Main Article Content
Introduction: Older men aged 50 years and over are the fastest-growing cohort in the prisons of the United States (US) and the United Kingdom (UK). This reflects wider demographic change, such as increased life expectancy, as well as harsher sentencing policies, and an increased eagerness of courts to pursue historical offenses particularly relating to sexual crimes. Research has shown that older men in prison often experience poorer physical health than younger prisoners and those with similar age in the general public. However, to date, no such study has explored the health-related needs of older men held in Northern Ireland prisons. The aim of this research was to explore the health and wellbeing needs of older men held in custody in Northern
Method: A questionnaire was completed by 83 men aged 50 years or over, who were in prison in Northern Ireland in 2016. Comparisons were made with similar community-based surveys.
Results: The data showed that on many indicators, older prisoners experience worse health than their peers living in the community.
Conclusion: These findings suggest that there is a need for appropriate healthcare planning for older men in prison which recognizes how their health may differ from other age cohorts within prison, as well as from those living outside a custodial establishment.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright of articles published in all DPG titles is retained by the author(s). The author(s) grants DPG the rights to publish the article and identify itself as the original publisher. The author grants DPG exclusive commercial rights to the article. The author grants any party the rights to use the article freely for non-commercial purposes provided that the original work is properly cited.
2 O’Hara K, Forsyth K, Senior J, et al. Social services will not touch us with a barge pole: Social care provision for older prisoners. J Forens Psychiatry Psychol. 2015;26(2):37–41. http://dx.doi.org/10.1080/14789949.2014.1000938
3 Fazel S, Hope T, O’Donnell I, et al. Health of elderly male prisoners: Worse than the general population, worse than younger prisoners. Age Ageing. 2001;30(5):403–7. http://dx.doi.org/10.1093/ageing/30.5.403
4 Kakouliss A, Le Mesurier N, Kingston P. The mental health of older prisoners. Int Psychogeriatr. 2010;22(5):693–701. http://dx.doi.org/10.1017/S1041610210000359
5 Crawley E, Sparks R. Older men in prison: Survival coping and identity. In: Liebling A, Maruna S, editors. The effects of imprisonment. Oxon: Routledge; 2006. p. 343–65.
6 Alvey J. Ageing prisoners in Ireland: Issues for probation and social work [Internet]. Irish Probat J. 2013;10(1):203–15 [cited 2022 May]. Available from: http://www.probation.ie/EN/PB/0/6B282E71A0461F078025802F003D9775/$File/IPJ2013pages203to215Abstract.pdf
7 Ferguson C, Coyle C. Health needs assessment of prisoners in Northern Ireland 2013/14. Belfast: Public Health Agency; 2014.
8 The Regulation and Quality Improvement Authority [RQIA]. Review of services for vulnerable persons detained in Northern Ireland prisons [Internet]. Belfast: RQIA; 2021 [cited 2022 May]. Available from https://www.rqia.org.uk/RQIA/files/95/955cfa4a-5199-4be7-9f1a-801e1369ce84.pdf
9 Lawrence S. Ageing in Northern Ireland prisons [Internet]. Belfast: ARK; 2021 [cited 2021 Aug 30]. Available from https://www.ark.ac.uk/ARK/sites/default/files/2021-06/policybrief17.pdf
10 Institute for Crime and Justice Policy Research. World prison brief data [Internet]. 2022 [cited 2022 May]. Available from: https://www.prisonstudies.org/map/europe
11 Northern Ireland Statistics and Research Agency [NISRA]. 2019 Mid year population estimates for Northern Ireland [Internet]. Belfast: NISRA; 2020 [cited 2021 Aug 30]. Available from: https://www.nisra.gov.uk/publications/2019-mid-year-population-estimates-northern-ireland
12 Devine P. Early E. Men’s health in numbers: Trends on the Island of Ireland [Internet]. Dublin: Men’s Health Forum in Ireland; 2020 [cited 2022 May]. Available from: https://www.mhfi.org/MensHealthInNumbers1.pdf
13 Office for National Statistics [ONS]. National life tables – Life expectancy in the UK: 2017 to 2019 [Internet]. London: ONS, 2020 [cited 2021 Aug 30]. Available from https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/lifeexpectancies/bulletins/nationallifetablesunitedkingdom/2017to2019/pdf
14 Arber S, Davidson K, Ginn J. Changing approaches to gender and later life. In: Arber A, Davidson K, Ginn J, editors. Gender and ageing: Changing roles and relationships. Maidenhead: Open University Press; 2003. p. 1–14.
