Visitation and quality of life among older adults in jail

• DOI: https://doi.org/10.1108/IJPH-06-2021-0058
• Published date: 16 December 2021
• Date: 16 December 2021
• Pages: 149-164
• Subject Matter: Health & social care,Criminology & forensic psychology,Prisoner health,Sociology,Sociology of crime & law,Public policy & environmental management,Policing,Criminal justice
• Author: Stephanie Grace Prost,Meghan A. Novisky

Visitation and quality of life among

older adults in jail

Stephanie Grace Prost and Meghan A. Novisky

Abstract

Purpose –The purpose of this paper aims to examine differences in measures of and relationships

between visitation and quality of life (QOL) among older and younger jailed adults. The authors also

explored the contributionof visitation to QOL among adults in this setting. The authorsanticipated fewer

visits and lower QOL among older adults. Framed by psychosocial developmental theory, the authors

also anticipated a larger effect in the relationship betweenvisitation and QOL among older rather than

youngeradults and that visitation would contributemost readily to psychological QOL.

Design/methodology/approach –Cross-sectional data from a large US jail were used(n= 264). The

authors described thesample regarding visitation and QOL measuresamong older (45) and younger

adults (44) and examined differences in measures of and relationships between visitation and QOL

using independent sample t-tests and bivariate analyses. The authors explored the contribution of

visitation to psychological, social relationships, physical and environmental QOL among jailed adults

using hierarchicalmultiple linear regression.

Findings –Older adults had fewer familyvisits and lower physical QOL than younger adults, disparities

were moderate in effect (d range = 0.33–0.35). A significant difference also emerged betweengroups

regarding the visitationand environmental QOL relationship (z = 1.66, p<0.05). Visitationcontributed to

variationin physical and social relationshipsQOL among jailed adults (Beta range= 0.19–0.24).

Originality/value –Limited research existsamong jailed older adults and scholars haveyet to examine

the relationshipbetween visitation and QOLamong persons in these settings.

Keywords Quality of life, Older adults, Visitation, Jails, Generativity, Psychosocial development

Paper type Research paper

Introduction

More than 11 million people are incarcerated throughout the world and the US is

responsible for incarcerating more than two million alone (Walmsley, 2018). The US is

further unique in its incarceration of largenumbers of older adults. Today, one in five adults

incarcerated in US prisons –21% of the total prisonpopulation –are at least 50 years of age

(Carson, 2020). A substantial increase from decades prior, only 5% of imprisoned adults in

the US were 50years of age or older in 1993 (Carson and Sabol, 2016). Roots of this

increase are numerous but are often linked to the retributive policies of the Wars on Crime

and Drugs initiated in the 1960s and 1970s, including mandatory-minimum sentencing,

habitual offender legislation and reductions in judicial discretion (Aday, 2003). Too,

overarching demographic trends manifest behind bars and the US population is aging

rapidly; by 2060, the number of Americans 65 years of age or older is projected to more

than double (Mather et al.,2015).

The dramatic growth of the number of incarcerated older adults has been met with

increasing research surrounding their unique, health-related needs compared to older

adults in the community (Combalbert et al.,2016;Di Lorito et al., 2018;Fazel et al.,2001).

And while understanding the health-related needs of incarcerated older adults is important,

a particularly meaningful yet underexplored indicator of health and well-being is quality of

Stephanie Grace Prost is

based at Raymond A. Kent

School of Social Work,

University of Louisville,

Louisville, Kentucky, USA.

Meghan A. Novisky is

based at the Department of

Criminology, Anthropology

and Sociology, Cleveland

State University, Cleveland,

Ohio, USA.

Received 23 June 2021

Revised 13 October 2021

Accepted 12 November 2021

The authors would like to thank

the persons who were

incarcerated who were willing

to participate in this project.

Without their insights, this effort

would not have been possible.

