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The Hidden Cost of An Unhealthy Diet In Prison

I was the senior prison physician for NV from 1987-2016 and 3/18 became the author of, '30 Years Behind Bars,' Trials of a Prison Doctor. Here is my opinion piece regarding the NV supreme court ruling that inmates in the state are not being provided with healthy diets.

The Nevada Supreme court has ruled that inmates in the state are not being provided with a healthy diet. There may be some in the community who would say, “So what, they did a crime and should be punished.”  What the community might not understand is by not giving the inmates a healthy diet they will end up spending more tax payer dollars because of the expenditure incurred in medical and legal costs. The current diet policy is penny wise and dollar foolish. I have some insight in this area as I was the senior prison physician for the state of Nevada from 1987-2016 and took care of the sickest inmates in the state.  Health care expenditure for inmates in prisons dwarfs the expenditure spent on food. When I started working in the prison the thing I noticed most about the food was the lack of fresh fruit ,vegetables and fiber. I was told that those products were too costly, too hard to store and could be diverted to make ‘pruno’ (homemade alcohol). That left me with a patient population that had chronic constipation, gut issues and chronic diseases related to mineral and micronutrient deficiencies. The prison diet tends to rely on cheap, highly processed foods, high in fat and sugar. The problem with this type of diet is that the high sodium content increases the risk of hypertension and worsens congestive heart failure and cirrhosis. The food with the highly refined carbohydrates and sugar increase diabetes. These diseases are costly to taxpayers.

Poor diets also adversely affect mood and the immune system adding to medical and psychological issues . Many inmates choose to buy food out of the store because of the poor diet, but that option is no better. The inmate store predominantlysells chips, cookies, ramen soup and products which contain high sodium ,high sugar and trans fats. I remember asking the store manager if he would at least sell plain oatmeal instead of the oatmeal packets with all the sugar in it and he told me no, because it wouldn’t sell. Prisons are costly and one can argue how much the cost savings in medical care would be if diets were improved, but what would save money is to first put less individuals in prison . Second would be to reinstitute the culinary arts program that at one time existed at Northern Nevada Correctional Center where the Regional Medical Facility is housed. The inmates could learn to make healthier diets there - earn a certificate, have a marketable skill and serve a diet that could help our sickest inmates and help the inmates who are interested in their health. That could also lower lawsuits against the prison, which is a win-win scenario.

Karen Gedney MD, Author of memoir, ’30 Years Behind Bars,’ Trials of a Prison Doctor

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