WHO report highlights a new approach to reducing NCD risks in prisons

Noncommunicable diseases (NCDs) are among the biggest health threats for people living in prisons – yet there are still not enough policies to address this serious problem. The new WHO report “Addressing the NCD burden in prisons in the WHO European Region: interventions and policy options” shares new data and lays out an updated approach to reducing these risks and bringing benefits to all Member States.

More than 1.5 million people are held in detention across the Region, and their health is more fragile than that of people in outside communities.

“Noncommunicable diseases cause 71% of deaths globally and present a challenge to health-care systems. However, NCDs are poorly recognized as an important health issue in prisons, where the main focus has traditionally been on the prevention of infectious diseases and injuries,” said Dr Hans Henri P. Kluge, WHO Regional Director for Europe.

“The underinvestment in NCDs witnessed in society at large is magnified in prison settings, where NCDs are still not considered a priority.”

Globally, it is estimated that around 30 million people, most of whom experience multiple disadvantages, move between prisons and communities each year. For some people in the Region, prison is a place where they gain access to health-care services for the first time in their life.

According to the new WHO publication, NCD policies in prisons should focus on more health factors than before, align with WHO-recommended approaches, and take account of the specificities of the prison setting in both the design and implementation of interventions and policies.

The WHO report sums up data from recent research on the NCD inequities facing people who live in prisons.

For several decades, WHO has focused on the 4 NCD risk factors that are most significant in places of detention: tobacco and alcohol use, low levels of physical activity, and unbalanced diets. But this WHO report shares a renewed vision that includes environmental pollution and systemic health-care factors as causes of concern.

“In prisons, many NCD risk factors overlap and have a cumulative negative effect on health,” explained Dr Carina Ferreira-Borges, Programme Manager of Alcohol, Illicit Drugs and Prison Health at WHO/Europe.

“For instance, environmental risks are estimated to be responsible for nearly a quarter of deaths, and limited access to health care may leave many underlying conditions, such as hypertension and diabetes, uncontrolled.”

The WHO report highlights the need for more comprehensive data that detention facilities can gather and share with each other to improve policies. To build related capacities among the prison health workforce, the WHO European Office for the Prevention and Control of NCDs announced a special training course called “Innovation in NCD policy and action: a course for prison health-care workers”. WHO invites all Member States to participate.