15 Thompson EH, Langendoerfer KB. Older men’s blueprint for “being a man”. Men Masc. 2016;19(2):119–47. http://dx.doi.org/10.1177/1097184X15606949
16 Devine P, Montgomery L, Carter Anand J, et al. Social isolation and older men – Learning from research. Community Dev J. 2019;54(2):273–89. http://dx.doi.org/10.1093/cdj/bsx021
17 O’Donnell S, Richardson N. Intersectional approaches to equity. In: Men’s health and well-being no country for middle-aged men? An intersectional approach to explore sources of psychological distress and patterns of seeking support among middle-aged men considered “at risk” of suicide in Ireland. Int J Mens Soc Community Health. 2020;3(2):e32–45. http://dx.doi.org/10.22374/ijmsch.v3i2.32
18 Canetto SS. Suicide: Why are older men so vulnerable? Men Masc. 2017;20(1):49–70. http://dx.doi.org/10.1177/1097184X15613832
19 Herreen D, Rice S, Currier D, et al. Associations between conformity to masculine norms and depression: Age effects from a population study of Australian men. BMC Psychol. 2021;9(32):1-10. http://dx.doi.org/10.1186/s40359-021-00533-6
20 Nowotny KM, Cepeda A, James-Hawkins L, et al. Growing old behind bars: Health profiles of the older male inmate population in the United States. J Aging Health. 2016;28(6):935–56. https://doi.org.10.1177/0898264315614007
21 Lindquist CH, Lindquist CA. Health behind bars: Utilization and evaluation of medical care among jail inmates. J Community Health. 1999;24(4):285–303. http://dx.doi.org/10.1023/a:1018794305843
22 Ministry of Justice [MOJ]. Offender management statistics bulletin, England and Wales, quarterly October to December 2017 [Internet]. London: MOJ, 2018 [cited 2021 Aug 30]. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/702297/omsq-q4-2017.pdf
23 Caverley S. Older mentally ill inmates: A descriptive study. J Correct Health Care. 2006;12:262–8. http://dx.doi.org/10.1177/1078345806295546
24 Kingston P, Le Mesurier N, Yortson G, et al. Psychiatric morbidity in older prisoners: Unrecognized and undertreated. Int Psychogeriatr. 2011:23(8):1354–60. http://dx.doi.org/10.1017/S1041610211000378
25 Fazel S, Hope T, O’Donnell I, et al. Unmet treatment needs of older prisoners: A primary care survey. Age Ageing. 2004;33(4):396–8. http://dx.doi.org/10.1093/ageing/afh113
26 Hayes AJ, Burns A, Turnbull P, et al. Social and custodial needs of older adults in prison. Age Ageing. 2013;42(5):589. http://dx.doi.org/10.1093/ageing/aft066
27 Maschi T, Viola D, Sun F. The high cost of the international aging prisoner crisis: Well-being as the common denominator for action. Gerontologist. 2012;53(4):543–54. http://dx.doi.org/10.1093/geront/gns125
28 Gaston S. Vulnerable prisoners: Dementia and the impact on prisoners, staff and the correctional setting. Collegian. 2018;25(2):241–6. http://dx.doi.org/10.1016/j.colegn.2017.05.004
29 Forsyth K, Heathcote L, Senior J, et al. Dementia and mild cognitive impairment in prisoners aged over 50 years in England and Wales: A mixed-methods study. Health Serv Deliv Res. 2020;8(27):1–116. http://dx.doi.org/10.3310/hsdr08270
30 Viggiani DN. Unhealthy prisons: Exploring structural determinants of prison health (English). Social Health Illn. 2007;29(1):115–35. http://dx.doi.org/10.1111/j.1467-9566.2007.00474.x
31 Woodall J, Dixey R, South J. Control and choice in English prisons: Developing health-promoting prisons. Health Promot Int. 2013;29(3):474-82. http://dx.doi.org/10.1093/heapro/dat019
