Mental and Physical Health of Older Incarcerated Persons Who Have Aged in Place in Prison

Abstract

This study describes physical and mental health of incarcerated males aged ≥50 years who spent at least 20 consecutive years in prison, comparing those with life sentences (“lifers”) with those expected to be released/paroled. Data included demographics, chronic medical conditions, self-reported and objective disabilities, depressive symptoms, suicidal ideation (SI), and social support. The 65 participants (M_age = 56.9, SD = 6.6) were racially diverse (40% White, 51% Black, 9% Hispanic/Other), incarcerated for M = 26.6 (SD = 4.5) years, and 34 (52%) were lifers. Among the 39 (60%) of participants with visitors, lifers had lower social support scores (p = .005). After controlling for age, race, and chronic conditions, lifers reported disability in a higher number of activities (p < .001), and had higher depressive symptoms (p = .08) and SI scores (p = .04). Health-related differences between lifers and those expected to be released have implications for prison systems including staff training, advance care planning, and need for expanding prison-based hospice programs.

Keywords

mental health physical function crime social support

Get full access to this article

View all access options for this article.

References

Aday

R. H.

(2005). Aging prisoners’ concerns toward dying in prison. OMEGA, 52(3), 199–216.

Ahalt

Trestman

R. L.

Rich

J. D.

Greifinger

R. B.

Williams

B. A.

(2013). Paying the price: The pressing need for quality, cost, and outcomes data to improve correctional health care for older prisoners. Journal of the American Geriatrics Society, 61(11), 2013–2019. https://doi.org/10.1111/jgs.12510

Baidawi

Trotter

Flynn

(2016). Prison experiences and psychological distress among older inmates. Journal of Gerontological Social Work, 59(3), 252–270. https://doi.org/10.1080/01634372.2016.1197353

Barnert

Perry

Morris

(2016). Juvenile incarceration and health. Academic Pediatrics, 16(2), 99–109. https://doi.org/10.1016/j.acap.2015.09.004

Barry

L. C.

Coman

Wakefield

Trestman

R. L.

Conwell

Steffens

D. C.

(2020). Functional disability, depression, and suicidal ideation in older prisoners. Journal of Affective Disorders, 266, 366–373. https://doi.org/10.1016/j.jad.2020.01.156

Barry

L. C.

Steffens

D. C.

Covinsky

K. E.

Conwell

Byers

A. L.

(2018). Increased risk of suicide attempts and unintended death among those transitioning from prison to community in later life. American Journal of Geriatric Psychiatry, 26(11), 1165–1174. https://doi.org/10.1016/j.jagp.2018.07.004

Binswanger

I. A.

Stern

M. F.

Deyo

R. A.

Heagerty

P. J.

Cheadle

Elmore

J. G.

Koepsell

T. D.

(2007). Release from prison: A high risk of death for former inmates. New England Journal of Medicine, 356, 157–165. https://doi.org/10.1056/NEJMsa064115

Bond

G. D.

Thompson

L. A.

Malloy

D. M.

(2005). Lifespan differences in the social networks of prison inmates. International Journal of Aging and Human Development, 61, 161–178.

Connecticut Department of Correction. (2012). CTDOC classification manual.

10.

De Claire

Dixon

. (2017). The effects of prison visits from family members on prisoners’ well-being, prison rule breaking, and recidivism: A review of research since 1991. Trauma, Violence, and Abuse, 18(2), 185–199. https://doi.org/10.1177/1524838015603209

11.

Dudeck

Drenkhahn

Spitzer

Barnow

Kopp

Kuwert

Freyberger

H. J.

Dunkel

(2011). Traumatization and mental distress in long-term prisoners in Europe. Punishment & Society, 13(4), 403–423. https://doi.org/10.1177/1462474511414782

12.

Federal Interagency Forum on Aging-Related Statistics. (2012). Older Americans 2012: Key indicator of well-being. https://agingstats.gov/docs/PastReports/2012/OA2012.pdf

13.

Geronimus

A. T.

Hicken

Keene

Bound

(2006). “Weathering” and age patterns of allostatic load scores among blacks and whites in the United States. American Journal of Public Health, 96(5), 826–833. https://doi.org/10.2105/AJPH.2004.060749

14.

