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America’s Crisis of “Death by Incarceration”

The US prison population is aging rapidly, and incarcerated seniors are not getting the care they need.

Doherty Tim, senior officer specialist, Federal Bureau of Prisons, chats with Ben Lupo, 64, from Youngstown, Ohio, at Devens federal prison in Massachusetts, on Tuesday, April 22, 2015.

Donald “Don” Snook is 73. He has been in prison for 52 years. Now incarcerated in Washington’s Stafford Creek Correctional Center, he wears compression socks and spends his days in a wheelchair, playing Sudoku on his prison-issued tablet. Snook has survived four strokes and lives with a chronic lung disease. He has an 80 percent blockage on the left side of his heart that can’t be treated, as he is too weak to recover from surgery.

In 2019, Snook was diagnosed with colon cancer, which spread to his lymph nodes. He recovered, only to be diagnosed with aggressive prostate cancer.

Washington State prisons have an Emergency Medical Placement program, which allows some seriously ill incarcerated people to complete their sentences in community-based medical institutions. But because Snook is serving a life sentence without the possibility of parole, he is not eligible. He has waited months for some medical appointments and relied on younger men in the prison to help him eat and walk when no nurses were around.

“They’re tryna kill me, I believe that,” Snook said.

America’s incarcerated population is getting older—and sicker. Unspecialized staff, low budgets, and systemic medical neglect have led to a lack of basic medical care for aging prisoners like Snook.

In prison, the health conditions that typically define someone as “elderly” begin at 55, according to studies from the National Institutes of Health—a full decade before most outside of prison begin to meet this definition. People aged 55 and over make up nearly 17 percent of the incarcerated population nationwide. In 1991, this number was just 3 percent.

“People in their 50s in prison exhibit a lot of the physical and cognitive decline characteristics that people in their 70s and 80s face in the community,” said Christian Gonzalez-Rivera, associate director of the Public Policy Program at the Roosevelt House Public Policy Institute.

Gonzalez-Rivera explained that both the stress of prison life and the conditions that led people to be imprisoned in the first place—often trauma, mental illness, or poverty—can lead to faster aging. “Because medical services are so inadequate in prison, by the time that people need care, they need a very high level of care and become a high-cost patient immediately.”

Incarcerating a young person costs up to $70,000 annually. For an older person, this can soar up to between $100,000 and $240,000, according to a 2023 elder parole brief. These costs are funded entirely by the taxpayer, and often, people do not receive the level of healthcare they require.

“If you commit a crime and the judge says you’re going to spend 20 years in prison, that is the sentence: taking away your liberties, your right to vote, to do other things,” said Marc Stern, a correctional physician in Washington State. “The sentence didn’t include losing your leg from diabetes or losing your life from poor care.”

Snook was arrested in 1975 for taking his aunt’s car without permission. He was placed in Washington State Penitentiary—Walla Walla—an infamously violent prison. Here, he says he was tortured by a fellow inmate, whom he killed in self-defense. In 1977, he killed another inmate. He was charged with first-degree aggravated murder, and is now sentenced to life without parole.

Snook found blood in his stool in early 2019. Doctors dismissed him, saying he had hemorrhoids. By the time he was finally diagnosed with colon cancer, it was Stage III.

In 2021, Washington’s Department of Corrections was investigated for delaying cancer diagnosis and treatments by the state’s Office of the Corrections Ombuds. The DOC declined to respond to a detailed list of questions from The Xylom regarding Snook’s health, explaining that HIPAA prevents them from discussing any incarcerated individual’s personal health information.

On the other side of the nation, in Pennsylvania, lives Irvin Moore. Now 79, Moore served 52 years for first-degree murder and aggravated robbery before being released in 2021.

“Medical care in prison is horrendous,” Moore said. “At best.”

“I’ve lost so many friends to Stage IV cancers of all different sorts,” he added. “How can a person get to that stage if they’re being examined and checked regularly? I think for the last six or seven years,........

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