Zenk et al.1 recently discussed the relative unavailability of healthier food in low-income communities of color. Another population experiencing disparities in access to healthy foods are prison inmates.2–4 Prisons offer a unique opportunity for implementing system and policy changes because the food environment can be completely controlled, yet many inmates—women, in particular—gain unhealthy amounts of weight.3,5
As part of a larger intervention to reduce chronic disease risk among women inmates, Coffee Creek Correctional Facility (CCCF) in Wilsonville, Oregon, implemented a reduced-calorie menu in its minimum-security facility cafeteria, moving from 3000 to 2200 daily calories in August 2012. However, inmates may still purchase supplementary food from prison commissary each week.
We conducted a small study to determine the amount and type of food women inmates purchased before and after implementation of the reduced-calorie menu. Specifically, we collected commissary receipts for two samples of women who were incarcerated for six to 24 months and resided in the minimum security facility during the study periods. Receipts were analyzed for all purchases made during three one-month time periods, including a baseline (May 2012, n = 128) and two follow-ups (October 2013, n = 102; May 2014, n = 133).
On average, women purchased more than 1000 calories per day from commissary. Top Ramen, nondairy creamer, Crystal Lite drink mix, and soda pop were purchased most often. Only a quarter of commissary food purchases met all Smart Snacks in Schools standards,6 fewer than 20% of total calories purchased. Women did not purchase more calories from commissary after the reduced-calorie menu was implemented (Table 1).
TABLE 1—
Commissary purchases among women inmates at Coffee Creek Correctional Facility-Minimum Security Facility: Wilsonville, OR
| May 2012 (n = 128) | October 2013 (n = 102) | May 2014 (n = 133) | |
| Calories/d, mean ±SD (min–max) | 1131 ±790 (25–3812) | 1182 ±849 (9–4462) | 967 ±698 (0–2709) |
| Calories/d from foods that met all Smart Snack standards, mean ±SD (min–max) | 156 ±181 (0–945) | 255 ±259 (0–1186) | 158 ±158 (0–888) |
| Items meeting Smart Snack standards, no./total no. (%) | 44/186 (24) | 48/190 (25) | 46/176 (26) |
The astonishing amount of calories women inmates purchased from prison commissary, a retail environment analogous to limited-service corner stores, clearly undermined institutional policies to promote health and address rising obesity and chronic disease rates. If a woman ate an extra 1000 calories per day, she would gain up to eight pounds per month.
Security concerns and logistical considerations limit the type of food offered through prison commissary. For example, canned fruit and vegetables are unfeasible because of metal pull tabs; fresh fruit can be made into an alcohol substitute. However, the Oregon Department of Corrections is currently working within these constraints to offer and promote healthier food alternatives through its prison commissary. Zenk et al’s1 conclusion that “policies and other interventions may need to address relative availability of healthier alternatives” fully applies to prison environments, and may help institutions reduce the burden of obesity and chronic diseases.3,7
References
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