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DAVIS ET AL.
(Gostin et al., 2007). As a result, many corrections-based
health practices are not driven by evidence (Cislo &
Trestman, 2013).
The minuscule amount of data available on incarcerated
peoples' BMI is critically important: The health
care costs associated with OW/OB adults in the United
States are significantly higher than health care costs for
adults of normal weight (Wang et al., 2011). It seems reasonable
that, in correctional settings, health care costs
of OB people will be significantly higher than those of
people of normal weight.
Medication costs increase with increasing BMI
(Counterweight Project Team, 2008). Obesity is associated
with dozens of health complications, including
worse outcomes in SARS-CoV-2 infections (Apovian
et al., 2015; Field et al., 2001; Herbert et al., 2012; Jensen
et al., 2014; Kwok et al., 2020; Leddy et al., 2009;
Mitchell & Shaw, 2015), and there is evidence that prisons
are obesogenic environments. Multiple factors inherent
to residing in correctional facilities could contribute
to an obesogenic phenomenon.
Conclusion
The health of incarcerated people is an unpopular topic,
but one that affects all Americans. The United States has
the world's most expensive health care system (Sarpel
et al., 2008), and the cost of providing health care to people
in prison is continuously increasing. With 97% of
incarcerated people under state and federal jurisdiction
sentenced to more than 1 year in prison (Carson, 2015),
the OB epidemic is likely contributing to the increasing
costs of medical care in incarcerated populations.
Health care professionals have a legal and ethical
imperative to ensure that people in prison do not become
less healthy while incarcerated. As evidenced by a study
from Japan, a healthful diet and frequent physical activity
may be the most cost-effective method to improve the
health of people incarcerated in U.S. prisons. Most incarcerated
people will be released back into society (Wilper
et al., 2009), thus improvements in their health translate
into improvements in public health.
Researchers, medical personnel, and policymakers
would benefit from a large-scale measured analysis of
incarcerated peoples' BMIs, including data points at the
time of imprisonment, while incarcerated, and at release.
Once the true prevalence of OW and OB has been quantified,
tangible action can be taken to mitigate the reported
ill effects of incarceration on people's body weight.
Authors' Contributions
D.D., R.H.G., and J.S. made substantial contributions to
the conception or design of the work, including the acquisition,
analysis, or interpretation of data for the work.
L.W. contributed by drafting portions of the work and
revising it critically for important intellectual content.
Author Disclosure Statement
The authors disclosed no conflicts of interest with respect
to the research, authorship, or publication of this article.
Funding Information
The authors received no financial support for the
research, authorship, or publication of this article.
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