32 Ross M. Health and health promotion in prisons. London: Routledge; 2013.
33 Smith C. Healthy prisons: A contradiction in terms? Howard J Crim Just. 2000;39:339–53. http://dx.doi.org/10.1111/1468-2311.00174
34 Baybutt M, Chemlal K. Health-promoting prisons: Theory to practice. Glob Health Promot. 2016;23(1_suppl):66–74. http://dx.doi.org/10.1177/1757975915614182
35 Woodall J, Freeman C. Promoting health and well-being in prisons: An analysis of one year’s prison inspection reports, Crit Public Health. 2020;30(5):555–66. http://dx.doi.org/10.1080/09581596.2019.1612516
36 Loeb S, Steffensmeier D. Older male prisoners: Health status, self-efficacy beliefs, and health-promoting behaviours. J Correct Health Care. 2006;12:269–78. http://dx.doi.org/10.1177/1078345806296031
37 Loeb S, Steffensmeier D. Older inmates’ pursuit of good health. Res Gerontol Nurs. 2011;4(3):185–96. http://dx.doi.org/10.3928/19404921-20100730-01
38 Maschi T, Morgen K, Zgoba K, et al. Age, cumulative trauma and stressful life events, and post-traumatic stress symptoms among older adults in prison: Do subjective impressions matter? Gerontologist. 2011;51(5):675–86. http://dx.doi.org/10.1093/geront/gnr074
39 Pageau F, Cornaz CD, Gothuey I, et al. Prison unhealthy lifestyle and poor mental health of older persons – A qualitative study. Front Psychiatry. 2021;12:690291. http://dx.doi.org/10.3389/fpsyt.2021.690291
40 Baumer H, Meek R. Sporting masculinities in prison. In: Maycock M, Hunt K, editors. New perspectives on prison masculinities. London: Palgrave Macmillan; 2018. p. 197–221.
41 Meek R. A sporting chance: An independent review of sport in youth and adult prisons [Internet]. London: Ministry of Justice; 2018 [cited 2022 May]. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/733184/a-sporting-chance-an-independent-review-sport-in-justice.pdf
42 Tennant R, Hiller L, Fishwick R, et al. The Warwick-Edinburgh mental well-being scale (WEMWBS): Development and UK validation. Health Qual Life Outcomes. 2007;5(1):63. http://dx.doi.org/10.1186/1477-7525-5-63
43 Thompson EH, Pleck JH. The structure of male role norm. Am Behav Sci. 1986;29(5):531–45. http://dx.doi.org/10.1177/000276486029005003
44 Aday RH. Golden years behind bars special programs and facilities for elderly inmates. Fed Probat. 1994;58(2):47–54.
45 Surveying Prisoner Crime Reduction Survey (SPCR) [Internet]. London: Ministry of Justice; 2014 [cited 2021 Aug 30]. Available from: https://www.gov.uk/government/collections/surveying-prisoner-crime-reduction-spcr
46 Omolade S. The needs and characteristics of older prisoners [Internet]. London: Ministry of Justice; 2014 [cited 2021 Aug 30]. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/368177/needs-older-prisoners-spcr-survey.pdf
47 Health Survey Northern Ireland. Belfast: Department of Health. [cited 2021 Aug 30]. https://www.health-ni.gov.uk/topics/doh-statistics-and-research/health-survey-northern-ireland
48 Heard C. Locked in and locked down – Prison life in a pandemic. Evidence from ten countries [Internet]. London: Institute for Crime and Justice Policy Research; 2021 [cited 2022 May]. Available from: https://www.prisonstudies.org/sites/default/files/resources/downloads/locked_in_and_locked_down.pdf
48 Padfield N, Maruna S. The revolving door at the prison gate: Exploring the dramatic increase in recalls to prison. Criminol Crim Justice. 2006;6(3):329–52. http://dx.doi.org/10.1177/1748895806065534
49 Weaver B, Tata C, Munro M, et al. Failure of recall to prison: Early release, front-door and back-door sentencing and the revolving prison door in Scotland. Eur J Prob. 2012;4:85–98. http://dx.doi.org/10.1177/206622031200400108
50 McElrath K. Drug use and drug markets in the context of political conflict: The case of Northern Ireland. Addict Res Theory. 2004;12(6):577–90 http://dx.doi.org/10.1080/16066350412331323056
