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The Graying of Mass Incarceration

Prisons, ill-suited for providing health care, are facing an explosion of elderly inmates.

by

Mary Fish turned sixty-eight in September. She did not celebrate with her sons or grandchildren. No one sang her happy birthday; nobody baked her a cake. Instead, she spent that day as she has her previous seventeen birthdays—behind bars. 

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 state’s 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 settings. 

“Hallways are filled with rollators and oxygen tanks,” she says. “You’ve got nursing assistants who are also incarcerated flipping people so they don’t develop bed sores.” 

And the need for these types of units will continue to rise, in some states above the one-in-seven national average. For one study, Prost interviewed 499 people incarcerated in Kentucky. One in four had been sentenced to life without parole or sentences that exceeded a natural life span.

America’s graying prison population is not the result of a crime spree by senior citizens but rather decades of national and state laws requiring decades-long, if not life, sentences with few chances of reprieve, even for those who had completely turned their lives around. 

The “lock ’em up and throw away the key” policies of earlier years did not anticipate the challenges of caring for thousands of people who become less agile or able to navigate crowded corridors, lengthy lunch lines, and prison bunk beds—let alone the more serious medical needs that frequently accompany aging. 

This became even more apparent when COVID-19 hit the United States—with prisons quickly becoming flashpoints for the virus’s spread. (As of November 13, state and federal prisons reported 182,776 confirmed COVID cases and 1,412 deaths.) People in prison are at heightened risk of contracting—and dying from—this raging pandemic. 

Even before the arrival of COVID-19, medical care in U.S. prisons and jails has been typically inadequate, often bordering on life-threatening. It has led to dozens of lawsuits, both individual and class action. In 2010, the U.S. Supreme Court ruled that California’s prison overcrowding impeded incarcerated people’s right to medical care and thus violated the Eighth Amendment prohibition against cruel and unusual punishment. 

Still, prison health care across the nation remains deficient. 

“Prisons aren’t built to be hospitals,” Prost says. Prisoners, she notes, typically acquire serious and chronic health conditions at a younger age than people who are not incarcerated. 

That was what happened to Robert Lind, who entered New York’s prison system at age thirty-eight with no health concerns. He was given a fifty-year-to-life sentence, also known as a virtual life sentence. He remained healthy during his first three decades behind bars. 

But when Lind turned seventy, he began having stomach pain, his wife, Michelle, tells me in a phone interview. One night, while the couple was on a “trailer visit”—where family members can spend one or two days together in a trailer on prison grounds—he vomited after dinner. The following morning, he vomited again. This time, the vomiting wouldn’t stop. 

Alarmed, Michelle wanted to call for medical help. But this would have ended their visit early and Lind persuaded her to wait. Later, he collapsed and was rushed to a hospital in Albany, where he underwent surgery for H. pylori, a stomach infection that can be caused by contaminated food or water. 

While recovering in the Intensive Care Unit, Lind was shackled by his feet to the bed, a precaution that Michelle, who was allowed to visit for a brief half hour, found outrageous. “My husband couldn’t even talk, he had so many tubes down his nose and mouth,” she says.

Two years later, Lind was diagnosed with pancreatic cancer. He spent a year undergoing radiation treatment five days a week at the hospital. Again he was handcuffed and shackled during the procedure.   

When the pandemic hit, Michelle worried about her husband’s safety. The radiation and chemotherapy had weakened his immune system. His age made him vulnerable to the ravaging effects of COVID-19. New York prisons halted all visits, but staff continued to come in and out. Lind called his wife four times a week—Tuesday, Thursday, Saturday, and Sunday. Normally reluctant to run up the phone bill, he wanted to reassure her that he was still alive. 

One Tuesday in May, Lind didn’t call. At first, Michelle didn’t worry. The prison is in a rural area and it wasn’t unusual for the phones to go out. When her phone remained silent on Thursday, she called the prison and learned that her husband had been hospitalized. She was not told more. 

“I was in terror mode,” Michelle says. “I know where he is—but I don’t know if he’s alive or dead.” A full week later, she learned that he had both pneumonia and COVID-19. She called every day but often could not get through. Two weeks later, Lind was returned to the prison. He must serve at least fourteen more years, before he is eligible to be considered for parole. 

At that point, Lind, if he’s alive, will be eighty-eight.

The graying of prison populations is happening not just in the United States but around the world. 

Across Europe, an average of nearly 12 percent of prisoners are over fifty. In the United Kingdom, the number rose from 7 percent in 2002 to 16 percent in 2018. In Japan, the number of prisoners aged sixty or older soared from 7 percent in 2008 to 19 percent in 2016.

In Japan, which has the highest elderly population, per capita, in the world, almost one in five women in prison is a senior citizen. There the boom is driven not by decades of draconian sentencing but a rise in petty crimes, typically shoplifting, among elderly women, nearly half of whom live in poverty. Most are serving relatively short sentences—ranging from one to three years—but their chronic poverty drives up the recidivism rate. 

