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Graham S, Muir NM, Formsma JW, Smylie J. First Nations, Inuit and Métis Peoples Living in Urban Areas of Canada and Their Access to Healthcare: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5956. [PMID: 37297560 PMCID: PMC10252616 DOI: 10.3390/ijerph20115956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/12/2023] [Accepted: 05/17/2023] [Indexed: 06/12/2023]
Abstract
In Canada, approximately 52% of First Nations, Inuit and Métis (Indigenous) peoples live in urban areas. Although urban areas have some of the best health services in the world, little is known about the barriers or facilitators Indigenous peoples face when accessing these services. This review aims to fill these gaps in knowledge. Embase, Medline and Web of Science were searched from 1 January 1981 to 30 April 2020. A total of 41 studies identified barriers or facilitators of health service access for Indigenous peoples in urban areas. Barriers included difficult communication with health professionals, medication issues, dismissal by healthcare staff, wait times, mistrust and avoidance of healthcare, racial discrimination, poverty and transportation issues. Facilitators included access to culture, traditional healing, Indigenous-led health services and cultural safety. Policies and programs that remove barriers and implement the facilitators could improve health service access for Indigenous peoples living in urban and related homelands in Canada.
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Affiliation(s)
- Simon Graham
- Department of Infectious Diseases, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC 3010, Australia
| | - Nicole M. Muir
- Psychology Department, York University, Toronto, ON M3J 1P3, Canada
| | | | - Janet Smylie
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
- Well Living House, and Department of Family and Community Medicine, St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada
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2
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Dean K, Lyons G, Johnson A, McEntyre E. First Nations Peoples in the forensic mental health system in New South Wales: Characteristics and rates of criminal charges post-release. Aust N Z J Psychiatry 2023; 57:904-913. [PMID: 36786199 DOI: 10.1177/00048674231151594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
BACKGROUND It is well established that First Nations Peoples in Australia are overrepresented within the criminal justice system. However, First Nations Peoples appear to be comparatively underrepresented in the forensic mental health system, and little is known about their outcomes once released from secure care. OBJECTIVE To compare the characteristics and rates of repeat criminal justice contact for a criminal charge of First Nations and non-First Nations forensic patients in New South Wales. METHODS Data on the sample were extracted from the New South Wales Mental Health Review Tribunal paper and electronic files matched to the Bureau of Crime Statistics and Research Reoffending Database. Characteristics of First Nations and non-First Nations patients were compared using univariate logistic regression analysis. Univariate and multivariate Cox proportional hazard regression was used to determine predictors of post-release criminal charges. RESULTS Key differences in the sociodemographic, clinical and forensic characteristics of First Nations compared with non-First Nations forensic patients were identified. The time to first criminal justice contact following release was significantly shorter for First Nations forensic patients (p < 0.01). CONCLUSION The findings of this study confirm that First Nations forensic patients have distinct and complex needs that are apparent at entry to the forensic mental health system and that their poorer criminal justice contact rates following release from secure care indicate that these needs are not being adequately met either during treatment or once in the community. Responses to these study findings must consider the complex and continuing impact of colonisation on First Nations Peoples, as well as the need for solutions to be culturally safe.
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Affiliation(s)
- Kimberlie Dean
- Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia.,Justice Health and Forensic Mental Health Network, NSW, Australia
| | - Georgia Lyons
- Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Anina Johnson
- Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
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Snow KJ, Petrie D, Young JT, Preen DB, Heffernan E, Kinner SA. Impact of dual diagnosis on healthcare and criminal justice costs after release from Queensland prisons: a prospective cohort study. Aust J Prim Health 2022; 28:264-270. [PMID: 35512815 DOI: 10.1071/py21142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 02/03/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND People released from prison have poorer health than the general public, with a particularly high prevalence of mental illness and harmful substance use. High-frequency use of hospital-based services is costly, and greater investment in transitional support and primary care services to improve the health of people leaving prison may therefore be cost-effective. METHODS A prospective cohort study of 1303 men and women released from prisons in Queensland, Australia, between 2008 and 2010, using linked data was performed. We calculated healthcare costs and the cost of re-incarceration. We compared healthcare costs to the general public, and assessed the impact of past mental illness, substance use disorder, and dual diagnosis on both healthcare and criminal justice costs. RESULTS Healthcare costs among the cohort were 2.1-fold higher than expected based on costs among the public. Dual diagnosis was associated with 3.5-fold higher healthcare costs (95% CI 2.6-4.6) and 2.8-fold higher re-incarceration costs (95% CI 1.6-5.0), compared with no past diagnosis of either mental illness or substance use disorder. CONCLUSIONS People released from prison incur high healthcare costs, primarily due to high rates of engagement with emergency health services and hospital admissions. Comorbid mental illness and substance use disorders are associated with high health and criminal justice costs among people recently released from prison.
