Older and incarcerated: policy implications of aging prison populations

Abstract

Prison populations worldwide are aging at an unprecedented rate, and associated age-related medical costs have had serious consequences for jurisdictions struggling to respond to the changes. Our examination of the situation in California shows that recognizing the changing healthcare needs of aging prison populations is critical to achieving effective and efficient policies and practices that affect this medically vulnerable and costly population. Chronic prison overcrowding usually accompanies the aging trends, and there is evidence that aging is strongly correlated with desistance from criminal behavior, suggesting an opportunity to at least partially address the challenges through early release of appropriate persons. Some relevant policies do exist, but they have not achieved this goal on a sufficient scale. Drawing lessons from California and available scholarship, we conclude with recommendations for those faced with responding to the unprecedented number of older adults now in prison, most of whom will eventually be released.

Understanding and Improving the Health of People Who Experience Incarceration: An Overview and Synthesis

“…Prisoners are on average younger than the surrounding population; however, older people are one of the fastest growing demographics in many prison systems ( 46 ), notably including in the United States ( 47 ). This makes it challenging for service providers to fund and deliver appropriate health care.…”

“…The reviews by Wirtz et al ( 30 ) and Poteat et al ( 31 ) are an important step toward building an evidence base regarding the health of incarcerated LGBTQ people, men who have sex with men, people who inject drugs, and sex workers; however, as the authors’ findings highlight, much work remains to be done with these and other minority populations in prison. In their review, Skarupski et al ( 48 ) also highlighted that, despite an aging prison population and evidence that prisoners age more quickly than do their community counterparts ( 62 ), not enough is known about the prevalence, prevention, or treatment of noncommunicable diseases in prison ( 8 ) or the health and medical costs associated with aging prison populations ( 46 ).…”

Older adults in jail: high rates and early onset of geriatric conditions

“…The cumulative burden of multiple chronic conditions and adverse health risks has led some criminal justice researchers and professionals to contend that prisoners may experience “ premature ” or “ accelerated ” aging (Aday 2003 ; Williams et al 2012b ). As a result, the age at which criminal justice-involved individuals are considered “older” varies considerably, with some systems using the community norm (age 65) and others using ages 50 or 55 to define “older age” (Psick et al 2017 ).…”

Institutional thoughtlessness and the needs of older probation clients

“…I'm not on drugs, no alcohol, no violence so they don't seem to know what to do with me. (P6) Such antipathy may also arise from the pains of psychological assessment (Crewe, 2011) and the utilisation of clinical and actuarial approaches to classifying risk (Kemshall, 2001), resulting in offending behaviour programmes focusing on reducing recidivism, an aim which may be difficult to reconcile for those convicted of historic offences, not least as age is also one of the most consistent predictors of desistance from offending (Psick et al, 2017). Compounding fears about undertaking a programme was also the uncertainty regarding what would happen post-programme completion.…”