Division of Geriatrics, Department of Medicine, University of California at San Francisco, San Francisco, California 94118, USA.
J Am Geriatr Soc. 2012 Jun;60(6):1150-6. doi: 10.1111/j.1532-5415.2012.03962.x. Epub 2012 May 29.
The U.S. criminal justice population is aging at a significantly more rapid rate than the overall U.S. population, with the population of older adults in prison having more than tripled since 1990. This increase is at the root of a prison healthcare crisis that is spilling into communities and public healthcare systems because nearly 95% of prisoners are eventually released. The graying prison population is also straining state and local budgets. In prison, older prisoners cost approximately three times as much as younger prisoners to incarcerate, largely because of healthcare costs. In the community, older former prisoners present the least risk of recidivism yet are vulnerable to serious and costly social and medical challenges such as housing instability, poor employability, multiple chronic health conditions, and health-related mortality; however older current and former prisoners are largely ignored in the current geriatrics evidence base. Knowledge about the health, functional, and cognitive status of older prisoners is limited, with even less known about risk factors for long-term poor health outcomes during and after incarceration. This article provides an overview of aging in the criminal justice system. It then describes how geriatric models of care could be adapted to address the mounting older prisoner healthcare crisis and identifies areas where additional research is needed to explore prison-specific models of care for older adults.
美国刑事司法人口的老龄化速度明显快于美国总人口，自 1990 年以来，监狱中老年人的数量增加了两倍多。这种增长是监狱医疗保健危机的根源，该危机正在蔓延到社区和公共医疗保健系统，因为近 95%的囚犯最终会被释放。不断老龄化的囚犯群体也给州和地方预算带来了压力。在监狱中，关押老年囚犯的成本大约是年轻囚犯的三倍，这主要是由于医疗保健费用。在社区中，以前的老年囚犯再次犯罪的风险最低，但他们容易受到严重和昂贵的社会和医疗挑战的影响，如住房不稳定、就业能力差、多种慢性健康状况和与健康相关的死亡率；然而，在当前的老年医学证据基础中，老年现犯和前犯在很大程度上被忽视了。关于老年囚犯的健康、功能和认知状况的知识有限，甚至对在监禁期间和监禁后长期健康状况不佳的风险因素知之甚少。本文概述了刑事司法系统中的老龄化问题。然后，它描述了如何调整老年护理模式来应对日益严重的老年囚犯医疗保健危机，并确定了需要进一步研究的领域，以探索针对老年人的特定监狱护理模式。
