Journal of Correctional Health Care - April 2023 - 121

Journal of Correctional Health Care
Volume 29, Number 2, 2023
ª The Author(s) 2023
DOI: 10.1089/jchc.21.06.0055
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LITERATURE REVIEW
Obesity Epidemic in U.S. Prison Populations:
A Meta-Analysis and Review of the Literature
Dawn M. Davis, MD, MPH,1* Lauren Wilson, LCSW,1 Joanne Salas, MPH,1 and Robert H. Gilman, MD2
Abstract
Limited existing evidence and health provider perceptions suggest that prevalence of obesity among incarcerated
people residing in U.S. correctional institutions is high. Evaluating evidence of obesity and weight
change during incarceration will allow for the determination of whether people are subject to weight gain
during incarceration. A systematic review of three online databases, gray literature, and reference lists of
articles of interest was conducted using the Preferred Reporting Items for Systematic Reviews and MetaAnalyses
(PRISMA) checklist. A meta-analysis to obtain pooled prevalence estimates of obesity among
U.S. incarcerated people was then completed. A total of 11 studies met our inclusion criteria. Results
show the estimated pooled prevalence of obesity in incarcerated men (30.0%) was less than the national
average. The estimated pooled prevalence of obesity in females (39.8%) was similar to the national average.
Keywords: health, incarceration, obesity, prison, inmate
Introduction
The United States has seen two populations rise over the
past several decades: people who are overweight (OW)
or obese (OB) and people who are incarcerated. The
United States now bears the dubious distinction of having
the greatest number of OB people (Ng et al., 2014) and
incarcerated people (Collier, 2014; Minton et al., 2021)
compared to any other nation.
The health consequences of being OW and OB have
been well documented for most of the U.S. population.
However, very little is known about the health of incarcerated
people. Specifically, there is an apparent paucity
of literature focused on people in U.S. prisons regarding
body mass index (BMI), the prevalence of OB, and
whether incarceration contributes to or causes OB.
With these data lacking, it is a challenge to extrapolate
the costs associated with OB among incarcerated people,
identify solutions to ameliorate OB, or effect policy
change.
Despite accounting for only 5% of the world's population,
the United States holds 25% of the world's incarcerated
people (Collier, 2014). The most recent data from
the U.S. Department of Justice find that nearly 2.1 million
adults were serving sentences in jails (correctional facilities
that hold individuals awaiting adjudication or serving
sentences less than 1 year) and prisons (correctional
facilities that house individuals serving sentences of
1 year or more) at year end 2019 (Minton et al., 2021).
The population of individuals incarcerated in the
United States increased over the past several decades,
peaked in 2007, and declined to its lowest levels in
20 years in 2019 (Minton et al., 2021). Despite an overall
1Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, Missouri, USA.
2Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
*Address correspondence to: Dawn M. Davis, MD, MPH, Department of Family and Community Medicine, Saint Louis University School of Medicine, 1008 S. Spring, SLUCare
Academic Pavilion, 3rd Floor, St. Louis, MO 63110, USA, Email: dawn.davis@health.slu.edu
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Journal of Correctional Health Care - April 2023

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