Prior Incarceration May Leave a Lasting Mark on Health in Older Adults, New Study Finds
A new study published in the Journal of the American Geriatrics Society sheds light on an uncomfortable but important truth: a history of incarceration can have long-lasting effects on health, even decades later. The research, led by Dr. Louisa W. Holaday and colleagues at the Icahn School of Medicine at Mount Sinai, found that older adults who have ever been incarcerated tend to report significantly worse physical and mental health compared to their peers who have never been to jail or prison.
The study’s results highlight the persistent impact of incarceration — long after release — and raise important questions about how society supports people as they age, particularly those who have been involved in the criminal justice system at some point in their lives.
What the Study Looked At
Researchers analyzed data from 1,318 adults aged 50 and older who participated in the Family History of Incarceration Survey. This survey aims to capture how incarceration — either personally or within families — influences long-term health and social outcomes.
Among these participants, 21% had experienced incarceration at least once. This means roughly one in five older adults in the study had spent time in jail or prison at some point.
The research team wanted to know: does having a criminal record or having spent time behind bars affect your health later in life, even if the incarceration happened a long time ago?
To answer that, they adjusted their analysis for other factors that also influence health, such as age, sex, race, education, income, and marital status. In other words, they didn’t just compare everyone straight across — they tried to isolate incarceration as a unique factor influencing health.
The Numbers Tell a Stark Story
After adjusting for these differences, the researchers found that people with a history of incarceration had about 90% higher odds of rating their physical health as “fair” or “poor” compared to those who had never been incarcerated.
And perhaps even more striking: the length of time since incarceration didn’t matter. Whether someone was incarcerated a few years ago or more than a decade ago, their self-reported health outcomes were about the same. The effects didn’t seem to fade with time.
On the mental health side, the connection between prior incarceration and poorer outcomes was somewhat weaker — and much of it could be explained by economic and employment differences. Simply put, incarceration can limit job opportunities and reduce income, which in turn affects mental health.
Even after accounting for these economic effects, however, the study found that older adults who had been incarcerated still fared worse overall than their peers.
Who Was Most Affected?
The study also revealed that certain groups are disproportionately represented among formerly incarcerated older adults. Compared with those who had never been incarcerated, they were:
- More likely to be men
- More likely to be non-Hispanic Black or of another non-White race/ethnicity
- More likely to have lower income and less education
- More likely to be unmarried
- More likely to meet disability criteria
These patterns align with what we already know about incarceration in the United States — that structural inequalities and systemic racism shape who ends up in the criminal justice system in the first place.
The Bigger Picture: Mass Incarceration and Aging in America
The study places these findings within a much broader social context. Since the 1970s, the U.S. has undergone a period of mass incarceration, beginning around 1973 and continuing through today.
That means many of today’s older adults — especially those now in their 60s, 70s, and 80s — have spent much of their lives in an era where imprisonment was both common and disproportionately affected people from disadvantaged backgrounds.
Today, millions of Americans have some history of incarceration, whether a short jail stay or a long prison sentence. The public health implications of this are only now coming into sharper focus as this population ages.
The researchers emphasize that incarceration should be recognized as a significant social determinant of health — one that can shape physical and mental well-being over decades.
What This Means for Healthcare Providers
One of the key takeaways from the study is the call for healthcare providers to consider incarceration history when assessing patients’ needs.
Doctors and clinicians rarely ask patients if they’ve ever been incarcerated, but this study suggests that they should — not as a judgmental question, but as a way to better understand health risks and tailor care.
By identifying formerly incarcerated patients, clinicians could connect them to community organizations, reentry programs, and social services that help with employment, housing, and healthcare access — all of which are crucial for improving long-term health outcomes.
This kind of screening is especially important in geriatrics, where small differences in income, social connection, or past trauma can dramatically influence health and longevity.
Why Incarceration Might Harm Health
The health consequences of incarceration are complex, but researchers have identified several key mechanisms that could explain the long-term effects:
- Chronic Stress and Trauma:
Living in a prison environment is inherently stressful. Exposure to violence, lack of autonomy, and isolation can cause long-term psychological distress. Chronic stress, in turn, contributes to diseases like hypertension, diabetes, and heart disease. - Disrupted Access to Healthcare:
While incarcerated, access to quality healthcare is inconsistent. After release, people often face barriers to getting medical care, either because of lack of insurance, stigma, or bureaucratic obstacles. - Socioeconomic Barriers:
Incarceration often limits employment opportunities, housing stability, and financial security — all of which are critical to maintaining good health. - Social Isolation:
Formerly incarcerated people are more likely to experience fractured family relationships, social stigma, and loneliness, which can increase the risk of depression and worsen chronic illness management. - Exposure to Infectious Diseases:
Prisons are high-risk environments for diseases like tuberculosis, hepatitis C, and HIV, which can have long-term effects even after release.
Related Research Supports the Findings
The new study is part of a growing body of evidence linking incarceration history with poorer health outcomes later in life.
For instance, a 2023 study using data from the Health and Retirement Study found that among more than 13,000 older adults, those with incarceration histories were more likely to have geriatric syndromes, such as mobility impairment, cognitive decline, and difficulties with daily living.
Another analysis published earlier this year found that prior incarceration was associated with increased risks for lung disease, cancer, depression, and difficulty walking, even after adjusting for age and other factors.
Together, these studies highlight that the effects of incarceration linger well beyond release. The experience of being locked up — combined with the barriers that follow afterward — appears to set in motion a cascade of health disadvantages that continue into older age.
Why This Research Matters
As the U.S. population ages, understanding the long-term effects of incarceration becomes more urgent. Tens of millions of Americans have spent time behind bars, and as they enter their later years, their health needs are becoming a pressing public issue.
This study doesn’t just point to a statistical association — it calls for a societal response. Addressing the health effects of incarceration means acknowledging the long reach of the justice system into people’s lives, often long after they’ve served their sentences.
Clinicians, policymakers, and social workers all have roles to play in reducing health disparities for older adults with incarceration histories. That might mean expanding access to reentry programs, strengthening Medicaid coverage after release, or simply ensuring that doctors know a patient’s full background when providing care.
The Takeaway
The message from this research is clear: incarceration leaves a long shadow. The physical and mental health impacts don’t disappear when someone walks out of prison — they often persist for years, even decades.
Recognizing this connection is the first step toward designing fairer, more effective systems of healthcare and social support for those who have paid their debt to society but still live with its consequences.
