Interest-holder priorities for health surveillance of people incarcerated in Canada: A qualitative study

Objectives: As a core function of public health, health surveillance for people who are incarcerated could address gaps in knowledge regarding their health status. The views of people who could use these data and who are included in health surveillance data should inform health surveillance. In this study, we aimed to identify the priorities of interest-holders for health surveillance of people incarcerated in Canadian correctional facilities.

Study design: We conducted an overall qualitative descriptive study with an embedded reflexive thematic analysis and a qualitative content analysis.

Methods: We conducted virtual or phone-based focus groups and interviews with people across Canada, including people with lived experience of incarceration, community-based advocates and researchers, and current correctional health care staff and leadership.

Results: Overall, 61 participants took part. We describe two types of interest-holder priorities: health conditions and issues, which we identified using content analysis, and health care characteristics and components, which we constructed through thematic analysis. The top priorities for health conditions and issues to track and monitor were mental health issues, substance use disorders and harm reduction, chronic diseases, and nutrition, diet, and healthy food. The health care themes that were priorities for health surveillance were access, wait times, health care equivalence, preventive care, and medication administration.

Conclusions: This study begins to fill the gap in population level health data for people who are incarcerated. Findings should have relevance for correctional authorities both within Canada and in other jurisdictions.