Incarceration acts as a structural determinant of health with higher rates of chronic and infectious diseasesIncarceration Linked to Higher Rates of Mental Illness and HIV

BackgroundPeople who experience incarceration in Canada have been historically more likely to experience poor health than community-based populations. Although incarcerated people are entitled to health care equivalent to community standards, evidence suggests this is inconsistently achieved in Canada. We conducted a narrative review to synthesize contemporary evidence on health status and health care utilization by incarcerated people in Canada, including changes observed during and after the COVID-19 pandemic.MethodsWe searched MEDLINE, PsycINFO, CINAHL, Scopus, and Web of Science for peer-reviewed literature published between January 1, 2014 and July 22, 2026 on the health of adults incarcerated in Canadian provincial, territorial, and federal correctional centers. Both title/abstract and full-text screening were completed independently by two reviewers, and findings were extracted and synthesized thematically across major health domains.ResultsAcross the 167 included articles, incarcerated people in Canada experience significantly higher rates of mental illness, substance use disorders, chronic disease, hepatitis C virus infection, and HIV. Mental health and substance use disorders were highly prevalent and often concurrent. Access to reproductive health care and maternal care in custody was limited compared to community care. Health care continuity was disrupted at admission, transfer, and release from correctional centers. These disparities were closely tied to community-based social determinants of health such as poverty, unstable housing, and systemic racism, and mortality risk was highest during transitions in and out of custody, when the risk of overdose death in the weeks following release was greatest.InterpretationIncarceration is an important structural determinant of health in Canada that intersects with community-based social determinants of health, contributing to health inequities. To reduce preventable death among people who experience incarceration in Canada, efforts are required to strengthen continuity of care, evaluate the quality of services in correctional centers, and address the social determinants of health and structural inequities that contribute to premature mortality.