Ethnic differences in the health of women prisoners

A Phenomenological Inquiry into the Psychological Experiences of Incarcerated Pregnant Women

OBJECTIVE

With the increasing number of incarcerated women worldwide, the rate of women who experience pregnancy in prison, has also increased in this population. Exploring the unique experience of pregnant prisoners can contribute to understanding the complex world of this vulnerable population and, as a result, tailoring programs to promote their health status. The objective of this study was to understand the psychological experience of pregnancy in prison based on the lived experiences of incarcerated women.

METHODS

This was a qualitative inquiry using van Manen's approach to phenomenology. Seven pregnant and four early postpartum women, with experience of pregnancy during incarceration, were selected purposefully in a prison in Iran from 2019 to 2020. In-depth semi-structured interviews were used to collect data. To analyze data, six-step van Manen's descriptive-interpretive phenomenological approach was adopted using MAXQDA10 software.

RESULTS

The main theme of "white torture", a term used to describe the psychological and emotional distress experienced by incarcerated pregnant women, emerged from the data analysis. This theme echoes the pressure and torment of pregnancy on incarcerated women and consists of two subthemes: "captive to bitter and harsh emotions" and "suffering from psychosomatic pain and injuries."

CONCLUSION FOR PRACTICE

As an emotional trauma, pregnancy puts incarcerated women under psychological torture. Policies should be developed towards the acknowledgment and meeting of the unique psychological needs of pregnant women in prison. It is also crucial for healthcare providers to provide women in prison with training on coping strategies to address the psychological and emotional challenges of pregnancy.

Effectiveness of a 4-Day Mindfulness-Based Intervention in a 2-Month Follow-Up for Chinese Incarcerated People

Mindfulness-based interventions, an evidence-based stress reduction approach, may help incarcerated people cope with stress-related problems in the challenging environment of prison. However, due to their unique living environment, the duration and instructor guidance required by standard mindfulness-based interventions would be infeasible in most prisons. Therefore, the aims of the current study were to test the effects of two different 4-day interventions (i.e., instructor-guided and audio-based) with content similar to Mindfulness-Based Cognitive Therapy for newly incarcerated males, and to compare the effectiveness of the two interventions relative to a no-intervention control group. Using daily assessments, we explored changes in perceived stress, insomnia, and negative affect in the 56 days following the instructor-guided (N = 25), audio-based (N = 21), and control (N = 44) intervention; length of mindfulness practice during the follow-up was also compared between the two intervention groups. Hierarchical linear model results showed significantly greater linear decreases in perceived stress after both mindfulness interventions during the 56-day follow-up (γ₁₁ = -0.011, p < .001, 95% CI [-0.017, -0.004] for instructor-guided intervention; γ₁₂ = -0.013, p < .001, 95% CI [-0.018, -0.006] for audio-based intervention), as compared to the control group. Compared to the control group, the instructor-guided group reported a significantly greater decrease in insomnia (γ₁₁ = -0.007, p < .001, 95% CI [-0.014, -0.002]), but the audio-based group did not (γ₁₂ = -0.002, p = .160, 95% CI [-.007, .004]). Neither mindfulness-based intervention group reported a significantly greater decrease in negative affect compared to the control group (γ₁₁ = -0.002, p = .170, 95% CI [-0.005, 0.001] for instructor-guided intervention; γ₁₂ = -0.002, p = .150, 95% CI [-0.006, 0.002] for audio-based intervention). No significant difference between the two intervention groups was found in the change of outcomes (γ₁₁ = 0.002, -0.005 and 0.000, p = .350, .130 and .390, 95% CI [-0.008, 0.011], 95% CI [-0.014, 0.004] and 95% CI [-0.004, 0.006] subsequently for perceived stress, insomnia and negative affect). Daily mindfulness practice was significantly longer for the audio-based group on the first day of follow-up (γ₀₂ = -0.758, p < .05, 95% CI [-1.333, -0.129]), but it gradually decreased to the same amount as the instructor-guided group (t (32) = 0.051, p = .959). Short-term mindfulness interventions, either instructor-guided or audio-based, appear to be beneficial for Chinese prisoners in reducing stress. Live instruction may have potential benefit in reducing insomnia and sustaining daily practice.

Rolling back the prison estate: the pervasive impact of macroeconomic austerity on prisoner health in England

Prisons offer policymakers an opportunity to address the pre-existing high prevalence of physical and mental health issues among prisoners. This notion has been widely integrated into international and national prison health policies, including the Healthy Prisons Agenda, which calls for governments to address the health needs of prisoners and safeguard their health entitlement during imprisonment, and the Sustainable Development Goals 2030 concerning reducing inequality among disadvantaged populations.

However, the implementation of the austerity policy in the United Kingdom since the re-emergence of the global financial crisis in 2008 has impeded this aspiration. This interdisciplinary paper critically evaluates the impact of austerity on prison health. The aforementioned policy has obstructed prisoners’ access to healthcare, exacerbated the degradation of their living conditions, impeded their purposeful activities and subjected them to an increasing level of violence.

This paper calls for alternatives to imprisonment, initiating a more informed economic recovery policy, and relying on transnational and national organizations to scrutinize prisoners’ entitlement to health. These systemic solutions could act as a springboard for political and policy discussions at national and international forums with regard to improving prisoners’ health and simultaneously meeting the aspirations of the Healthy Prisons Agenda and the Sustainable Development Goals.

Childhood Adversity and Mental Health Correlates of Obesity in a Population at Risk

The staggering prevalence of obesity and obesity-related health conditions takes exorbitant tolls on health care resources. This cross-sectional study with private evaluations of 636 adult inmates in a southern state prison was conducted with regressions comparing obese (body mass index [BMI] ≥ 30) to nonobese individuals to define obesity risk factors. Obese individuals more likely were female, were victims of childhood sexual abuse, suffered greater severity of childhood sexual abuse, attempted suicide, reported drug dependency, were non-Caucasian, and were older than nonobese. Psychopathy predicted lower BMI. Though obesity might be expected in victims of childhood physical abuse, traumatic brain injury, or other mental health conditions due to mobility or decision-making deficits, neither were significant. Adjusting for related variables, childhood sexual abuse remained significant. Females attempted suicide more frequently and suffered greater childhood sexual abuse.

Psychological distress and perceived health in inmates in Norwegian prisons

Background: Perceived health is a subjective measure of an individual’s health based on self-reported, and self-knowledge about one’s health status. It is related to one’s functional status, morbidity, and mortality and serves as an important indicator in determining an individual’s health status and health-related quality of life. The main purpose of this study is to explore (i) how a sample of adult inmates perceived their health and (ii) identify factors that may be associated with their perceived health. Methods: This was a cross-sectional study, where data collection involved the use of a structured questionnaire. The study sites were six prisons. A total of 144 inmates, 13 women (14%) and 131 men (91%) took part in the study. Results: The odds of having perceived good health were reduced by increasing age of the inmate (OR = 0.94, 95% CI = 0.90–0.98) and increased by high level of education (OR = 4.11, 95% CI = 1.09–15.50) and long time spent in prison (OR = 3.56, 95% CI = 1.09–15.50), adjusting for ethnicity and a previous history of murder/manslaughter ( p > .02). In the same adjusted analysis, the odds of perceived good health were decreased with medium high and high depressive score (OR = 0.06, 95% CI = 0.02–0.17 and OR = 0.06, 95% CI = 0.00–0.48, respectively). Conclusions: Psychological distress, time spent in prison, level of education and age were independent predictors of perceived health. High levels of psychological distress predict poor perceived health. Low level of education predict poor perceived health, while time spent in prison and age predict good perceived health.