The United States has one of the largest prison populations on earth.

According to the Bureau of Justice Statistics, there were about 2.3 million people incarcerated, including 1.4 million in state prisons, 200,000 in federal prison, and 700,000 in other jails, at the end of 2010.

One little known fact about the mass incarceration of men and women is the rapidly rising subset of elderly inmates -- a phenomenon that has been partially caused by stiffer sentencing guidelines, and which will also increase health care costs upon an overloaded correctional system.

According to Human Rights Watch (HRW), the number of state and federal prisoners age 65 or above soared at a rate 94 times the rate of the broader prison population between 2007 and 2010.

“Among the reasons for the increase are long (including life) sentences that reflect ‘tough-on-crime’ policies,” HRW stated.
“Many older prisoners remain incarcerated even though they are too old and infirm to threaten public safety if released.”

There are now more than 26,000 prisoners above age 65. There are more than 124,000 prisoners age 55 or older.

HRW warned that unless sentencing and release policies change, U.S. prisons “will increasingly resemble old age homes behind bars,” adding that due to their higher rates of illness and impairments, “older prisoners incur medical costs that are three to nine times as high as those for younger prisoners.”

Jamie Fellner, senior adviser to the U.S. Program at HRW and author of the report, stated: “Prisons were never designed to be geriatric facilities. Yet U.S. corrections officials now operate old age homes behind bars.”

HRW discovered that 9.6 percent of prisoners (almost one in ten) are now serving life sentences, which means a large number of very old inmates. Another 11.2 percent have sentences in excess of 20 years -- thus, one-fifth of prisoners will leave prison (or die) when they are elderly.

The associated health care costs are staggering.

HRW found that in Florida (a state with one of the largest inmate populations) the 16 percent of the prison population age 50 or over accounted for 40.1 percent of all episodes of medical care and 47.9 percent of all hospital days.

In Georgia, prisoners aged 65 or older had an average yearly medical cost of $8,565, compared with the average of $961 for those under 65.

In Michigan, the average annual health care cost for a prisoner is estimated at $5,801; and this cost increases with their age, from $11,000 for those aged 55-59 to $40,000 for those aged 80 or older.

The New York Times reported that the state of California, which has the nation's largest prison system, the percentage of inmates above the age of 50 increased to 17 percent in 2010, from just 4 percent in 1990.

“We have an awful lot of people who are probably going to die in prison,” said Nancy J. Kincaid, spokeswoman for the state’s Correctional Health Care Services, according to the Times.
“There are people with 40-year sentences, 30-year sentences. We have to figure out how to care for these people.”

The U.S. prison infrastructure is simply not able to cope with a dramatically higher population of elderly inmates.

“[Prison authorities] are constrained, however, by straitened budgets, prison architecture not designed for common age-related disabilities, limited medical facilities and staff, lack of planning, lack of support from elected officials, and the press of day-to-day operations,” HRW cautioned.

“While serving time in prison can be hard for anyone, it is particularly challenging for the growing number of older prisoners who are frail, have mobility, hearing, and vision impairments, and are suffering chronic, disabling, and terminal illnesses or diminishing cognitive capacities.”

Indeed, while aging is difficult in regular society, behind prison walls, the elderly face a multitude of challenges and extreme hardships.

“Walking a long distance to the dining hall, climbing up to a top bunk, or standing for count can be virtually impossible for some older prisoners,” HRW noted.

“Incontinence and dementia impose their own burdens.”

Fellner added: “Prison staff who work with the elderly know it makes no sense to yell at a prisoner who doesn’t understand what they are saying. As one sergeant told me, staff have to give older prisoners ‘a little more leeway’ when it comes to enforcing the rules.”

HRW recommends a shift in policy with respect to old people stuck in prison.

“How are justice and public safety served by the continued incarceration of men and women whose bodies and minds have been whittled away by age?” Fellner asked.

Fellner concluded to the Times: “Age should not be a get-out-of-jail-free card, but when prisoners are so old and infirm that they are not a threat to public safety, they should be released under supervision. Failing that, legislatures are going to have to pony up a lot more money to pay for proper care for them behind bars.”