Ageing prison population means new health concerns

Morgan Liotta

14/07/2020 3:31:52 PM

Nearly one in four people in Australian prisons are aged 45 and over. How do their healthcare needs differ?

Picture of a prison block corridor
A new report presents the social, economic and lifestyle factors that can impact older people’s health in prison. (Image: AAP)

Australia’s prison population is ageing rapidly, which means the health burden for these people is likely to shift.
According to a new Australian Institute of Health and Welfare (AIHW) report, the ageing of Australia’s incarcerated people is due to a number of reasons.

People are living longer, but changes have also been made to sentencing options, while there is an increase in the number of older men in custody due to more prosecution of historical offences, such as for child sexual abuse.
The report on health in prison shows the number of people aged 45 and over has risen 79% from 5300 to 9600 since 2009, while the growth rate of younger people in prison was slower at 24,000 to 33,500 (40%).
As a result, the proportion of people aged 45 and over has increased from 18% to 22% of the total prison population over the same period.
People in prison aged 65 and over increased 143%, from 505 to 1225, while the prison population aged 60–64 showed the smallest increase, from ­519 in 2009 to 810 in 2018 (56%).
These increases are against a backdrop of overall prison population growth of 47% over a 10-year period.
The findings are cause for concern, as the AIHW found people in prison experience age-related health conditions earlier than those in the community due to social and lifestyle characteristics both before and during incarceration.
Older people in prison are 1.7 times more likely (46%) than younger people (28%) to report having ever been diagnosed with a chronic condition – cardiovascular disease, diabetes, asthma, arthritis or cancer. 

  • Cardiovascular disease – 19% of older people have ever been diagnosed, compared to 5% of younger people
  • Diabetes – 15% of older people have ever been diagnosed, compared to 5% of younger people
  • Arthritis ­– 20% of older people have ever been diagnosed, compared to 5% of younger people
Data for the report was drawn from the 2018 National Prisoner Health Data Collection (NPHDC), which focuses on how healthcare needs differ for younger and older people in prison. Older people entering and already in prison are defined as those aged 45 and over, with younger counterparts making up those aged 18­–44.
Other findings show that although older people are less likely (43%) than their younger counterparts (70%) to have used illicit substances in the 12 months before entering prison, they are 1.6 times more likely to self-report consuming alcohol four or more times per week.
Older people entering prison were also 1.8 times (36%) more likely than younger people (20%) to report not smoking tobacco – 19% of older entrants never smoked, compared to 12% of younger entrants, while 17% of older and 8% of younger entrants were ex-smokers.
In-house prison clinics were found to be used more frequently by older people, with most visits for medication or vaccination, pathology and chronic condition management.
Around two in five older people in prison received blood pressure medications, compared to one in 10 younger people.

These clinics dispense less antidepressants or mood stabilisers to older people (36%) compared to younger people (46%).
The AIHW report also notes accelerated ageing occurs to a greater extent among people in prison because they are more likely to live in poverty, achieve a lower standard of education, and experience housing instability and lack of employment.
The four main types of sentences served by older people in prison are: 
  • people who are incarcerated for the first-time at an older age
  • ageing people who enter and exit prison multiple times during their lifetime and return to prison at an older age
  • people who are serving a long sentence and grow old while incarcerated
  • people who are sentenced to shorter periods of incarceration later in life.
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