51 McCrystal P, Percy A, Higgins K. Exclusion and marginalisation in adolescence: The experience of school exclusion on drug use and antisocial behaviour. J Youth Stud. 2007;10(1):35–54. http://dx.doi.org/10.1080/13676260701196103
52 Department of Justice Northern Ireland [DOJNI]. The Northern Ireland prison population 2017/2018: Research and statistical bulletin 26/2018 [Internet]. Belfast: Department of Justice; 2018[cited 2022 May]. Available from: https://www.justice-ni.gov.uk/sites/default/files/publications/justice/Northern%20Ireland%20Prison%20Population%202017_18.pdf
53 Ievins A, Crewe B. “Nobody’s better than you, nobody’s worse than you”: Moral community among prisoners convicted of sexual offences. Punishm Soc. 2015;17(4):482–501. http://dx.doi.org/10.1177/1462474515603803
54 Grundy E, Holt G. The socioeconomic status of older adults: How should we measure it in studies of health inequalities? J Epidemiol Community Health. 2001;55:895–904. http://dx.doi.org/10.1136/jech.55.12.895
55 Scottish Prison Service. 14th Survey bulletin – Older prisoners in custody 2013 [Internet]. Edinburgh: Scottish Prison Service; 2014 [cited 2021 Aug 30]. Available from: https://www.sps.gov.uk/Corporate/PrisonerSurvey2013OlderPrisoners.aspx
56 Wright KN. A study of individual, environmental, and interactive effects in explaining adjustment to prison. Justice Q. 1991;8(2):217–242. http://dx.doi.org/10.1080/07418829100091011
57 Criminal Justice Inspectorate. Report on an unannounced inspection of Maghaberry Prison 11–22 May 2015 [Internet]. Belfast: Department of Justice; 2015 [cited 2022 May]. Available from https://www.justice-ni.gov.uk/sites/default/files/publications/doj/cjini-an-unannounced-inspection-of-maghaberry-prison-11-to-22-may-2015.pdf
58 Trotter C, Baidawi S. Older prisoners: Challenges for inmates and prison management. Aust N Z J Criminol. 2014;48(2):200–18. http://dx.doi.org/10.1177/0004865814530731
59 McNamara C, McNamara P. Placing the promotion of health and well-being on the Irish prison agenda – The complexity of health promotion in Irish prisons. Irish J Appl Soc Stud. 2014;4(1):48–59. http://dx.doi.org/10.21427/D7K430
60 Lalor T. Ethnic identifiers in Irish prisons: Context and recommended practice for improving data collection on travellers and minority ethnic groups in Irish prisons [Internet]. Newbridge: Travellers in Prison initiative; 2017 [cited 2022 May]. Available from https://www.ssgt.ie/wp-content/uploads/2017/11/TPI-Ethnic-Identifiers-in-Irish-Prisons-Book.pdf
61 Martynowicz A. Not so multicultural prison: Polish prisoners in a transitional prison system. Criminol Crim Justice. 2016;16(3):337–49. http://dx.doi.org/10.1177/1748895815599579
62 Gavin P. “Prison is the worst place a traveller could be”: The experiences of Irish travellers in prison in England and Wales [Internet]. Irish Prob J. 2019;16:135–52. Available from: https://www.pbni.org.uk/wp-content/uploads/2019/12/The-Experiences-of-Irish-Travellers-in-Prison-in-England-and-Wales.pdf50
63 Garrihy J, Watters A. Emotions and agency in prison research. Methodol Innov. 2020;13(2):1-14. http://dx.doi.org/10.1177/2059799120926341
64 Earle R, Phillips C. Prison ethnography at the threshold of race, reflexivity and difference. In: Drake, Deborah H, Earle R, Sloan J, editors. The Palgrave handbook of prison ethnography. Palgrave studies in prisons and penology. Basingstoke: Palgrave Macmillan; 2015. p. 230–51.
65 Williams J. Social care and older prisoners. Br J Soc Work. 2013;13(5):471–91. http://dx.doi.org/10.1177/1468017311434886
66 House of Commons. Health and social care committee. Prison health: Twelve report of session 2017–19 [Internet]. London: House of Commons; 2018 [cited 2021 Aug 30]. Available from: https://publications.parliament.uk/pa/cm201719/cmselect/cmhealth/963/963.pdf