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Affiliation(s)
- K J Snow
- Centre for International Child Health, Department of Paediatrics, University of Melbourne, Parkville, Vic., Australia
| | - D Petrie
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, Vic., Australia
| | - J T Young
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Vic. 3053, Australia; and School of Population and Global Health, The University of Western Australia, Perth, WA, Australia; and National Drug Research Institute, Curtin University, Perth, WA, Australia
| | - D B Preen
- School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | - E Heffernan
- Queensland Forensic Mental Health Service, Queensland Health, Brisbane, Qld, Australia
| | - S A Kinner
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Vic. 3053, Australia; and Centre for Adolescent Health, Murdoch Children's Research Institute, Carlton, Vic., Australia; and Griffith Criminology Institute, Griffith University, Mount Gravatt, Qld, Australia; and Mater Research Institute-UQ, School of Medicine, University of Queensland, Brisbane, Qld, Australia; and School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic., Australia
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Mekonnen B, Hailemariam S, Ejigu A, Shifera N, Simieneh A. Preparedness and Readiness Against COVID-19 Pandemic in Prison Institutions and Detention Centers in Southwest Ethiopia. Int J Gen Med 2021; 14:337-346. [PMID: 33564262 PMCID: PMC7866933 DOI: 10.2147/ijgm.s287066] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 01/13/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Prisons and detention centers in Ethiopia lack adequate hand washing, personal protective equipment, and quarantine areas. As a result, they are vulnerable to the expansion of the COVID-19 pandemic. Despite its high risk for the COVID-19 pandemic, no study has been made to assess the preparedness and readiness in prison institutions and detention centers. METHODS A cross-sectional study design mixed with a qualitative approach was conducted from May 1 to June 30, 2020. A total of four prison institutions and 17 detention centers were included in the study. A simple random sampling technique was employed to select the institutions. The data were entered into the EpiData and exported to SPSS Windows version 22 for data management and analysis. Descriptive statistics was employed for the quantitative section and content analysis was used to analyze the qualitative data. RESULTS Five out of 17 detention centers and three out of four prison facilities did not fulfill the standards related to human rights. Almost all detention centers and prison facilities did not implement recommended activities of risk assessment and management of COVID-19. In addition, none of the prison facilities and detention centers had quick access to laboratory tests for suspected cases. Neither the prison facilities nor the detention centers had a contingency plan for the COVID-19 pandemic. Moreover, all staff working in prison facilities and detention centers mentioned that training regarding COVID-19 had not yet been given. However, in all prisons and detention centers, preventive measures such as physical distancing, utilization of hand washing facilities, wearing masks, and keeping respiratory hygiene were not practiced.
