Volume 60, Issue 6 p. 1150-1156
Ethnogeriatrics and Special Populations

Addressing the Aging Crisis in U.S. Criminal Justice Health Care

Brie A. Williams MD

Corresponding Author

Brie A. Williams MD

Division of Geriatrics, Department of Medicine, University of California at San Francisco, San Francisco, California

San Francisco Veterans Affairs Medical Center, San Francisco, California

Address correspondence to Brie Williams, Division of Geriatrics, University of California at San Francisco, 3333 California Street, Laurel Heights, Suite 380, San Francisco, CA 94118. E-mail: [email protected]Search for more papers by this author
James S. Goodwin MD

James S. Goodwin MD

Division of Geriatric Medicine, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas

Search for more papers by this author
Jacques Baillargeon PhD

Jacques Baillargeon PhD

Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, Texas

Search for more papers by this author
Cyrus Ahalt MPP

Cyrus Ahalt MPP

Division of Geriatrics, Department of Medicine, University of California at San Francisco, San Francisco, California

Search for more papers by this author
Louise C. Walter MD

Louise C. Walter MD

Division of Geriatrics, Department of Medicine, University of California at San Francisco, San Francisco, California

San Francisco Veterans Affairs Medical Center, San Francisco, California

Search for more papers by this author
First published: 29 May 2012
Citations: 121

Abstract

The U.S. criminal justice population is aging at a significantly more rapid rate than the overall U.S. population, with the population of older adults in prison having more than tripled since 1990. This increase is at the root of a prison healthcare crisis that is spilling into communities and public healthcare systems because nearly 95% of prisoners are eventually released. The graying prison population is also straining state and local budgets. In prison, older prisoners cost approximately three times as much as younger prisoners to incarcerate, largely because of healthcare costs. In the community, older former prisoners present the least risk of recidivism yet are vulnerable to serious and costly social and medical challenges such as housing instability, poor employability, multiple chronic health conditions, and health-related mortality; however older current and former prisoners are largely ignored in the current geriatrics evidence base. Knowledge about the health, functional, and cognitive status of older prisoners is limited, with even less known about risk factors for long-term poor health outcomes during and after incarceration. This article provides an overview of aging in the criminal justice system. It then describes how geriatric models of care could be adapted to address the mounting older prisoner healthcare crisis and identifies areas where additional research is needed to explore prison-specific models of care for older adults.