Half of the people in Canadian prisons experienced abuse during childhood, according to research led by McMaster University.
The findings from a systematic review and meta-analysis of studies done over the past 31 years were published today in the American Journal of Public Health.
"We need to know the health status of people in prison, in order to improve health care and other services within correctional facilities, and to develop strategies to prevent further criminal justice system involvement," said Claire Bodkin, first author and a medical student of McMaster's Michael G. DeGroote School of Medicine.
She developed the research with Fiona Kouyoumdjian, assistant professor of the Department of Family Medicine.
The research team included studies published since 1987 that reported data on prevalence of a history of abuse before the age of 18 years among people in Canadian prisons, including any abuse, physical abuse, sexual abuse, emotional abuse, and neglect. This included 34 studies in the review and 29 non-overlapping studies in meta-analysis.
Based on these studies, the prevalence of a history of child abuse was two-thirds (65.7 per cent) of women; however, only one study reported prevalence among men and it was more than a third (35.5 per cent).
The prevalence of childhood sexual abuse was 50 per cent among women and 22per cent among men, and the prevalence of neglect was 52 per cent among women and 42 per cent among men.
The prevalence of childhood physical abuse was 48 per cent and the prevalence of childhood emotional abuse was 52 per cent, with no significant differences between men and women. Prevalence estimates varied substantially across studies for all types of abuse.
"Prisons should incorporate trauma-informed approaches, to recognize that most people have a history of child abuse, and to prevent further trauma," said Bodkin.
"But at the end of the day, prisons are an inherently distressing environment. People in prison have minimal control over their daily activities or interactions, and are isolated from their coping mechanisms and support systems. A trauma informed approach only goes so far.
"We have a health equity issue on our hands, and we need to talk about how to reduce rates of incarceration in the first place. We need to ask why this population has such a high prevalence of exposure to childhood abuse, and how to ensure people have access to the health and social services they need in community.
She added: "More research is needed to better understand the association between a history of childhood abuse and criminal justice system involvement, and to prevent childhood abuse and mitigate its adverse effects."
Bodkin added that since most people who experience childhood abuse do not go on to be imprisoned themselves, research should also be done to explore what protects those people from doing so.
Researchers on the paper were from the McMaster's Michael G. DeGroote School of Medicine and its Department of Family Medicine, the Dalla Lana School of Public Health at the University of Toronto, St. Michael's Hospital, and the School of Population and Public Health at the University of British Columbia.
The research did not have external funding.