Choosing health in prison: Prisoners' views on making healthy choices in English prisons

Objective: To explore the views of prisoners on making healthy choices in prison. Design: In-depth semi-structured interviews were carried out with 111 prisoners in 12 prisons between September and November 2005. Prisoners interviewed included women, older prisoners, young offenders and prisoners from Black and minority ethnic groups. Setting: Prisons in the north and south of England, including men's prisons (categories A-D), young offenders' institutions and a women's prison. Method: Prisoners were interviewed individually by pairs of interviewers, using a topic guide concerned with experiences of health care in prison. Interviews were audiotaped and transcribed. Data were analysed thematically. This article presents prisoners' views on making healthy choices in the areas identified in the 2004 white paper Choosing Health, as priorities for action in public health. Results: All the priority areas of Choosing Health were relevant to the self-identified health needs of prisoners. Opportunities to make healthy choices varied between prisons, particularly in relation to diet, exercise and access to smoking cessation support. Alcohol misuse was considered insufficiently addressed in prison. Conclusion: While imprisonment offers prisoners an opportunity to access health promotion services, in the priority areas identified in Choosing Health prisoners are often prevented from making healthy choices by the prison setting. Barriers exist within the prison setting which limit the ability of prisoners to maintain and improve their health. © SAGE 2008