Health conditions among women in prisons: a systematic review

Abstract

Despite rapidly rising incarceration rates, the health needs of women in custody are overlooked. This Review aims to summarise the current evidence on the health of women in prisons around the world. In this systematic review, we searched peer-reviewed and grey literature databases for quantitative studies published between Jan 1, 2003, and Jan 29, 2025. Our population of interest was people detained in carceral spaces designated for women as part of the criminal-legal system worldwide. We included studies that reported the prevalence of health conditions (based on the Global Burden of Disease Study, or in the International Classification of Disease 11th revision) among women in custody. We assessed risk of bias using the JBI Critical Appraisal Checklist for Studies Reporting Prevalence Data. We identified 18 008 unique records, 247 studies (including more than 452 261 women) were included for analysis. Nearly all studies had a high risk of bias in at least one domain. Communicable diseases and mental health conditions were the most frequently described topics. Prevalence of many conditions varied widely between studies and across geographical regions. We identified gaps in the literature, particularly around non-communicable conditions and in the geographical representation of data. Globally, women in custody experience a high burden of health conditions but there are substantial gaps in current evidence and a need for improved data collection and reporting. Additionally, limitations found in some studies included the exclusion of people with complex health-care needs and the use of measures such as self-reporting, which depend on previous access to health care, and it is likely that the true burden of health conditions among incarcerated women is even greater. The findings of this Review call the correctional, health, and research communities to act to reduce the health inequities faced by women in prison.