United States: to lower prison health costs, Maryland serves healthy food

Not long after taking over as warden of the Maryland Correctional Institution for Women in Jessup, Margaret M. Chippendale noticed a sizable problem: Women were leaving the system a lot heavier than when they arrived.

She made an easy connection in the dining hall. The women were being served the same food as male prisoners, a 3,200-calorie menu filled with carbs, such as three slices of white bread at a meal.

“Women here already have a number of health issues,” Chippendale said. “This wasn’t helping.”

In an effort to stem the weight gains, and improve chronic health conditions such as heart disease and diabetes that disproportionately affect those incarcerated, she worked with a dietitian to retool the offerings and slowly cut about 1,000 calories a day from the meals.

About three years after the effort began, the prison has replaced the white bread with wheat and gives out less. It has added items such as fish, fresh fruits and vegetables, as well as cottage cheese and yogurt full of the calcium the aging female population needs. It serves drinks with less sugar.

Chippendale said she eventually expects to show savings on health care costs, including medications, the biggest part of her budget. The dietitian is now talking up the changes to other correctional institutions in the state.

The women in Jessup, who have had a say in the new menus, report greater satisfaction. More are coming to the dining hall rather than eating food they buy in the commissary. They say that has improved morale in the prison, which could translate into fewer squabbles and heightened safety.

Jermel Chambers, a 54-year-old incarcerated since 2000, said she’s been through a lot of menu changes, mostly so bad that women were avoiding the dining hall and eating only unhealthy food they bought in the commissary. But now almost everyone comes together for meals.

“There’s someone who has been here for 35 years,” she said, “and when she comes to lunch, you know there’s been a change.”

The women also say it could improve the health of their families, if they bring the lessons learned about nutrition home with them when they are released.

“We couldn’t have done this without input from them,” Chippendale said of the inmates. “We needed buy-in. . We’ll probably continue to tweak the menu forever.”

Significant challenges remain, Chippendale said. Some women did not embrace the new healthier but often unfamiliar foods. The menu still can’t be tailored well to individual health needs. Getting the fresh food without increasing the food budget — currently $3.30 to $3.50 per inmate per day — is an ongoing issue. An increase in funding is unlikely, even if the goal is saving money down the road.

The warden also can’t yet measure improvements in health or medical spending. It’s unclear when she could have evidence, as health care has been a complicated issue for correctional systems in Maryland and across the country. Health hinges on more than food.

The U.S. Department of Justice found in 2016 that half of prisoners had a chronic health condition and two-thirds were currently on some kind of prescription medication. Close to three-quarters were obese, with women more likely to be so.

In Maryland, advocates say the prisons have done somewhat better tending to chronic ailments in recent years than have the jails where detainees stay for short, often chaotic periods. But there is a lot of room to improve health care.

Nicole Hanson, executive director of Out For Justice, which promotes policies for ex-offenders re-entering society, said health care is not only constitutionally guaranteed to inmates but can put them on a better path, save money and protect the public from uncontrolled infectious diseases.

She and Julie Magers, coalition leader with the Maryland Prisoners’ Rights Coalition, applauded any effort to improve the prison menu for taste, quality and nutrition, given the well-known link between food and health, both medical and mental. They say offerings in the past have been “terrible” and contributed to the women’s health problems.

They said they hope the fresh food is actually fresh and healthy and that the Maryland Department of Public Safety and Correctional Services eventually takes the makeover system-wide. They also said they hope women leave the institution able to make good decisions about feeding themselves and their families.

“People are used to sugar and junk food and ramen noodles, so it will take time and education to change,” Magers said. “They need to teach them why this is important.”

The menu in the Jessup facility is gender-specfic, and the corrections department doesn’t have plans to retool the menu for men in other prisons, said Gerard Shields, a spokesman.

To make the changes for women at Jessup, the warden met with Rudeine Demissie, the institution’s dietary manager, who said the system was bound by national standards and state requirements. The pair worked to change a state law that required the same menu for men and women in prison.

After getting the law changed to allow the Jessup facility to create the gender-specific menu with fewer calories, Demissie said she had to rework the contracts that supplied the food for the old menu.

She now has to continually hunt down deals for fresh food through institutional vendors, sometimes buying fruit and vegetables that are unspoiled but blemished and less desirable to grocery stores. She has to work with the 800 inmates on their preferences.

“We transitioned gradually,” Demissie said. “When we prepared iced tea, we didn’t use as much sugar. We phased it in.”

Several inmates who say they like the new menu credit Demissie with considering their input. Change can be hard, especially for some who are more accustomed to fast food than home-cooked meals.

The women said they particularly look forward to spring rolls, baked potatoes with steamed broccoli on top and whiting fish. They eat their tuna with less mayonnaise.

The new food has made them feel better, they said, and they hope to sustain healthy eating when they leave.

Dacora Ross, a 24-year-old who has been in the facility since 2015, said she never thought much about her diet or how it could affect her health. Since the menu changes, she’s discovered foods like cherry tomatoes. She said she even called her mother to tell her how much she liked them.

Deborah Rowe, 54, said she came from a small county jail last year about 20 pounds heavier than when she arrived there. She was pleased to find that the menu was changing for the better and decided to get involved with the improvements, talking with other women and reporting back to Demissie. She said few women noticed a reduction in portions because the meals no longer consist of “empty calories” and are far more filling.

Rowe was inspired to start exercising and said she’s lost the weight she put on.

“They have been integrating little changes here and there,” she said. “I hear from everyone how happy they are for a piece of fresh fruit.”

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