In response, Japanese prisons have hired specialized workers to help the elderly with bathing and using the toilet during the day; at night, these become the guards’ responsibilities. Legislators are also trying to stop elder crime. In 2016, Japan’s government passed a law designed to reduce recidivism among its senior citizens, adopting a plan to help them find jobs and housing.  But recidivism among the elderly remains high.

Most prison sentences in Europe are substantially shorter than those in the United States, with fewer people growing old behind bars. In Spain, for instance, less than 2 percent of prison sentences are for more than five years. In France, a 2012 tally found fewer than 500 prisoners (or 0.7 percent) were serving life sentences. And in both countries, people become eligible for parole upon reaching age seventy. Release is not automatic; inmates must successfully argue that they have earned the opportunity to spend their remaining years outside of prison.   

In New York State, the Release Aging People in Prison (RAPP) campaign has urged lawmakers to pass the Elder Parole Act, which would require prisoners fifty-five and older who have served at least fifteen years to get a pardon review.

If the act passes, Lind, who has been imprisoned for thirty-six years, would immediately become eligible for parole. Otherwise, he must wait another fourteen years. 

In prison, Lind has earned his associate and bachelor’s degrees. He has helped countless other inmates with their parole applications and other paperwork. “He’s a completely different person” than when he was arrested in 1983, Michelle says.

RAPP director Jose Saldaña got to know Lind during his own thirty-eight-year incarceration. He notes that Lind was among a small group of incarcerated men who developed the prison’s Transitional Service Program, which provides reentry-related services. 

“The most effective therapeutic programs,” Saldaña says, “were developed by and for incarcerated people. Most have languished in prisons across the state for up to three to four decades, and some even longer. They could safely return to their families and home communities.” 

“The COVID-19 pandemic is far from over and continues to create a greater sense of urgency. For the most vulnerable, death is still around the corner.’

Saldaña, who was released in 2018, has encouraged the Linds to join the fight for elder parole. And that’s what Michelle has been doing. Before the pandemic, she and other RAPP members met with state legislators in Albany to share their stories and advocate for the bill. Now she works from home, participating in virtual press conferences and media interviews.  

In Oklahoma, the law now allows people aged sixty and older who have served at least ten years or one-third of their sentence to apply for a parole hearing. But it excludes anyone convicted of violence, including Fish, whose eight-year sentence stems from a fight over a stolen baby monitor.   

California law now requires parole hearings for incarcerated persons age fifty and over who have served at least twenty years. Commissioners are supposed to consider the person’s advanced age and diminished physical condition. Prisoners who have been sentenced to death or life without parole are not eligible.

Between 2014 and 2020, only 28 percent of the 4,232 Californians granted elder parole hearings were approved.

Linda Axell, an inmate at the California Institution for Women, had served thirty years in prison by 2018, when she was sixty-four, and had already been denied parole six times. The commissioners noted that she had no prior record and acknowledged that her advanced age made it unlikely that she would commit another crime. But they still denied her release and pushed her next parole hearing off for another five years. 

“I was truly shocked, traumatized,” Axell writes me from prison, noting that she had minimal disciplinary violations and has spent three decades “attending all kinds of self-help, getting vocations, tutoring in education.” Now she holds little hope for her next hearing: “I fear denial again because the Board says I am in denial.”

Another way elderly prisoners can find release is through clemency. This can take two forms: a commutation, which shortens a prison sentence, or a pardon, which overturns a conviction. In many states, including California and New York, a governor can grant clemency to anyone convicted of a state crime. In Oklahoma, the pardon and parole board must first recommend a person for commutation before the application goes to the governor. In every state, clemency is a long shot.

In California, through June, Democratic Governor Gavin Newsom had issued forty-one pardons and sixty-five commutations, most during the pandemic. 

Even before COVID-19 struck, advocates have been pushing governors to issue clemencies to aging people in prison. But the pandemic—and its rapid spread behind bars—adds urgency to their demands.

In New York, the RAPP campaign has organized rallies, vigils, and phone campaigns demanding that the governor step up his use of clemency. “If the risk is low, let them go” is their rallying cry, reflecting that most people age out of harmful behaviors, including criminal acts. 

“For some men and women, who have already languished in prison for decades, a commutation of their sentence [or the passage of the elder parole bill] is the only hope they have of not dying in prison,” Saldaña says. 

That is where the Linds have placed their hopes. In 2016, Lind applied for commutation. He received a letter from Governor Andrew Cuomo’s office notifying him that he was a candidate for pro-bono legal assistance. That was the last he heard about his application. Cuomo has granted twenty-four commutations during his three terms in office, and just three after the pandemic hit U.S. prisons in March.  

“The COVID-19 pandemic is far from over and continues to create a greater sense of urgency,” Saldaña says. “For the most vulnerable, death is still around the corner.”

Michelle Lind lives every day with the fear that her husband will die in prison. “What does he have—five good years left?” she asked. “Let him spend that time with his children and grandchildren. Send him home.”