title: Health status and access to health services of female prisoners in Greece: a cross-sectional survey.
abstract: Self-reported health status of prisoners' population and access to health services during incarceration have not been adequately explored in Greece. The purpose of this study was to assess female prisoners' health status and access to healthcare in the Attica detention center "Korydallos".
  
  
  
  A cross-sectional survey was carried out in 2014. A semi-structured questionnaire was developed, including questions on the prisoners' socio-demographic characteristics, self-reported health status before and after incarceration, access to and quality of the provided health services. Inmates who were in solitary confinement, suffered from serious psychiatric problems, or were unable to understand the Greek language were excluded from the study. Data were collected via personal interviews and information received was anonymized. Descriptive statistics and bivariate analyses were used. The difference between self-reported general health status prior to and during detention was analyzed by Wilcoxon test, while the relationship between health status and access to healthcare was explored with coefficient Spearman's rho. Statistical significance was set at p ≤ 0.05 level and statistical analysis was performed using the software SPSS 19.
  
  
  
  Of the 135 prisoners, 101 participated in the study. 60.4 % mentioned a moderate or poor health status, while the respective percentage before detention was 32.7 %. Health status deterioration and poor mental health were reported by more than half of the respondents. Additionally, the vast majority expressed raised feelings such as sadness, anxiety or discomfort which affected negatively their everyday life while in prison. Regarding risk factors during imprisonment; tobacco consumption has increased by 16.6 % and 7.9 % of the sample admitted having used drugs. Moreover, the access to and the quality of provided health services in prison were described as poor/ very poor by 46.5 % and 49.5 %, respectively. A significant correlation between the access to and the quality of health care services and health status was observed.
  
  
  
  Healthcare provision at the "Korydallos" prison is not satisfying since the access to as well as the quality of healthcare are not adequate. Imprisonment leads to deterioration of self-reported health status. Our findings should constitute a starting point for further research in order to introduce more effective interventions aiming at meeting prisoners' health needs.
authors.affiliation: Department of Social and Educational Policy, University of Peloponnese, Damaskinou & Kolokotroni Str, 20100, Corinth, Greece.
authors.forename: Mary
authors.initials: M
authors.lastname: Geitona
authors.affiliation: Department of Social and Educational Policy, University of Peloponnese, Damaskinou & Kolokotroni Str, 20100, Corinth, Greece. elinamil1@yahoo.gr.
authors.forename: Stella-Olga
authors.initials: SO
authors.lastname: Milioni
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006115:Greece; D006296:Health Services / Q000592:standards / Q000706:statistics & numerical data; D006297:Health Services Accessibility; D006304:Health Status; D006801:Humans; D011329:Prisoners / Q000523:psychology / Q000706:statistics & numerical data; D012307:Risk Factors; D057566:Self Report; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology
keywords: Access to healthcare; Female prisoners; Greece; Health status; Imprisonment