Greene

Ahalt

Stijacic-Cenzer

Metzger

Williams

(2018). Older adults in jail: High rates and early onset of geriatric conditions. Health & Justice, 6(1), Article 3. https://doi.org/10.1186/s40352-018-0062-9

15.

Guralnik

J. M.

Ferrucci

Simonsick

E. M.

Salive

M. E.

Wallace

R. B.

(1995). Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. New England Journal of Medicine, 332, 556–562. https://doi.org/10.1056/NEJM199503023320902

16.

Guralnik

J. M.

Simonsick

E. M.

Ferrucci

Glynn

R. J.

Berkman

L. F.

Blazer

D. G.

Scherr

P. A.

Wallace

R. B.

(1994). A short physical performance battery assessing lower extremity function: Association with self-reported disability and prediction of mortality and nursing home admission. Journal of Gerontology, 49(2), M85–M94. https://doi.org/10.1093/geronj/49.2.M85

17.

Hebert

(2019). Too easy to keep: Life-sentenced prisoners and the future of mass incarceration. University of California Press.

18.

Hedegaard

Curtin

S. C.

Warner

(2020). Increase in suicide mortality in the United States, 1999-2018 (No. 362) [NCHS data brief]. U.S. Department of Health and Human Services.

19.

Heisel

M. J.

Flett

G. L.

(2006). The development and initial validation of the Geriatric Suicide Ideation Scale. American Journal of Geriatric Psychiatry, 12(9), 742–751. https://doi.org/10/1097/01.JGP.0000218699.27899.f9

20.

Heisel

M. J.

Flett

G. L.

(2016). Investigating the psychometric properties of the Geriatric Suicide Ideation Scale (GSIS) among community-residing older adults. Aging and Mental Health, 20(2), 208–221. https://doi.org/10.1016/0277-9536(91)90150-B

21.

Jarman

(2020). Only one way to swim? The offence and the life course in accounts of adaptation to life imprisonment. The British Journal of Criminology, 60, 1460–1479. https://doi.org/10.1093/bjc/azaa036

22.

Jimenez

L. B.

Cross

S. H.

Boucher

N. A.

(2021). “He needed just about everything”: Caring for aging adults post incarceration. Journal of Applied Gerontology. https://doi.org/10.1177/0733464821990511

23.

Kazemaian

Travis

(2015). Imperative for inclusion of long termers and lifers in research and policy. Criminology & Public Policy, 14(2), 355–396. https://heinonline.org/HOL/License

24.

Kim

Thomas

P. A.

(2017). Direct and indirect pathways from social support to health? The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 74(6), 1072–1080.

25.

Kroenke

Spitzer

R. L.

Williams

J. B.

(2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x

26.

Liem

Kunst

(2013). Is there a recognizable post-incarceration syndrome among released “lifers”? International Journal of Law and Psychiatry, 36(3–4), 333–337. https://doi.org/10.1016/j.ijlp.2013.04.012

27.

Lin

S. F.

Beck

A. N.

Finch

B. K.

Hummer

R. A.

Master

R. K.

(2012). Trends in US older adult disability: Exploring age, period, and cohort effects. American Journal of Public Health, 102, 2157–2163. https://doi.org/10.2105/AJPH.2011.300602

28.

Maschi

Viola

Morgen

Koskinen

(2015). Trauma, stress, grief, loss, and separation among older adults in prison: The protective role of coping resources on physical and mental well-being. Journal of Crime and Justice, 38(1), 113–136. https://doi.org/10.1080/0735648X.2013.808853

29.

Mauer

(2018). Long-term sentences: Time to reconsider the scale of punishment. UMKC Law Review, 87(1), 113–131.

30.

McKillop

Boucher

(2018). Aging prison populations drive up costs: Older individuals have more chronic illnesses and other ailments that necessitate greater spending. Pew Charitable Trusts. https://www.pewtrusts.org/en/research-and-analysis/articles/2018/02/20/aging-prison-populations-drive-up-costs

31.

Mezuk

Diez Roux

A. V.

Seeman

. (2010). Evaluating the buffering vs. direct effects hypotheses of emotional social support on inflammatory markers: The Multi-Ethnic Study of Atherosclerosis. Brain, Behavior, and Immunity, 24(8), 1294–1300. https://doi.org/10.1016/j.bbi.2010.06.006

32.

