The Graying Mass Incarceration: Prisons, ill-suited for providing health care, are facing an explosion of elderly inmates.

• Author: Law, Victoria
• Position: Essay

In 2002, Fish received two prison sentences totaling forty-eight years for assault and burglary. After entering prison, she stopped using drugs and alcohol. She's participated in self-help groups, including Alcoholics Anonymous and Narcotics Anonymous, and various prison programs.

At age fifty-three, Fish began working in the prison's laundry room for $11 a month. For twelve hours a day, she pushed carts crammed with clothes and sheets, loading them in and out of the institutional washing machines and dryers. "I now have two herniated discs in my back," she tells me in a letter from prison. She also enrolled in college courses, earning two associates degrees, which helped her shave some time off her sentence for good behavior.

Fish, who is serving her sentence at the Mabel Bassett Correctional Center, Oklahoma's largest women's prison, says she has eight years of prison left to go. She's worried about catching COVID-19. Besides her back problems, she has high blood pressure, high cholesterol, and diabetes. Still, Fish considers herself lucky compared to other women aging around her. She does not have a terminal illness or a degenerative disease. She does not need a cane, walker, or wheelchair. But she knows her time is running out.

"I sure don't want to die in prison," Fish wrote me. It's one of her biggest fears.

In 2018, the U.S. Department of Justice reported that nearly 21 percent of the nation's prison population, or almost 300,000 people, were fifty or older. Outside prison, fifty is no longer considered elderly But incarceration, with years of bad food, little opportunity to exercise, and inadequate medical care, accelerates the physiological aging process and often shortens life expectancy.

Between 1995 and 2010, the number of prisoners aged fifty-five or older nearly quadrupled while the number of all prisoners grew by 42 percent. At this rate, one-third of the prison population will be over age fifty by 2030. This would mean that, in the next ten years alone, 490,000 prisoners will be age fifty or older, not including people in jails. Prisons will face an explosion of geriatric needs--and the skyrocketing costs that come with it.

In 2017, Oklahoma incarcerated 5,214 people over age fifty, a steep increase from eighty-five in 1980. In 2000, California locked up 4,900 people over age fifty-five; by 2010, that number had more than doubled to 13,600.

At the end of 2018, 30,336 California prisoners were over age fifty, about a quarter of the states prison population. California spends about $138,000 annually on each incarcerated person over the age of fifty-five. In 2016, 10,140 of New York's 52,344 prisoners were fifty and older.

A 2013 study found that 69 percent of U.S. prisoners ages sixty-five and over had been sentenced to life in prison. Add in the 44,311 people serving sentences of fifty years or more, or virtual life sentences, and that makes 206,268 people--or one in seven prisoners--who face dying behind bars.

Stephanie Prost, an assistant professor at the University of Louisville who has extensively researched aging in prisons, understands how decades of tough-on-crime sentencing has led to prison wings that resemble long-term-care...