Medical nutrition therapy in Canadian federal correctional facilities

Abstract

BackgroundUnder- and over nutrition as well as nutrition risk factors such as communicable and non-communicable diseases are a common and major cause of morbidity and mortality in correctional facilities. Consequently, medical nutrition therapy (MNT), a spectrum of nutrition services aimed at optimizing individual well-being, is being recognized as integral to the health of people who experience incarceration. However, there is a paucity of research that explores the delivery of MNT in correctional facilities.MethodsA scoping review combined with secondary analysis of qualitative data (field notes, in-depth stakeholder interviews) from a 2-year ethnographic study about food insecurity and incarceration was undertaken to gain insights about the delivery of corrections-based MNT in Canada. Thematic analysis of all documents was done using an interpretive framework.ResultsAn understanding about MNT was developed within three themes: 1) specialized service provision in a unique environment; 2) challenges with the provision of MNT; and 3) consideration of corrections-based MNT alternatives. An incarcerated individual’s nutritional health was conceptualized as culminating from various factors that included dietary intake and health status, enabling environments, access to quality health services, and clinical nutrition services. Nutrition care practices, which range from health promotion to rehabilitation, are challenged by issues of access, visibility, adequacy, and environmental barriers. Their success is dependent on demand (e.g., ability of recipient to act) and factors that enable quality health and food services. Advancing corrections-based MNT will require policies that provide supportive food and health environments and creating sustainable services by integrating alternatives such as peer approaches and telehealth.ConclusionsProfessional associations, government, researchers and other stakeholders can help to strengthen corrections-based MNT by fostering shifts in thinking about the role of health practitioners in these contexts, preparing future health professionals with the specialized skills needed to work in these environments, generating evidence that can best inform practice, and cultivating collaborations aimed at crime prevention, successful societal reintegration, and the reduction of recidivism.Electronic supplementary materialThe online version of this article (10.1186/s12913-019-3926-3) contains supplementary material, which is available to authorized users.

Food Security in the Context of Paternal Incarceration: Family Impact Perspectives

“…In some instances, family members became formally diagnosed with chronic health conditions (e.g., diabetes, dyslipidemia), a common experience related to incarceration [ 65 ]. Often these conditions required adhering to therapeutic diets.…”

Prison food and the carceral experience: a systematic review

“…In countries with a more rigid approach, the only way to get a different meal from the planned menu is by having a special diet (therapeutic, religious or conscience) (Correctional Service Canada, 2019a, 2019b, 2019c, 2019d, 2019e; Varoucha-Azcarate, 2019). It is widely known that under those circumstances, a situation may arise where people will try to gain control over the prison food offering (like feigning illness) (Chatterjee and Chatterjee, 2018; Davison et al , 2019; de Graaf and Kilty, 2016; Varoucha-Azcarate, 2019). This can create power struggles between inmates, health professionals and prison officials when trying to determine who requires a special diet and is trying to gain control of the food being offered to match their preferences better, increase food variety or get food they deem to be healthier (Chatterjee and Chatterjee, 2018; Davison et al , 2019).…”

Mulheres detentas do Recife-PE: saúde e qualidade de vida

“…4,11,17 Among the inmates' lifestyle habits, smoking, the use of illicit drugs and the lack of physical activity stand out, data similar to those of national and international studies. [4][5][6]17 Smoking, lack of activity, unhealthy eating and the use of sugar-sweetened beverages are associated with the development of respiratory and cardiovascular diseases, and are risk factors for the emergence of several diseases, including cancer and diabetes, not only among inmates but, in all the strata of the population. [4][5][6][18][19][20] The female prisoners evaluated their health negatively and the majority reported some problem related to this aspect.…”

“…[4][5][6]17 Smoking, lack of activity, unhealthy eating and the use of sugar-sweetened beverages are associated with the development of respiratory and cardiovascular diseases, and are risk factors for the emergence of several diseases, including cancer and diabetes, not only among inmates but, in all the strata of the population. [4][5][6][18][19][20] The female prisoners evaluated their health negatively and the majority reported some problem related to this aspect. Most of these women came from family nuclei with unfavorable living conditions and often entered the prison with pre-existing health problems that were aggravated by the prison situation.…”

“…Many inmates in these custody facilities have a history of inadequate access to preventive care and primary care health services, leading to the evolution of acute or chronic morbidities. [4][5][6][7] In addition, physical and psychological violence is linked to the daily lives of incarcerated women, almost irreversibly compromising their health. Research conducted with women incarcerated in Recife, Pernambuco, found that 87% had suffered some type of physical or sexual violence that influenced the development of depression and drug use.…”