Research Unit, Justice Health and Forensic Mental Health Network, Sydney, Australia.
Centre for Global Health and Equity, Swinburne University of Technology, Melbourne, Australia.
BMC Public Health. 2023 Aug 10;23(1):1520. doi: 10.1186/s12889-023-16464-3.
Health literacy is an important factor for enabling people to manage their health and live long fulfilling lives. People in prison are frequently from marginalised communities, often out of reach of conventional community based health organisations, and have poorer health outcomes. It is essential to understanding the health literacy profiles of people in prison, and its contribution to the well-established health inequities and outcomes of this population. This study aimed to use a multi-dimensional health literacy measurement tool to describe the strengths and challenges of adults incarcerated in NSW prisons.
A cross-sectional survey was conducted for people in prison across 14 publicly operated metropolitan prisons. Data were collected from 471 participants using the Health Literacy Questionnaire (HLQ). Participant characteristics and health conditions were also collected. Data were analysed using descriptive statistics. Effect sizes (ES) for standardised differences in means were used to describe the magnitude of difference between participant characteristic groups.
Participants' median age was 38.0 (range 19 - 91) years. Males comprised 81% of the sample, 21% identified as Aboriginal and/or Torres Strait Islander, and 53% reported a health problem. People in prison had lower scores for all nine HLQ scales when compared to the general Australian population. Small to medium ES were seen for mean differences between most demographic groups. Compared to males, females had lower scores for several of the HLQ scales including 'having sufficient information to manage health' (ES 0.30 [95% Confidence Interval (CI) 0.07, 0.53]), 'ability to actively engage with health care professionals' (ES 0.30 [95% CI 0.06, 0.53]), 'navigating the healthcare system' (ES 0.30 [95% CI 0.06, 0.53]), and, 'ability to find good health information' (ES 0.33 [95% CI 0.10, 0.57]). Differing health literacy scale scores with small to medium ES were found when comparing participants by legal status. Mainly small ES were seen when comparing other participant characteristic groups.
This study provides insights into the health literacy strengths and challenges for people in NSW prisons. These findings highlight the important role health literacy could have in addressing health disparities in this vulnerable population and can inform prison health services.
健康素养是人们管理自身健康并过上充实生活的重要因素。监狱中的人员通常来自边缘化社区，往往无法接触到传统的社区卫生组织，且健康状况较差。了解监狱中人员的健康素养状况及其对该人群中已确立的健康不平等和结果的影响至关重要。本研究旨在使用多维健康素养测量工具来描述新南威尔士州监狱中成年人的优势和挑战。
对 14 所公共运营的大都市监狱中的囚犯进行了横断面调查。使用健康素养问卷（HLQ）从 471 名参与者中收集数据。还收集了参与者的特征和健康状况。使用描述性统计数据进行分析。使用标准化差异均值的效应量（ES）来描述参与者特征组之间差异的大小。
参与者的中位年龄为 38.0 岁（范围 19-91 岁）。男性占样本的 81%，21%自称为土著和/或托雷斯海峡岛民，53%报告存在健康问题。与澳大利亚一般人群相比，监狱中的人员在 HLQ 的所有九个量表上的得分都较低。在大多数人口统计学群体之间的平均差异中，观察到小到中等 ES。与男性相比，女性在 HLQ 的几个量表上的得分较低，包括“拥有足够的信息来管理健康”（ES 0.30 [95%置信区间（CI）0.07，0.53]）、“积极参与医疗保健专业人员”（ES 0.30 [95% CI 0.06，0.53]）、“导航医疗保健系统”（ES 0.30 [95% CI 0.06，0.53]）和“找到好的健康信息”（ES 0.33 [95% CI 0.10，0.57]）。在比较参与者的法律地位时，发现健康素养量表得分存在小到中等 ES 的差异。当比较其他参与者特征组时，主要观察到小 ES。
本研究提供了新南威尔士州监狱中人员健康素养优势和挑战的见解。这些发现强调了健康素养在解决该弱势群体健康差距方面的重要作用，并为监狱卫生服务提供了信息。