DOI 10.1108/IJPH-06-2021-0058 VOL. 18 NO. 2 2022, pp. 149-164, ©Emerald Publishing Limited, ISSN 1744-9200 jINTERNATIONAL JOURNAL OF PRISONER HEALTH jPAGE 149

life (QOL). Additionally, while an excess of 10 million adults filters through US jails annually

(Zeng and Minton, 2021), research regarding incarcerated older adults more often relates

to prison settings. Thus, we know surprisingly little about the QOL of jailed older adults, nor

how visitation –an oft-cited measure of social support –may contribute to QOL among

these persons. Therefore,we used cross-sectional secondary data from adults incarcerated

in a large US jail (n= 264) to examine differencesin measures of and relationships between

visitation and QOL among older and younger adults and to explore the contribution of

visitation to QOL among jailed adults. We found that older jailed adults report significantly

fewer visits and lower physical QOL relative to their younger, jailed peers, that the

relationship between visitation and QOL is distinct for older and younger adults and that

visitation accounted for variation in physical and social relationshipsQOL. Before the further

detail of findings, we first synthesize what is known about health and QOL among older

jailed adults and introduce ourtheoretical framework.

Health and quality of life among older adults in jail

Broadly, persons who are incarcerated have poorer health than persons who are not

incarcerated (Massoglia and Pridemore, 2015). This includes measures of physical health

such as chronic (e.g. diabetes, hypertension and asthma) and infectious conditions (e.g.

hepatitis and tuberculosis; Binswanger et al.,2009;Maruschak et al.,2015) and mental

health problems (depressive, manic and psychotic symptoms; serious psychological

distress; Bronson and Berzofsky, 2017;James and Glaze, 2006). The etiology of this health

burden is complex and contributes to accelerated aging and expedited degradation of

biophysiological systems leading to earlier presentation and a greater number of chronic

health problems among persons who are incarcerated compared to those who have never

been incarcerated (Aday, 2003;Binswanger et al.,2009;Maschi et al.,2013;Maschi and

Morgen, 2020;Massoglia and Pridemore,2015).

Further, older adults in these spaces tend to have worse health than their younger

counterparts and when compared to community-dwelling older adults (Combalbert et al.,

2016;Di Lorito et al.,2018;Fazel et al.,2001;Maschi and Morgen, 2020). Older adults 55

years of age or older also account for 61% of deaths in custody in state prisons (Carson,

2021a) and 27% of deaths in custody in local jails (Carson,2021b). Most recently, concerns

have also been raised regarding the heightened risks of COVID-19 infection and

complications among incarcerated older adults (Prost et al., 2021).

While research addressing the health-related needs of older incarcerated adults has

expanded in recent years, we still know little of their QOL. The World Health Organization

(WHO) defines “quality of life” as an “individual’s perception of their position in life in the

context of the culture and value systems in which they live and in relation to their goals,

expectations, standards and concerns” (WHOQOL Group, 1998, p. 551). QOL is

multidimensional, holistic and subjective and is often described as encompassing several

key facets parallel to biopsychosocial ecological models including physical, psychological,

social and setting or environmental domains. Critically, health and QOL are deeply

intertwined (Karimi and Brazier, 2016) and broadly understood to relate positively to one

another (namely, as health increases, QOL increases). Thus, QOL is recognized as an

important indicator of both health and well-being in research and practice (Buiting and

Olthuis, 2020). QOL also reflects a restorative and strengths-based approach to

rehabilitation yet is rarely examinedin the criminal legal system (Muller and Bukten, 2019).

Scholars have revealed that the QOL of persons incarcerated in prison is often lower than

that of non-incarcerated, community-dwelling persons (Chung et al., 1998;Combalbert

et al., 2018;De Smet et al.,2017;Mooney et al., 2002). Further, environmental QOL often

emerges as the lowest facet of QOL among persons incarcerated in prison, including older

adults (Combalbert et al.,2019;Mooney et al., 2002;Prost et al., 2019a;Prost et al., 2019b;

Prost et al., 2021). There is also evidence that QOL is lower among women compared to

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