New evidence highlights the lasting health impact of incarceration on older adults
A recent analysis published in the Journal of the American Geriatrics Society reveals that older adults with a history of incarceration report worse physical and mental health than their peers, even when their time behind bars occurred many years ago. The study examined responses from 1,318 US adults aged 50 and older who participated in the Family History of Incarceration Survey and found that 21% had been incarcerated at some point in their lives.
Who is affected, and what does the data show?
Formerly incarcerated older adults tended to differ from those who had never been incarcerated in several ways. They were more likely to be men, identify as non-Hispanic Black or “other” race/ethnicity, be unmarried, and have lower income and education levels. These factors are important because they help explain why health disparities exist and how social determinants intersect with the experience of incarceration.
Physical health associations remain strong over time
After adjusting for a range of potential confounders—including demographic and socioeconomic factors—the researchers found that prior incarceration was associated with about 90% higher odds of reporting “fair” or “poor” physical health. Importantly, the length of time since release did not moderate this association. In other words, individuals incarcerated more than a decade ago exhibited similarly elevated risks of poorer self-rated physical health as those more recently released.
Mental health and the role of income and employment
The link between incarceration history and mental health was more nuanced. The study suggested that income and employment partly explained the mental health association, underscoring how economic stability and job access influence mental well-being. The findings imply that addressing financial security and employment opportunities could help mitigate some mental health challenges faced by aging adults with incarceration histories.
Implications for healthcare providers
Experts suggest that clinicians consider incorporating incarceration history screening into routine assessments for patients aged 50 and older. Recognizing a patient’s incarceration background could illuminate risk factors for poorer health and guide referrals to targeted services and community organizations that specifically serve this population. Such screening can be a critical first step toward holistic care that addresses medical needs alongside social and economic barriers.
Why this matters in the context of mass incarceration
Mass incarceration began in 1973, meaning a large share of today’s older adults spent substantial portions of their adult lives within the corrections system or its aftermath. The findings highlight the enduring health consequences of this era’s policy environment, even for those whose incarceration occurred long ago. Understanding these effects is essential to improving health outcomes and reducing disparities among aging populations.
What can be done?
Community health systems and clinicians can take several concrete steps to support formerly incarcerated patients:
– Implement routine screenings for incarceration history in primary care and geriatrics settings.
– Build connections with organizations that provide medical, housing, employment, and social support tailored to formerly incarcerated individuals.
– Address social determinants of health by connecting patients to ride services, housing assistance, and food security programs as needed.
– Offer mental health services with attention to trauma, stigma, and the unique stressors faced by this population.
– Advocate for policies that expand access to affordable healthcare and employment opportunities for people with incarceration histories.
Conclusion
The study underscores a critical public health insight: incarceration history matters for the health of older adults, long after release. By screening for prior incarceration and connecting patients to appropriate services, clinicians can help mitigate health disparities and support healthier aging for a generation shaped by the era of mass incarceration.
Source: Holaday LW, et al. Journal of the American Geriatrics Society
