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Contextualising the pervasive impact of macroeconomic austerity on prison health in England: A qualitative study among international policymakers

Ismail, Nasrul


Nasrul Ismail
Associate Lecturer - HAS - HSS - UHSS0001


Background: Prisons offer the state the opportunity to gain access to a population that is at particularly high risk of ill-health. Despite the supportive legal and policy structures surrounding prison rehabilitation, the oppressive nature of the austerity policy in England threatens its advanced improvement.

Methods: Using grounded theory methodology, this is the first interdisciplinary qualitative study to explore the impact of macroeconomic austerity on prison health in England from the perspective of 29 international prison policymakers.

Results: The far-reaching impact of austerity in England has established a regressive political system that shapes the societal attitude towards social issues, which has exacerbated the existing poor health of the prisoners. Austerity has undermined the notion of social collectivism, imposed a culture of acceptance among prison bureaucrats and the wider community, and normalised the devastating impacts of prison instability. These developments are evidenced by the increasing levels of suicide, violence, radicalisation and prison gangs among prisoners, as well as the imposition of long working hours and the high levels of absenteeism among prison staff.

Conclusions: This study underscores an important and yet unarticulated phenomenon that despite being the fifth largest economy in the world, England’s poorest, marginalised and excluded population continues to bear the brunt of austerity. Reducing the prison population, using international obligations as minimum standards to protect prisoners’ right to health and providing greater resources would create a more positive and inclusive system, in line with England’s international and domestic commitments to the humane treatment of all people.


Ismail, N. (2019). Contextualising the pervasive impact of macroeconomic austerity on prison health in England: A qualitative study among international policymakers. BMC Public Health, 19(1), 11.

Journal Article Type Article
Acceptance Date Jul 29, 2019
Online Publication Date Aug 5, 2019
Publication Date Aug 5, 2019
Deposit Date Aug 9, 2019
Publicly Available Date Aug 12, 2019
Journal BMC Public Health
Electronic ISSN 1471-2458
Publisher BMC
Peer Reviewed Peer Reviewed
Volume 19
Issue 1
Article Number 1043
Pages 11
Keywords Public Health, Environmental and Occupational Health
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Ismail (2019) Contextualising The Pervasive Impact Of Macroeconomic Austerity On Prison Health - A Qualitative Study Among International Policymakers (670 Kb)


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This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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