The ageing prisoner population: demographic shifts in Australia and implications for the economic and social costs of health care

• DOI: https://doi.org/10.1108/IJPH-09-2020-0062
• Published date: 23 September 2021
• Date: 23 September 2021
• Pages: 325-334
• Subject Matter: Health & social care,Criminology & forensic psychology,Prisoner health,Sociology,Sociology of crime & law,Public policy & environmental management,Policing,Criminal justice
• Author: Natasha Ann Ginnivan,Rafal Chomik,Ye In (Jane) Hwang,John Piggott,Tony Butler,Adrienne Withall

The ageing prisoner population:

demographic shifts in Australia and

implications for the economic and social

costs of health care

Natasha Ann Ginnivan, Rafal Chomik, Ye In (Jane) Hwang, John Piggott, Tony Butler and

Adrienne Withall

Abstract

Purpose –The Australian prisoner population has experienced a dramatic increase in the number of

older inmates over the past decade,consistent with the greying of the prisoner populationthat is being

observed worldwide. Reviews suggest the need for further evidence and practice outside of the USA.

This paper aims to review and discussthe cost and social implications of the rising health-care needs of

this populationin Australia.

Design/methodology/approach –A review of internationalresearch and policies is presented, as well

as the resultsof basic economic modelling relating to the expectedrise in health-care costs of the ageing

prisonerpopulation in Australia.

Findings –Taking into considerationthe continued rise in incarcerationrates, the calculations showthat

the health costs of prisonerscould increase by anywhere between 17% and 90% depending on whether

the increase of older prisonerscontinues as it has in the past decade. These trends are likelyto continue

over the next decade and will result in higher health costs of prisons under a number of different

imprisonment scenarios.Policy responses in Australia have been slow so far,with most initiatives being

undertakenin the USA with promising results.

Practical implications –The authors suggest that in the absence of a coordinated policy response,

covering a rangeof interventions, costs will continue to increase,particularly as this population continues

to age more rapidly than the general population due to an accumulation of risk factors.Well-conceived

interventionswould be a worthwhile investmentfrom both financial and social perspectives.

Originality/value –To the best of the authors’ knowledge, this is the first commentary to acknowledge

this risingpublic health issue and to both review and model its implicationsfor the future.

Keywords Health in prison, Prisoners, Public health, Health policy, Elderly prisoners, Equivalence

Paper type Viewpoint

Introduction

Around the world, and especially in Anglophone countries with substantial prisoner populations

such as Australia, the UK and the USA, the prisoner population is ageing more rapidly than the

general population (Carson and Sabol, 2016;Ginnivan et al., 2018;House of Commons Justice

Committee, 2020). This is presenting special challenges to authorities charged with

administering prisons and to society more generally, as the ageing profile of released prisoners

reshapes post-release support requirements. Three sets of challenges can be identified. Firstly,

the infrastructure of the prison environment will need to adjust to cope with a burgeoning cohort

of older prisoners. Secondly, health costs, which are on average higher for a prisoner of any

given age than for the general population, will climb disproportionately with prisoner ageing, with

Natasha Ann Ginnivan is

based at the School of

Psychology, University of

New South Wales, Sydney,

Australia. Rafal Chomik is

based at the Centre of

Excellence in Population

Ageing Research,

University of New South

Wales, Sydney, Australia.

Ye In (Jane) Hwang is

based at the School of

Population Health,

University of New South

Wales, Sydney, Australia.

John Piggott is based at the

Centre of Excellence in

Population Ageing

Research, University of

New South Wales, Sydney,

Australia. Tony Butler and

Adrienne Withall are both

based at the School of

Population Health,

University of New South

Wales, Sydney, Australia.

Received 3 September 2020

Revised 27 August 2021

3 September 2021

Accepted 6 September 2021

The authors would like to

acknowledge the support of the

Australian Research Council

Centre of Excellence in

Population Ageing Research

(CEPAR; CE170100005).

DOI 10.1108/IJPH-09-2020-0062 VOL. 18 NO. 4 2022, pp. 325-334, ©Emerald Publishing Limited, ISSN 1744-9200 jINTERNATIONAL JOURNAL OF PRISONER HEALTH jPAGE 325