The prison population is aging. The number of people in prison who are 55 years and older grew by 280% from 1999 to 2016, compared with just 3% for the population younger than 55 years.1 In 2020, nearly one-third of people with life sentences were older than 55 years of age.2 The aging of the population in prison (long-term correctional facilities, eg, for individuals with sentences of >1 year, vs short-term facilities such as jails) has been mostly attributed to the large population first imprisoned in the 1970s and 1980s as the rate of incarceration of the US population more than quadrupled between 1970 and 2009.3 Causes of increased incarceration during this era included more punitive sentencing (eg, mandatory minimum sentences and 3-strikes laws) and intensified policing and enforcement of drug laws.3

Providing care to an aging population in prison poses significant challenges to the criminal legal system. It is twice as expensive to imprison older (vs younger) individuals,4-6 and the built environment and available resources are often misaligned with needs resulting from age-related disability such as cognitive impairment, functional limitations, or hearing loss.5,7,8 The vulnerability of this population and the challenges of providing care in prisons were evident during the COVID-19 pandemic, during which rates of deaths in prisons surpassed deaths in nursing homes and rates of compassionate release from federal prisons increased, particularly for older adults.9,10

Data on the demographic characteristics and health status of people who are in prison are sparse.6 The primary source of this information comes from the Survey of Prison Inmates, conducted by the Bureau of Justice Statistics. The survey is conducted at irregular intervals (most recently, 2016), and questions about health status are heavily slanted toward substance use and mental health.11 Consequently, studies of disability to date have primarily relied on qualitative methods or primary data collection at individual facilities with limited generalizability and small samples.6,12 Collectively, the absence of longitudinal data on the health status of older adults in prison is a barrier to identifying and addressing the evolving care needs of this vulnerable population.

The aim of this study was to use nationally representative longitudinal data and methods to strengthen our understanding of the prevalence of disability among older adults in prisons over time, both prior to and during the COVID-19 pandemic, with foundational information for evidence-based planning and policy.3,5 We developed an algorithm that draws on publicly available data to identify a population of older adults likely in prison. Then, we described the prevalence of disability among older adults in prison, in contrast with community-dwelling peers. Finally, we examined changes in prevalence of disability of the likely population in prison prior to and during the COVID-19 pandemic. Understanding these changes is critical to interventions and policies addressing this population.

Miller, K. E., Shen, K., Yang, Y., Williams, B. A., & Wolff, J. L. (2024). Prevalence of Disability Among Older Adults in Prison. JAMA Network Open, 7(12), e2452334-e2452334.