiratory viral infections, chronic non-specific lung disease, pneumonia, etc.); mental disorders - 19.6% (alcoholism, drug addiction), infectious and parasitic diseases - 17.3% (tuberculosis, sexually transmitted infections) diseases of the skin and subcutaneous tissue - 10.9% (scabies, pediculosis). In Russia during the 1990s, the death rate of prisoners increased by 3.2 times (from 323.0 to 1027.3 per 100 thousand of convicts). However, since the late 1990s, there is a steady decline in mortality, which is determined primarily by a decrease in prisoners mortality from tuberculosis. Doctors availability (excluding dentists) for persons who are in prisons in republic of Tatarstan is 45.4 per 10 thousand, nurses availability - 109.1. These values are higher than in the institutions of the Ministry of Health, in terms of doctors - by 3.2%, and nurses - 18.1%. Prisons represent an important public healthcare resources, allowing to identify, treat, and prevent a large group of diseases in complicated target group which is often difficult to get by civilian health services. Existing problems in the prisoners health, poor material and technical resources of medical services are due to inadequate funding of the Department of the correctional system. Lack of legal framework does not allow the administration to take into account features of the most vulnerable categories of prisoners.