In state after state, prison systems have long been plagued by inadequate health care, resulting in the spread of treatable diseases and, in many cases, preventable deaths behind bars. A key demographic trend threatens to make that problem even worse: Over the last several decades, the prison population has been rapidly aging, and prisoners’ health needs have become more significant, Vox reports. People 55 years older made up 3 percent of the prison population in 1991; by 2021, they accounted for 15 percent. The number of older prisoners is steadily growing, with no signs of abatement: In 2020, there were about 166,000 incarcerated people aged 55 years or older; that number grew to about 178,000 in 2021 and 186,000 in 2022.
The graying of the incarcerated population is effectively turning the prison system into a de facto nursing home, leaving hundreds of thousands of older people in its care each year. The result is skyrocketing costs: The Bureau of Prisons’ health care spending on federal inmates rose from $978 million in 2009 to $1.34 billion in 2016, and various states have seen similar increases. Still, conditions in prisons continue to be detrimental to people’s health and often lead to accelerated aging. Prisoners are much more likely to exhibit signs of cognitive decline, including dementia, at an earlier age than the general population, and one study found that a 59-year-old in prison has the same morbidity rate -- how often people get a disease-- as a nonincarcerated 75-year-old. “We have facilities that aren't considered humane,” said Lauren-Brooke Eisen of the Brennan Center for Justice. “They’re not places for elderly people who have dementia and diabetes and maybe walkers or wheelchairs.”