Title: Right to Health in Prison
Funder: Medical Research Council

Abstract: There are over 10 million prisoners worldwide. The majority come from the poorest and most vulnerable groups in society. Their health is much worse health than that the general population and it deteriorates further after incarceration. With an estimated prison population of 607,731, Brazil has one of the highest rates of imprisonment at 301 per 100,000 population. Although Brazil is a signatory of the UN Universal Declaration of Human Rights (UDHR), which includes basic principles for the treatment of prisoners including access to healthcare, there is evidence of widespread prisoner neglect and maltreatment. In 2016 alone there were 379 deaths in Brazilian prisons due to violence and neglect. The majority of prisoners have an African background, belong to the poorest communities and are a highly stigmatised group. This contributes to an apparent widespread social indifference in Brazilian society. In Scotland, the prison population is considerably smaller than in Brazil; however, at 7692 the rate of imprisonment of 143 per 100,000 population, it is still amongst the highest in Northern Europe. Only England, Estonia, Latvia and Lithuania have higher rates of imprisonment. The prison population is overwhelmingly young, male and from the most deprived and vulnerable groups; but in contrast to Brazil, the majority are indigenous Scots, with only a small minority from ethnic minorities. In 2012, responsibility for healthcare provision was transferred from the Scottish Prison Service (SPS) to NHS Scotland because of concerns about the quality of provision. However, five years after the transfer there is no evidence a reduction in health inequalities or an improvement in addressing the health care needs of prisoners, whose health status remains considerably worse than that of the general population, We have brought together a diverse team of researchers from Scotland and Brazil working in the fields of public health, law, human rights, media and communications and social sciences, who will work together to create a realistic plan for improving access to healthcare in prisons. We will work together both face to face in interactive workshops and through the world-wide-web on three Work Packages. In the first, we will explore the views of government, members of the legal profession, the prison and health services and prison and health care workers about the role of prisons in Brazilian society and prisoners' human rights. We will also analyse how prisoners and prisons are portrayed in selected media and public relations materials from government agencies. In work package 2 we will review human rights law and examine how it is applied in practice in Brazil. This will involve engagement with members of the legal profession as well human rights organisations. In Work Package 3 we will explore male and female prisoners' experiences of accessing healthcare in prison. Special emphasis will be placed on empowering prisoners and breaking silence by obtaining their testimony and witnessing of prison life, access to healthcare, and strategies for change. In addition to interviews and focus groups with prisoners, we will also collect examples of art work and creative writing produced as part of creative arts projects operating within the selected prisons. This will allow prisoners to tell their stories in their own voices. We will share our work locally, nationally and internationally through: a web-portal specially designed for the project; academic papers; research and policy briefings; and through a public event designed to engage both professionals and members of the public. Through a consultation process we will work with researchers and stakeholders to produce a draft action plan to improve prisoners' access to health together. We will then develop a programme of research priorities to support the action plan and apply for funding for the research.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING;3.2 INTERVENTIONS TO ALTER PHYSICAL AND BIOLOGICAL ENVIRONMENTAL RISKS
Health categories: GENERIC HEALTH RELEVANCE