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Affiliation(s)
- Besufekad Mekonnen
- Department of Public Health, Mizan-Tepi University, Mizan-Aman, Southern Nation Nationality and People Region, Ethiopia
| | - Shewangizaw Hailemariam
- Department of Midwifery, Mizan-Tepi University, Mizan-Aman, Southern Nation Nationality and People Region, Ethiopia
| | - Amare Ejigu
- Department of Midwifery, Mizan-Tepi University, Mizan-Aman, Southern Nation Nationality and People Region, Ethiopia
| | - Nigusie Shifera
- Department of Nursing, Mizan-Tepi University, Mizan-Aman, Southern Nation Nationality and People Region, Ethiopia
| | - Asnake Simieneh
- Department of Medical Laboratory, Mizan-Tepi University, Mizan-Aman, Southern Nation Nationality and People Region, Ethiopia
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Field C, Zovko A, Bowman J. An examination of chronic ill-health and lifestyle factors among inmates: searching for the healthy immigrant effect in New South Wales Prisons. Int J Prison Health 2020; 16:207-219. [PMID: 32378834 DOI: 10.1108/ijph-01-2019-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this paper is to compare the rates of chronic health conditions and lifestyle factors between Australian-born and overseas-born inmates and to uncover predictive relationships between lifestyle factors and health outcomes for both groups. DESIGN/METHODOLOGY/APPROACH Data are presented from a cross-sectional study based on a sample of inmates from correctional sites in New South Wales (NSW). The inclusion of results here was guided by the literature relating to the healthy immigrant effect. FINDINGS Results indicate that a higher proportion of Australian-born inmates consumed alcohol at higher levels and were more likely to smoke on a daily or almost daily basis than overseas-born inmates. Australian-born inmates were also more likely than overseas-born inmates to have been diagnosed with cancer, epilepsy or hepatitis C. Physical activity predicted the number of diagnoses for Australian-born inmates while physical activity and smoking frequency predicted the number of diagnoses for overseas-born inmates. PRACTICAL IMPLICATIONS Overseas-born inmates make up a considerable portion of the prison population in NSW. A better understanding of those health and lifestyle factors that distinguish them from Australian-born inmates provides important insight regarding health promotion and the planning of service provision for those providing health care in this space. ORIGINALITY/VALUE Comparison of the health of immigrant and native-born prison inmates has not been undertaken before and promises to provide important information regarding those factors that distinguish a sizeable minority in the prison population.
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Affiliation(s)
- Courtney Field
- Justice and Forensic Mental Health Network, Malabar, Australia
| | | | - Julia Bowman
- Research Unit, Justice and Forensic Mental Health Network, Malabar, Australia.,Faculty of Health, University of Technology Sydney, Sydney, Australia
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Perdacher E, Kavanagh D, Sheffield J. Well-being and mental health interventions for Indigenous people in prison: systematic review. BJPsych Open 2019; 5:e95. [PMID: 31679537 PMCID: PMC6854355 DOI: 10.1192/bjo.2019.80] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Indigenous people are overrepresented in prison populations of colonised justice systems, and Indigenous prisoners in these countries are at a particularly high risk of poor mental health and well-being. There is an acute need to ensure the access of these groups to culturally appropriate, evidence-based interventions. AIMS To conduct a systematic review, evaluating quantitative and qualitative evaluations of mental health and well-being interventions designed for Indigenous people in custody. METHOD A search of relevant peer-reviewed journal articles to August 2019 was conducted. The focus was on colonised countries under a Western model of justice and health, including Canada, Australia, New Zealand and the USA. The review utilised Scopus, Web of Science, PubMed, PsycNET, EBSCO, Proquest Criminal Justice Database and Informit. RESULTS Of the 9283 articles initially found, only three quantitative and two qualitative evaluations of mental health or well-being interventions for Indigenous people in custody were identified. None were randomised controlled trials. Culturally based interventions appeared to have high acceptability and potential for increased recovery from trauma, reduced alcohol-related problems and lower reoffending. However, no studies quantitatively assessed mental health or well-being outcomes. CONCLUSIONS As yet there is no high-quality evidence on the impact on mental health and well-being from interventions specifically for Indigenous prisoners, although existing studies suggest programme features that may maximise acceptability and impact. There is a moral, social and practical imperative to build a strong evidence base on this topic.
