International Public Health and Corrections: Models of Care and Harm Minimization
The development of the prison as the unchallenged institution of punishment is relatively recent compared to other social institutions, such as the asylum, the workhouse, and the hospital—being less than 250 years old (Morris & Rothman, 1995; Human Rights Watch). In contrast to these other social institutions, prisons have continued to grow. The International Centre for Prison Studies (Kings College, London) estimates that three in four jurisdictions throughout the world are currently expanding their prison systems (International Centre for Prison Studies).
In this situation, and with the downgrading of other institutions, the modern prison is taking on functions previously carried by others, such as the mental asylum (mental illness) (Rosen, 2006) and the poorhouse (welfare and accommodation).
Incarceration is an institution of “unequal power,” between the dominant social structure and the individual who is contained within. Apart from the ethical and philosophical issues implicit in this “relationship,” the health consequences are extreme on the individual, but also on the community from which the prisoner comes and will return. The modern prison, while posing health risks to the community (Freudenberg, 2001), also promises to deliver health gains to individuals engaged in it, albeit nonconsensually.
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