Create Supportive Environments

Although the public health literature provides strong evidence that supportive environments contribute to improved health, few such interventions have been implemented or evaluated in correctional settings. Specific steps correctional officials can take to improve elements of the prison or jail physical environment that influence health are reduction in overcrowding; comprehensive pest control strategies; adequate lighting and ventilation; and noise control. Improvements in the social environment include increasing opportunities for family visits and telephone calls; staff training and supervision to reduce hostile or violent interactions among inmates or between inmates and staff; clear policies and protocols to prevent sexual violence and coercion among inmates and between inmates and staff; and availability of assistance for those with addictions, especially those going through withdrawal while incarcerated.

Another dimension of the correctional environment that has been inadequately studied is food. While adequate nutrition is an essential component of health, incarcerated populations lose the right to choose their diet. In some facilities, processed, tasteless foods are used as a punishment for inmates who have violated rules. In a few, agricultural programs provide incarcerated individuals with an opportunity to learn gardening or farming skills and to provide fresh produce for the facility and other facilities have offered heart-healthy diets. Few correctional facilities have examined the nutritional quality of food items offered in inmate canteens. Having access to a balanced diet that promotes health would appear to be a basic human right; whether improved nutrition could lead to improved health or criminal justice outcomes has yet to be studied. Given high rates of diabetes and obesity in the low-income communities from which most people in correctional facilities come and return to, using prisons and jails to improve nutritional status could help to control these epidemics.

Similarly, growing evidence points to the short- and long-term benefits of regular physical activity in promoting mental and physical health and preventing weight gain, chronic diseases, and mental health conditions. A healthy correctional facility should ensure that all inmates have access to regular physical activity and avoid depriving inmates of opportunities to exercise as a punishment.

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