Lifestyle initiatives are being taken into prisons to deliver healthy living messages to the most disadvantaged groups in society, writes David Williams
The 2004 Choosing Health white paper identified health inequalities and committed the NHS to creating a society where people are encouraged to make healthier choices, particularly people from disadvantaged groups.
It focuses on ensuring people in different groups have access to helpful information and on securing better access to healthier choices in disadvantaged groups. It is particularly aimed at public health initiatives in sexual health, harm reduction and diet and exercise.
In UK prisons, many of the problems that Choosing Health tries to address are greatly exacerbated because more than 90 per cent of prisoners have mental health and/or substance misuse problems. Long-term health interventions are difficult when a little over half of prisoners are serving sentences of six months or less.
The prison population is currently 80,762. Of these, between 50 and 70 per cent are dependant on opiates, 80 per cent smoke and 30 per cent have a history of some degree of deliberate self-harm.
The Care Services Improvement Partnership is running NHS pilots to promote Choosing Health, including two in West Midlands prisons HMP Drake Hall and HMP Swinfen Hall. Multi-agency regional prison partnership boards have been established to oversee the pilots, supported by CSIP. The pilots include the following initiatives:
- The Walking the Way to Prison Health project, which provides prisoners with pedometers. It is transferable from the 'inside' to the 'outside', and can stand alone or work as part of one of the projects below;
- Skilled for Health is a literacy and numeracy scheme designed to improve access to health information;
- Health Trainer provides people with a personal trainer to help them stop smoking, lose weight and exercise, and to provide nutritional information and advice.
Physical activity helps people feel better, improves mood and reduces anxiety. It can also raise physical self-perceptions and self-esteem, particularly among those who start out with low self-esteem.
Running in parallel are prolific and priority offender schemes, which recognise that 80 per cent of crime is committed by 20 per cent per cent of offenders. These community-focused projects aim to reduce levels of reoffending. Health is an intrinsic part of the scheme and CSIP West Midlands is taking the lead on pathway three of the region's reducing regional reoffending action plan, which focuses on mental and physical aspects.