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Affiliation(s)
- Elke Perdacher
- School of Psychology, The University of Queensland; Program Coordinator Postgraduate Training, Queensland Forensic Mental Health Service, Queensland Health; and Team Member, Forensic Mental Health Stream, Queensland Centre for Mental Health Research, Australia
| | - David Kavanagh
- Honorary Professor, School of Psychology, The University of Queensland; and Professor, Centre for Children's Health Research/Institute of Health & Biomedical Innovation/School of Psychology & Counselling, Queensland University of Technology, Australia
| | - Jeanie Sheffield
- Honorary Lecturer, School of Psychology, The University of Queensland, Australia
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Kendall S, Lighton S, Sherwood J, Baldry E, Sullivan E. Holistic Conceptualizations of Health by Incarcerated Aboriginal Women in New South Wales, Australia. QUALITATIVE HEALTH RESEARCH 2019; 29:1549-1565. [PMID: 31079548 DOI: 10.1177/1049732319846162] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
While there has been extensive research on the health and social and emotional well-being (SEWB) of Aboriginal women in prison, there are few qualitative studies where incarcerated Aboriginal women have been directly asked about their health, SEWB, and health care experiences. Using an Indigenous research methodology and SEWB framework, this article presents the findings of 43 interviews with incarcerated Aboriginal women in New South Wales, Australia. Drawing on the interviews, we found that Aboriginal women have holistic conceptualizations of their health and SEWB that intersect with the SEWB of family and community. Women experience clusters of health problems that intersect with intergenerational trauma, perpetuated and compounded by ongoing colonial trauma including removal of children. Women are pro-active about their health but encounter numerous challenges in accessing appropriate health care. These rarely explored perspectives can inform a reframing of health and social support needs of incarcerated Aboriginal women establishing pathways for healing.
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Affiliation(s)
- Sacha Kendall
- 1 University of Technology Sydney, Sydney, New South Wales, Australia
| | - Stacey Lighton
- 1 University of Technology Sydney, Sydney, New South Wales, Australia
| | | | - Eileen Baldry
- 3 University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Elizabeth Sullivan
- 1 University of Technology Sydney, Sydney, New South Wales, Australia
- 4 The University of Newcastle, Callaghan, New South Wales, Australia
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Lakhan P, Askew D, Hayman N, Pokino LA, Sendall C, Clark PJ. Optimising Hepatitis C care in an urban Aboriginal and Torres Strait Islander primary health care clinic. Aust N Z J Public Health 2019; 43:228-235. [PMID: 30908846 DOI: 10.1111/1753-6405.12888] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 02/01/2018] [Accepted: 02/01/2019] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVE Describe the sociodemographic and clinical characteristics of patients with Hepatitis C Virus (HCV) attending an urban Indigenous primary health clinic (IPHC) in Brisbane, Australia. METHODS A retrospective chart review of sociodemographic characteristics, presence of liver disease and treatments, lifestyle behaviours and comorbidities in patients with a HCV infection was conducted between October 2015 and March 2016. RESULTS One hundred and thirteen patients with confirmed HCV infection were aged between seven and 63 years; 66% were male, and 84% were Indigenous. Sixty-nine per cent had been incarcerated; 41% had experienced conflict or domestic violence; 47% were injecting drugs; 72% had depression; and 61% had anxiety. Cirrhosis was present in 7/95 patients with adequate data and associated with age (p=0.02). Eleven patients had commenced direct acting antiviral (DAA) therapy in the 18 months that it had been available. CONCLUSIONS The study highlights the opportunities for enhancing treatment of patients with HCV infection. Opportunities to improve treatment rates in an Indigenous primary healthcare include optimising diagnostic pathways, improving patient engagement, and general practitioner and peer worker participation. Implications for public health: HCV poses a serious threat to public health in Australia and IPHCs are key sites to addressing this for Indigenous people. Optimising care of patients with HCV attending IPHC requires recognition of the complex health needs and social context, to reduce the incidence and consequences of HCV infection.
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Affiliation(s)
- Prabha Lakhan
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Queensland
| | - Deborah Askew
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Queensland.,The University of Queensland, Primary Care Clinical Unit, Royal Brisbane and Women's Hospital, Queensland
| | - Noel Hayman
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Queensland
| | - Leigh-Anne Pokino
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Queensland
| | - Cheryl Sendall
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Queensland
| | - Paul J Clark
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Queensland.,Faculty of Medicine, The University of Queensland.,Department of Gastroenterology, The Princess Alexandra and Mater Hospitals, Queensland
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