Prison population: physical health care needs

Research into physical health challenges experienced by people in prison. One of four studies on the health needs of Scotland's prison population.


1. The 17 areas of physical health need were: Ischaemic (Coronary) Heart Disease (CHD) and Other Heart Disease (OHD); Musculoskeletal Disorders; Diabetes; Epilepsy; Asthma; Chronic Obstructive Pulmonary Disease (COPD); Blood Borne Viruses (BBV); Sexually Transmitted Infections (STI); Oral Health; Cancer; Cerebrovascular Disease (Stroke); Digestive Conditions: Chronic Liver Disease (CLD), Chronic Kidney Disease (CKD) and Disorders of the Oesophagus, Stomach and Duodenum (DOSD); Respiratory Tract Infection (RTI); Covid-19; Dementia; Pregnancy, Maternal Health and Post-Natal Care; Acquired Brain Injury.

2. In the US, jails hold individuals convicted of minor offences or awaiting trial, and prisons hold individuals convicted of more serious offences.

3. Seroprevalence is the percentage of people in a population who have antibodies showing that they have been infected by a virus.

4. The NHS Health Check is a screening check that assesses risk of developing heart disease, stroke, diabetes and kidney disease among people aged 40 – 64 years used in England and Wales. In Scotland, it is known as the NHS Well man/Well woman check.

5. In 2018/19, 79% of people in prison received sentences of one year or less, rising to 91% receiving a sentence of two years or less (Scottish Government, 2021). However, the impact of the extension to the Presumption Against Short Sentences legislation to sentences of up to 12 months from July 2019 is not yet known.

6. In May 2021, 30% of people in Scottish prisons were on remand, either awaiting trial or convicted waiting to be sentenced (SPS, 2021).

7. Information relating to all persons in Scotland's prisons was extracted from the PR2 system (including PR2 number, name and a range of demographic information). Where possible, the Community Health Index (CHI) number was linked to the PR2 data, allowing data from a range of health datasets held by PHS to be collated for each individual (e.g. from hospital admissions, prescribing data, Scottish Morbidity Record, Scottish Care Information- Diabetes Collaboration, Electronic Communication of Surveillance in Scotland).

8. Approval to access these data was given by Scottish Government. 2019 data were selected following advice from SHS colleagues within Scottish Government, who advised that Covid has necessitated a change in SHS survey methodology. The impact of these changes on SHS data is not yet known, so the project team were advised to utilise pre-Covid (2019) SHS data for the current study.

9. The figures in this section are from annual population figures published by SPS

10. Ethnicity and arrival/departure figures are not available prior to 2010/11. The ethnicity and arrival/departure figures are from Scottish Government prison population statistics

11. The figures in this section are from the International Centre for Prison Studies, World Prison Brief

12. Public Health Scotland: Scottish heart disease statistics and General practice – disease prevalence data visualisation

13. There are important considerations regarding these comparisons. PHE (2015) only report figures for Type I and Type II Diabetes combined, which may partly explain the higher prevalence rates in prison samples from England compared to Scotland.

14. Ethnicity figures for Type I Diabetes were not available from PHS-PCLS due to low numbers of non-White prison residents with this diagnosis.

15. SHeS 2019 and SHS 2019 (for SHS, household grossing weight was used to calculate prevalence rates).

16. Public Health Scotland: General practice – disease prevalence data visualisation

17. Public Health Scotland: General practice – disease prevalence data visualisation

18. These figures are not specific to HIV, but include other conditions such as hypogammaglobulinemia and deficiency of immunoglobulin. Figures disaggregated by ethnicity were not available due to low numbers.

19. Public Health Scotland: Blood borne viruses and sexually transmitted infections

20. Public Health Scotland: Scottish Adult Oral Health Survey

21. Public Health Scotland: Cancer incidence in Scotland

22. Public Health Scotland: Scottish stroke statistics and General practice – disease prevalence data visualisation

23. SHS 2019 - 20.77%

24. Ethnicity figures for digestive problems were not available from PHS-PCLS due to low numbers of non-White prison residents with these diagnoses. For similar reasons, disaggregated figures for CKD are not available.

25. Note: Forsyth et al. (2020) derived their prevalence estimates by administering psychometric tools rather than examining the health care notes of participants. Indeed, Forsyth and colleagues note that only 2 out of 59 persons living in prison who were identified as having dementia had a formal diagnosis on their records. This might explain the lower prevalence rate for persons living in prison in Scotland, which was derived from health care records rather than from psychometric tests.

26. Public Health Scotland: Dementia benchmarking toolkit

27. Ethnicity figures for Dementia and neurological conditions (excluding epilepsy) were not available from PHS-PCLS due to low numbers of non-White persons living in prison in Scotland with these diagnoses.

28. Name removed to preserve anonymity.

29. Simon Community Scotland works alongside Local Authorities to provide support for individuals who are homeless with the provision of emergency shelter and to address the underlying reasons for their homelessness.

30. The Wise Group provides the New Routes Throughcare Mentoring service which is delivered as a Public Social Partnership between public, social, and voluntary sector organisations (including Sacro, Apex Scotland, SAMH and Families Outside) and is funded by the Scottish Government.

31. Intensive Treatment Unit

32. With the easing of the pandemic, services have been re-established and support workers are again able to meet liberated individuals at the gate should this support be required.



Back to top