Health Policy in Prisons

The subject of the prison policy is mostly male population (there are, 5-7% of woman among prison inmates). Most of them are living under the harsh physical, psychical and social conditions. In addition, many prison inmates came to serve their sentence with developed risky life styles. That is why prisons are breeding an array of health problems. Typical are mental health problems, drug addiction and infectious diseases among which dominant role have tuberculosis, AIDS and hepatitis. The prison health care is rather neglected area. Recently, there were efforts to change this situation. The most prominent changes were characterized by measures of primary prevention, screening and systematic check-ups. That orientation has brought some improvements. However, introducing of the concept of the social determinants of health brought into the domain of the prison health care additional demands. From the point of view of these demands, the health policy in prisons should be based on two principles: the holistic principle, and the principle of human rights. The two blind alleys should be avoided: biomedical approach because of its superficiality and the risk factors approach because of its partiality. The four priorities should be followed: the professional one, the contextual one, the developmental one, and the economical one. The engagement should focus on the primordial prevention, domain of meanings, psycho- social development and sustainability. This is the health directed approach and not the medical one, and it can be allied with the similar engagement of other professionals working along the similar directions