Aging Behind Bars: Study Highlights Rising Disability Rates Among Older Adults in Prisons

A new study from the Department of Health Policy and Management reveals that older adults in prison are significantly more likely to experience disabilities, with cognitive impairments being twice as prevalent compared to their peers living in community settings.

The study published this month in JAMA Network Open and led by HPM researchers Katherine Miller, PhD, Karen Shen, PhD, and Jennifer Wolff, PhD, offers a comprehensive analysis of the health disparities faced by individuals aged 55 and older in prison compared to their community-dwelling counterparts.

The research used data from the American Community Survey (ACS) from 2008 to 2022 and found rapid growth in the population of older incarcerated individuals, with the number of individuals aged 55+ in prisons growing from 102,700 in 2008 to 171,700 in 2022. While the growth slowed during the COVID-19 pandemic, the overall trend signals a demographic shift in correctional facilities.

Additionally, the study found that there were disproportionately high disability rates, with older adults in prisons reporting disabilities at nearly double the rate of their community-dwelling peers. Cognitive impairments were particularly stark, with 15% of incarcerated individuals aged 55+ reporting difficulty, compared to just 7% in the community. The prevalence of disabilities among older incarcerated adults remained stable over the study period, including during the pandemic.

"Our analysis reveals a hidden crisis among older adults in prisons. Not only has this population grown by 67% in just over a decade, but the prevalence of disabilities, particularly cognitive impairments, highlights the urgent need for tailored care models," said Miller. "Without intervention, correctional facilities risk becoming de facto nursing homes ill-equipped to meet these complex needs."

The aging of the prison population stems from a combination of factors, including longer sentences, harsh sentencing laws enacted in the 1970s and 1980s, and low rates of compassionate release. However, prisons are not designed for geriatric care. According to prior research, the cost of incarcerating an older individual is nearly double that of a younger person. Yet, facilities often lack the resources and infrastructure to address age-related disabilities such as impaired mobility or dementia.

The implications for policy and practice are myriad. As the prison population ages, policymakers face mounting pressure to address the unique needs of this population group. The study calls for evidence-based interventions to improve care delivery. In the absence of evidence some facilities have introduced care units for cognitively impaired older adults, which require further evaluation to understand their efficacy.  Further, the study points to the need to reevaluate compassionate care release policies. With low rates of recidivism among older adults, particularly those with disabilities, expanding compassionate release programs could ease the strain on correctional healthcare systems.

The findings have broad implications beyond the correctional system. As incarcerated individuals with disabilities transition back into the community, they will place additional demands on healthcare and social service systems. The researchers urge policymakers to consider these downstream effects when designing interventions.

As challenges of aging behind bars continue to grow, the study serves as a clarion call for action, shining a light on the need for systemic reforms that balance justice with humanity in addressing the needs of this vulnerable population.