By Emilia Janca, Louise Southalan, Stuart Kinner.

A group of international collaborators with expertise in health in custodial settings, including WEPHREN members, recently prepared a submission to the Pan American Health Organization (PAHO) Commission on Equity and Health Inequalities in the Americas.

The Commission, chaired by Professor Sir Michael Marmot, was established in 2016 and is collecting information on the root causes of health inequalities in the Americas.  

The submission, entitled “the role of prisons, jail and youth detention centres in addressing health inequalities in the Americas”, was developed in collaboration with contributors based in Australia, the United Kingdom, Brazil, Russia, Canada and the United States, along with the WHO(Europe) Health in Prisons Programme.

The submission describes the remarkably high rates of incarceration in the PAHO region, the health issues for people who experience incarceration, and the impact of incarceration on families and wider communities.

Given the concentration of ill health and disadvantage among people who experience incarceration in the PAHO region, the submission argues that responding to the health needs of these vulnerable individuals is essential to addressing health inequalities at the population level.

It also highlights the importance of continuity of care in developing effective, sustainable responses, which in turn requires coordination of custodial and community health services.

Key issues covered by the submission include the need for responses incorporating effective healthcare governance in custodial settings, good data to inform policy and practice, and regional coordination to support monitoring and data collection and build regional capacity.  The submission advocates for the establishment of a PAHO Health in Prisons Program and the expansion of the WHO(Europe) survey of prison health systems to the PAHO region, including in youth detention settings.

The Commission’s report, along with concrete recommendations to reduce health equity gaps, will be released later this year.


The full submission is available here

Further information about the Commission is available here.



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