Gender disparities in weight gain among offenders who are obese upon entering correctional facilities

Abstract

Background: Obesity is a significant health issue for offenders, who have a higher prevalence of obesity-related conditions, such as diabetes, compared to non-incarcerated populations. Within incarcerated populations, there are obesity disparities in terms of race, gender, and age, as well as excess weight gain during incarceration. Methods: This longitudinal study was conducted for 2005 – 2010 in collaboration with a Department of Corrections in the east south central region of the United States. From electronic health records of 10,841 offenders, weight, height, and demographic data were extracted. As determined from these data, 2,622 offenders met the inclusion criteria (two or more valid weight and height measurements and length of incarceration > zero). Results: Women offenders who entered corrections as obese had a mean (and standard deviation) body mass index (BMI) of 36.2 (5.3) at baseline; the mean for men was 34.2 (4.4). For women who were obese at baseline, their BMI increased by 1.0 (3.3); for men their BMI decreased by 0.7 (3.1). Gender differences for changes in BMI among the obese population were significant (χ2 = 15.8, p < 0.001). Women and men also differed in regard to weight gain (χ2 = 34.0, p < 0.001). Further, those women and men who were not obese at baseline had an increase in BMI that was greater than the increase for the group that entered corrections as obese (p > 0.001). Conclusions: Women offenders, obese or not at baseline, had greater gains in weight in comparison to men. However, there were no significant differences in BMI changes for race or correlations with age or length of incarceration. The findings related to gender warrant further investigations to explain these disparities and to evaluate the capacity of the corrections system to meet the health needs of women.