Prison healthcare is the medical specialty in which healthcare providers care for people in prisons and jails. Prison healthcare is a relatively new specialty that developed alongside the adaptation of prisons into modern disciplinary institutions. Enclosed prison populations are particularly vulnerable to infectious diseases such as hepatitis, tuberculosis, AIDS or HIV, and Covid-19. Incarcerated people also have higher rates of chronic medical conditions than the general population including arthritis, asthma, hypertension, cervical cancer, and mental health issues such as depression, mania, anxiety, substance use disorders and post-traumatic stress disorder. Many environmental factors specific to jails or prisons also pose a significant health risk to incarcerated people, including solitary confinement, overcrowding, exposure to extremes of temperature due to lack of air conditioning or heating, noise pollution, lack of privacy, and lack of ability to make medical decisions (lack of autonomy). These conditions link prison healthcare to issues of public health, preventive healthcare, and hygiene. Prisoner dependency on provided healthcare raises unique problems in medical ethics.
Scope of field Prison populations create specific medical needs, based on the communal nature of prison life and differing rates of imprisonment for different demographics. For example, general population ageing has increased the number of elderly prisoners in need of geriatric healthcare. In addition, treatment for mental health, sexually transmitted infections like HIV, and substance abuse are all important elements of prison healthcare, as well as knowledge of public health methods. Universal screening for sexually transmitted infections (STIs) in prison populations has been shown to improve infection detection rates and uptake in treatments. In the United States, inmates infected with HIV have superior access to treatment and care than the general population. HIV infected prisoners typically see their condition improve while incarcerated and oftentimes reduce their HIV to the point that they have undetectable viral loads. In the United States, universal screening for sexually transmitted infections, while allowing prisoners the opportunity to opt out of screening (rather than only screening prisoners who display symptoms) significantly increased detection rates of STIs. In New York City, such universal screening increased the rate of chlamydia detection by 1636% and gonorrhea detection by 885%. After instituting universal screening, the rate of chlamydia in New York City overall increased by 59%. The separation of prison healthcare from other medical specialties and healthcare systems leads to its isolation and stigmatization as a field, despite some countries' promise for "equivalence" in healthcare between prison and non-prison patients. Some hospitals have a prison ward which is used to treat people held in police custody or convicted criminals. Some prison wards specialize in treating patients with severe mental health issues. Healthcare policy and services in prisons recognise the differences in health needs between women and men. Women in prison have specific needs in relation to menstruation, pregnancy, post-partum health, contraception, mental health and menopause. The United Nations Rules for the Treatment of Women Prisoners and Non-custodial Measures for Women Offenders (2010) outline standards for care of women offenders and prisoners and are known as the 'Bangkok Rules'.
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