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Prison environment and non-communicable chronic disease modifiable risk factors: length of incarceration trend analysis in Mexico City
  1. Omar Silverman-Retana1,
  2. Edson Servan-Mori2,
  3. Stefano Michele Bertozzi3,
  4. Emanuel Orozco-Nuñez2,
  5. Sergio Bautista-Arredondo2,
  6. Ruy Lopez-Ridaura4
  1. 1Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
  2. 2Centre for Health Systems Research, National Institute of Public Health Mexico, Cuernavaca, Mexico
  3. 3School of Public Health, University of California Berkeley, Berkeley, California, USA
  4. 4Centre for Population Health Research, National Institute of Public Health Mexico, Mexico City, Mexico
  1. Correspondence to Dr Ruy Lopez-Ridaura, Center for Population Health Research, National Institute of Public Health, Mexico City ZC 14080, Mexico; rlridaura{at}


Background There is a lack of evidence regarding chronic disease modifiable risk factors among prisoner populations in Latin America. The purpose of this study was to estimate the prevalence of modifiable risk factors for chronic diseases and to assess their relationship with length of incarceration.

Methods We analysed data from a cross sectional study in which 4241 prisoners were randomly selected to answer a questionnaire with socio-demographic and health behaviour content using an audio computer-assisted self-interview format. Physical activity (PA), low-quality diet, current smoking and alcohol or cocaine use during the last month in prison were our main outcomes. Quantile regression models and logistic regression models were performed.

Results Our final analytical sample consisted of 3774 prisoners from four Mexico City prisons. PA was estimated as 579 median metabolic equivalents-min/week, prevalence of alcohol use was 23.4%, cocaine use was 24.2% and current smoking was 53.2%. Our results suggest that, as length of incarceration increased, PA as well as alcohol and cocaine use increased, whereas the quality of diet decreased.

Conclusion This study supports the hypothesis that exposure to prison environment (measured by length of incarceration) fosters modifiable risk factors for chronic diseases, particularly diet quality and cocaine use.

  • prisoners
  • prison environment
  • non-communicable chronic disease
  • modifiable risk factors
  • Mexico City

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  • Contributors OS-R, RL-R and ES-M contributed to the conception of the study and the analysis plan. OS-R performed the data analysis and drafted the first version of the manuscript. All authors reviewed and approved the final version of the manuscript.

  • Funding This manuscript is an adaptation of a master of science thesis of O-SR. His graduate work was funded by the Mexican National Council on Science and Technology (CONACyT). The original research study was supported by the Ministry of Health of Mexico City under contract INSP- 2010-340 during 2010.

  • Disclaimer The funders did not have any role in the design of this substudy, data analysis, decision to publish or drafting the manuscript.

  • Competing interests None declared.

  • Ethics approval Institutional Review Board at the National Institute of Public Health, Mexico (protocol ID # 821).

  • Provenance and peer review Not commissioned; externally peer reviewed.