Healthcare Among the Elderly Prison Population

Increase in the elderly inmate population

The number of prisoners in the United States has kept surging over the years. It is estimated that the percentage of prisoners aged 55 years and above has increased by a margin of 33 % from 2000 to 2005. Within this period the prison population grew by a record 8 %. A study conducted by the southern legislative conference in the southern states inferred that the elderly prisoner population increased by an average of 145% between 1997 and 2007. Health care costs have skyrocketed because of the increase in the population of elderly people in the United States prisons.

This has been reflected in escalating state prison budgets which have increased by 10 % from 2005 to 2006. It is expected that the percentage of elderly prisoners will continue to rise. Taking good care of one prisoner in the federal prisons costs the federal authorities an average of $25 000 annually, a round figure of $33 per day for every average prisoner. Upkeep of elderly prisoners costs $100 per day. All the inmates are entitled to housing allowance from the government which has been increasing as they grow old. North Carolina prison division in 2005 had a total of 36 663 inmates out of which 3 490 were aged 50 years and above (Loeb and Steffensmeier, 2006). This was 10 percent of the whole prison population.

Taking care of older prisoners is thrice that of younger inmates. Costs of housing elderly inmates are four times that of younger inmates. Fifty-six percent of elderly inmates are normally convicts of violence or sex crimes. Sixty-two percent of these elderly inmates serve sentences of up to 10 years or longer whereas 28 % are serving life sentences and 31 percent on death row. The ethnicity of aging inmates in the Carolina prison showed that the prisoners with American and European origins were 37%, the unknown 33%, Asia Pacific Islanders 0%, others 1%, American Indians 1%, Hispanics and Latinos 1%, and African American 27%.

Cost and quality of care received in prison

A major cause of alarm in Iowa correctional institutions has been the ever-increasing health care cost. This has affected the finances of the department of corrections whose expenditure on health care has over the past years exhibited an increasing trend. Normal general practices of medical services that the inmates receive are provided for by the department of corrections.

In the year 1992, 36 inmates were suffering from hepatitis B viral infection, 124 with TB, 36 with disorders related to seizures, 18 inmates with chronic obstructive pulmonary disease, 188 prisoners with hepatitis C viral infection, 24 inmates with insulin-dependent diabetes, 138 inmates with hypertension, 23 inmates with coronary heart disease, 15 inmates undergoing prenatal care, 14 with cancer complications, 92 asthmatic inmates, 119 inmates with mental instability and other mental problems.

Health care services in the prisons are provided for by physicians and the nursing staff who are in the payroll system of the department of corrections (Loeb and Steffensmeier, 2008). There is always one full-time general physician and some other private-sector physicians. Full-time psychiatrists are 3 in number. One of them becomes the departmental medical director and also doubles up as an on-site psychiatric.

The five physician assistants of whom 2 are full-time, 2 full-time contracts, and 1 on a part-time contract provide medical practitioner services under the watchful eyes of the physician. The nurses provide intake health screening and nursing health services. They undertake 24-hour nursing coverage at prisons. Iowa medical and classification center enjoys the services of two full-time dentists. They also contract private providers. Additional health services are also provided by Clarinda and Mount Pleasant mental health institute who in turn get cost reimbursements. Optometry services are contracted by the department of corrections. In the year 1990, the department of correction spent a massive $ 3 849 318 on the health care of the prisoners. This marked a percentage increase in expenditure of 8.51 %. In 1991, DOC spent $4 474 397 which translated to a 16.24 percent increase in their health care costs expenditures.

In 1992, the department of corrections spent $ 4 734 554 on health care of the inmates which was an increase of 5.81 percent relative to the previous years. The inmate population for the subsequent years was 3843, 4049, and 4481. The percentage increase in inmate population was 15.41%, 6.14%, and 9.86%. From 1987 to 1992, there was some decline in average prison health care costs. The number of inmates grew leading to an increase in costs of medical supplies and services. In this period, there was a decline in cost per inmate which was attributed to growth in inmate population rather than the department of corrections increased efficiency.

Some of the factors that lead to an increase in prison health care costs include the increased inmate population. From 1987 to1992, the inmate population grew by 60.8 percent. Variable and fixed costs estimates by the Iowa prison system show that each inmate added to the prison population leads to an increase in health care costs by $ 992 in variable costs whereas the fixed costs are estimated at $266 000 for the prison system for the six years.

Within the six years, the national health care escalates by an average of 7.7 percent annually (Linder and Meyers, 2007). Costs related to laboratory testing skyrocketed. This is attributed to federal legislation – The 1988 Clinical Laboratory Improvement Amendment Regulations that intends to phase in over the coming years. The regulations defined and raised standards for quality controls, test calibration and validation, procedure manuals, and other areas.

Pryor Bill expected pharmaceutical manufacturers Medicaid same rebates as one given to institutional buyers. This was supposed to extend rebate benefit to more buyers hence an increase in price for previous buyers like the Iowa state for the company to maintain its profit margin. AIDS testing was done for newly admitted offenders. By that time 19 inmates were positive among which 8 had active AIDS and therefore required medication.

Per-patient AIDS costs are estimated at $19000 annually. Between the years 1987 and 1992, DOC estimated that 12 and 15 AIDS-infected inmates will be admitted in prison in 1993. AIDS scare has to lead to an increase in health care costs because of precautionary measures taken by health care providers in dealing with patients.

Why the elderly inmates should receive health care

As the population of the elderly keep on increasing annually in the federal prisons the society’s perception of the prison population is set to change. This calls for a complete overhaul in prison administration as the old inmates continue to pose unique and costly problems to the DOC. The prison authorities have to provide special diets, round-the-clock nursing care, and alter their facilities. Older inmates have unique medical and social needs. They have to access unlimited preventive health care needs.


Because of the ever-increasing costs associated with keeping elderly prisoners in correctional facilities the government of states should consider releasing those old inmates without threatening them to national security to do community service.

Reference List

Linder, J.F. & Meyers, F.J. (2007). Palliative care for prison inmates” Don’t let me die in prison”, JAMA, 298(8): 894-901.

Loeb, S.J. & Steffensmeier, D. (2006). Older male prisoners: Health status, self efficacy belief and health-promoting behaviors, Journal of correctional health care, 12(4): 269-278.

Loeb, S.J., Steffensmeier, D. & Lawrence, F. (2008). Comparing incarcerated and Community-dwelling older men’s health, West J Nurs Res, 30(2): 234-249.