Project Collaborators External

• Professors Gregory Dore, Jason Grebely, Andrew Lloyd, and Dr Maryam Alavi, Dr Evan Cunningham, Dr Behzad Hajarizadeh, Dr. Doug James, Dr. Michael Doyle 

The mental and physical health disparities between individuals who are incarcerated and the general population in Australia present a significant public health challenge. Incarcerated individuals report higher rates of communicable diseases, mental disorders, and substance use disorders, with Indigenous Australians facing disproportionate harm. Currently, about 43,000 people are incarcerated in Australia, including over 13,000 in New South Wales (NSW). The elevated rates of hepatitis C (HCV) and opioid dependence among this population further contribute to these inequities.  

There is a critical need for more evidence on the provision and effectiveness of prison health services, including treatments for opioid dependence and HCV, to reduce these disparities. Additionally, the high rates of drug and suicide-related mortality after release from prison highlight the necessity for further research on health inequities that individuals experience after incarceration.  

Our study aims to address these gaps by investigating the health, social, and recidivism outcomes of those who experience incarceration in New South Wales (NSW), Australia. POST will particularly focus on the impact of substance dependence, including opioid dependence, and HCV, on adverse outcomes among people who have been incarcerated in NSW. Additionally, our team will examine the impact of treatments, such as opioid agonist treatment (OAT) and HCV treatments, on adverse health and social outcomes during and after incarceration.  

Design and Method

This project is a retrospective cohort study of 216,000  individuals who have been incarcerated in NSW since January 1st, 2000, identified through the NSW Bureau of Crime Statistics and Research database. Data for the POST project was probabilistically linked to multiple NSW- and Australian-wide datasets. These datasets cover areas such as opioid agonist treatments, hospital admissions, emergency department presentations, ambulance data, mental health care contacts, drug and alcohol treatments, notifiable conditions, HIV notifications, cancer registry, Medicare claims, pharmaceutical benefits, homelessness services, income assistance, and death registrations. This extensive linkage ensures a thorough view of the health and social outcomes of those who have experienced incarceration in NSW.  

Progress/Update

POST has been approved by NSW Population and Health Services Research Ethics Committee, the Australian Institute of Health & Welfare (AIHW) ethics committee, NSW Corrective Services, NSW Bureau of Crime Statistics and Research (BOCSAR) ethics committee, and the Aboriginal Health and Medical Research Council Ethics Committee (AH&MRC).  

We have received partial data from NSW-based data custodians for the POST cohort.  

Benefits

Ultimately, POST aims to inform evidence-based interventions and policies that will improve health, social, and recidivism outcomes for people who are currently or formerly incarcerated. Additionally, POST will use real-world data to inform the delivery of treatment for opioid dependence, HCV, and related harms during and after incarceration.