Prisons were never meant to be nursing homes; and yet, increasingly, they are asked to perform this function. They do so ineffectively, at a great cost to community’s health, finances, safety, and undermine the criminal justice system’s ideals of rehabilitating and reintegrating people into society.
Currently, 25% of individuals incarcerated in federal prisons are over the age of 50 and this number is growing at an alarming speed. Incarcerated individuals have higher rates of mortality and morbidity across health care conditions, go through a process of accelerated aging (i.e. have the health problems of someone 10-15 years older then them in the community), and have a life expectancy of around 62. An increase in the number of those aging in prisons exacerbates the already high rates of mental and physical disabilities, chronic and acute conditions. It also brings about new challenges such as high rates of co-morbidities, as well as illnesses and symptoms commonly associated with aging – such as dementia, which has now reached a rate of 5% in older prisoners.
My recently published book, Punished for Aging: Vulnerability, Rights and Access to Justice in Canadian Penitentiaries, contextualizes the significant failures of prisons to meet the exacerbated needs of older prisoners on the background of the systemic issues rampant in Canadian corrections and of the general disengagement of the public, courts, and government with such issues:
“The data from 197 interviews with older prisoners not only reaffirmed long-standing issues, but also put a new spin and sense of urgency on the need to address them. Aging is linked to a significant increase in the number of chronic and acute medical conditions, terminal illnesses and death, mental decline, and loss of family support. Aging is also associated with a decline in the risk of misbehaviour in prison and of re-offending once released. Coupled with the inability o the system to address the medical and social needs of older individuals, the risk decline calls into question the need for continued incarceration and points to an enhanced obligation to prioritize release appropriate planning for release, and community support. Furthermore, when individuals do not receive the care they need and continue to languish in prisons under conditions that contribute to their physical and mental decline, the access to legal recourse is key, not only for their own well being but also for the well being and validity of out system of rights […]
As a society faced with a growing problem, we need to adapt and make changes. When these changes do not come naturally, we need to involve the government, parliament, and the courts in a conversation. When this conversation fails to happen, we must bring the matter to courts, as the strongest protectors of our rights and the last resort mechanism that can force change. If courts fails to get involved in a substantive manner, a void is created. Like a domino effect, lack of access top courts leads to ineffective prison oversight, which leads to lack of reforms, which leads to lack of accommodation, which leads to denial of rights, which leads to pain and suffering, which leads to broken individuals, which leads to longer prison terms, which leads to greater demands on taxpayers money, less healthy and stable released individuals, and a big dent in our humanity, our democracy, and our inclusive society.”
Prison issues are everyone’s issues. Failing to address health issues of already marginalized individuals, and indeed exacerbating them, is a significant public health risk that affects the health and resources of our community. Failing to adequately care for people means they will not be successfully rehabilitated and reintegrated with potentially negative impacts to the safety of their new community. Investing in ineffective institutions like prisons diverts public funds from community programs like health care, social welfare, childcare, and drug treatments that are more effective in preventing crime. Finally, turning a blind eye to prisoners’ inhumane treatment and rights violations, diminishes all of our rights. Change is slow to come for incarcerated people and so far, change has not come from courts or government. Instead, change has come from public pressure and from people understanding why prison issues are essential for a functioning community.
Punished for Aging can be found here:
Iftene A., Incarceration in Canada: Risks to and Opportunities for Public Health, in Tracey Bailey, Tess Sheldon, and Jacob Shelley, Public Health Law and Policy in Canada, 4th ed (Toronto: LexisNexis).
Iftene A. and Downie J. “End-of Life Care for Federally Incarcerated Individuals in Canada,” McGill Law and Health Journal (forthcoming 2020).
Iftene A. “Unlocking the Doors to Canadian Older Inmate Mental Health Data: Rates and Potential Legal Responses,” (2016) 47 International Journal of Law and Psychiatry 36.
Correctional Investigator of Canada and the Chief Commissioner of the Canadian Human Rights Commission, Call on Federal Government to Respect the Dignity of Older Persons in Federal Custody,2019, Online: https://www.oci-bec.gc.ca/cnt/rpt/oth-aut/oth-aut20190228-eng.aspx.
Fiona Kouyoumdjian et al., “Health Status of Prisoners” (2016) 62 Can. Fam. Physician 215