Mezuk

Rafferty

J. A.

Kershaw

K. N.

Hudson

Abdou

C. M.

Lee

Eaton

W. W.

Jackson

J. S.

(2010). Reconsidering the role of social disadvantage in physical and mental health: Stressful life events, health behaviors, race, and depression. American Journal of Epidemiology, 172(11), 1238–1249. https://doi.org/10.1093/aje/kwq283

33.

Nellis

(2021). No end in sight: America’s enduring reliance on life imprisonment. The Sentencing Project. https://www.sentencingproject.org/publications/no-end-in-sight-americas-enduring-reliance-on-life-imprisonment/

34.

Noonan

(2015). Mortality in local jails and state prisons, 2000-2013 (NCJ 248756) [Statistical tables]. U.S. Department of Justice.

35.

Prison Policy Initiative. (2021). The most significant criminal justice policy changes from the COVID-19 pandemic. https://www.prisonpolicy.org/virus/virusresponse.html

36.

Puthoff

M. L.

(2008). Outcome measures in cardiopulmonary physical therapy: Short physical performance battery. Cardiopulmonary Physical Therapy Journal, 19(1), 17–22. https://doi.org/10.1097/01823246-200819010-00005

37.

R Core Team. (2020). R: A language and environment for statistical computing. R Foundation for Statistical Computing. https://www.R-project.org/

38.

The Sentencing Project. (2018). The facts of life sentences. https://www.sentencingproject.org/wp-content/uploads/2018/12/Facts-of-Life.pdf

39.

Sherbourne

Stewart

(1991). The MOS social support survey. Social Science & Medicine, 32(6), 705–714. https://doi.org/10.1016/0277-9536(91)90150-B

40.

Subramanian

Shames

(2014). Sentencing and prison practices in Germany and the Netherlands: Implications for the United States (VERA Institute of Justice, October 2013). Federal Sentencing Reporter, 27(1), 33–45. https://doi.org/10.1525/fsr.2014.27.1.33

41.

Tomitaka

Kawasaki

Ide

Akutagawa

Ono

Furukawa

(2018). Stability of the distribution of patient health questionnaire-9 scores against age in the general population: Data from the national health and nutrition examination survey. Frontiers in Psychiatry, 9, Article 390. https://doi.org/fpsyt.2018.00390

42.

U.S. Department of Justice Civil Rights Division. (2020). Americans with Disabilities Act Section 504 of the Rehabilitation Act. https://www.ada.gov/accessiblecells.htm

43.

Urban Institute. (2017). A matter of time: The causes and consequences of rising time served in America’s prisons. https://apps.urban.org/features/long-prison-terms/a_matter_of_time_print_version.pdf

44.

Violent Crime Control and Law Enforcement Act of 1994, 34 U.S.C. § 10101. (1994). https://www.congress.gov/bill/103rd-congress/house-bill/3355/text

45.

Walmsley

(2018). World prison population list (12th ed.). Institute for Criminal Policy Research. https://www.prisonstudies.org/sites/default/files/resources/downloads/wppl_12.pdf

46.

Wangmo

Handtke

Bretschneider

Elger

B. S.

(2018). Improving the health of older prisoners: Nutrition and exercise in correctional institutions. Journal of Correctional Health Care, 24(4), 352–364. https://doi.org/10.1177/1078345818793121

47.

Wildeman

Wang

E. A.

(2017). Mass incarceration, public health, and widening inequality in the USA. The Lancet, 389(10077), 1464–1474. https://doi.org/10.1016/S0140-6736(17)30259-3

48.

Williams

B. A.

Lindquist

Sudore

R. L.

Strupp

N. M.

Willmott

D. J.

Walter

L. C.

(2006). Being old and doing time: Functional impairment and adverse experiences of geriatric female prisoners. Journal of the American Geriatrics Society, 54(4), 702–707. https://doi.org/10.1111/j.1532-5415.2006.00662.x

49.

Zimet

G. D.

Powell

S. S.

Farley

G. K.

Werkman

Berkoff

K. A.

(1990). Psychometric characteristics of the multidimensional scale of perceived social support. Journal of Personality Assessment, 55(3–4), 610–617. https://doi.org/10.1080/00223891.1990.9674095