Public health is the art and science of preventing disease and injury, prolonging life, and promoting health through the organized efforts of society. Public health practice informs and empowers individuals and communities, and creates healthy environments through the use of evidence-based strategies and accountability mechanisms. The balance of health risks and health gains is the essential issue in considering the public health impacts of prisons (Glaser & Greifinger, 1993).
The systematic management of risks in the correctional setting associated with air, food, and water, through the science of environmental health has been poorly developed. The California Department of Corrections and Rehabilitation has uniquely developed an audit tool for prisons (California Department of Corrections and Rehabilitation), but apart from this there is little accessible information or a strong evidence base.
Crowding within prisons is almost normative (Walmsley, 2005)—increased incarceration across the world brings with it increased occupancy levels. The normalization of physical violence and extreme lack of privacy, with the ever-present possibility of sexual abuse are almost inevitable consequences of this situation. Few countries limit the occupancy of their prisons to the actual bed capacity of their facilities. Norway and Iceland, notably, do not exceed their capacity; this is achieved through the delay of entry to prison once a person is sentenced, or explicit release of one prisoner to make room for a "more needy" occupant.
Some prison systems are underpinned by complex transport systems for moving prisoners between prisons and between prisons and courthouses; this provides further conduits for disease transmission and propagation (Levy et al., 2003).
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