Policing/Incarceration
Exploring Body Mass Index Changes in Federal Adults in Custody Enid Velez-Valle* Enid Velez-Valle Mitchel Holliday Ellen Smith
The obesity epidemic affects both communities and correctional institutions alike. While previous studies have highlighted disparities in obesity rates based on age, sex, race and ethnicity within correctional settings, there is a limited information on fluctuations in Body Mass Index (BMI) during long-term incarceration. This retrospective analysis included Adults in Custody (AICs) from federal institutions across the United States who began incarceration at any point between January 1, 2018, and December 31, 2021, and who had at least two recorded measures of height and weight within two years of incarceration. BMI was calculated using weight and height and categorized as Underweight (BMI < 18.5), Healthy Weight (BMI 18.5-24.9), Overweight (BMI 25-29.9), Obese Class 1 (BMI 30-34.9), Obese Class 2 (BMI 35-39.9), or Obese Class 3 (BMI 40+). Changes in BMI score from the last to the first measurement were tracked and categorized as a change if they constituted a change in BMI category (No Change, Category Increased, Category Decreased). Information on age, sex, race, ethnicity and education attainment was also collected to identify fluctuations by demographics among the incarcerated population. All analyses were conducted using SAS Enterprise Guide version 8.3. A total of 37,261 AICs were identified and followed for two years. On average, there was no change in BMI score during this period. However, when stratified by category, notable changes emerged. AICs initially in the Underweight category gained weight (81.9%) and those AICs initially in Obese categories lost weight (23.1-34.3%). Significant differences by demographics were observed by race (chi-square (χ2)=0.017), ethnicity (χ2=0.049), age group (χ2=0.013) and education attainment (χ2=0.003). These findings suggest the need of targeted public health efforts including age, cultural background and educational attainment to support individuals at both ends of the BMI spectrum and reach desired weight outcomes.