title: Ageing prisoners' disease burden: is being old a better predictor than time served in prison?
abstract: BACKGROUND
  The number of older prisoners entering and ageing in prison has increased in the last few decades. Ageing prisoners pose unique challenges to the prison administration as they have differentiated social, custodial and healthcare needs than prisoners who are younger and relatively healthier.
  
  
  OBJECTIVE
  The goal of this study was to explore and compare the somatic disease burden of old and young prisoners, and to examine whether it can be explained by age group and/or time served in prison.
  
  
  METHODS
  Access to prisoner medical records was granted to extract disease and demographic information of older (>50 years) and younger (≤ 49 years) prisoners in different Swiss prisons. Predictor variables included the age group and the time spent in prison. The dependent variable was the total number of somatic diseases as reported in the medical records. RESULTS were analysed using descriptive statistics and a negative binomial model.
  
  
  RESULTS
  Data of 380 male prisoners from 13 different prisons in Switzerland reveal that the mean ages of older and younger prisoners were 58.78 and 34.26 years, respectively. On average, older prisoners have lived in prison for 5.17 years and younger prisoners for 2.49 years. The average total number of somatic diseases reported by older prisoners was 2.26 times higher than that of prisoners below 50 years of age (95% CI 1.77-2.87, p < 0.001).
  
  
  CONCLUSIONS
  This study is the first of its kind to capture national disease data of prisoners with a goal of comparing the disease burden of older and younger prisoners. Study findings indicate that older inmates suffer from more somatic diseases and that the number of diseases increases with age group. RESULTS clearly illustrate the poorer health conditions of those who are older, their higher healthcare burden, and raises questions related to the provision of healthcare for inmates growing old in prison.
authors.affiliation: Institute for Biomedical Ethics, University of Basel, Basel, Switzerland.
authors.forename: Tenzin
authors.initials: T
authors.lastname: Wangmo
authors.forename: Andrea H
authors.initials: AH
authors.lastname: Meyer
authors.forename: Wiebke
authors.initials: W
authors.lastname: Bretschneider
authors.forename: Violet
authors.initials: V
authors.lastname: Handtke
authors.forename: Reto W
authors.initials: RW
authors.lastname: Kressig
authors.forename: Bruno
authors.initials: B
authors.lastname: Gravier
authors.forename: Christophe
authors.initials: C
authors.lastname: Büla
authors.forename: Bernice S
authors.initials: BS
authors.lastname: Elger
mesh_terms: D000328:Adult; D000367:Age Factors; D017281:Cost of Illness; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D008875:Middle Aged; D015233:Models, Statistical; D011329:Prisoners / Q000706:statistics & numerical data*; D011330:Prisons / Q000706:statistics & numerical data; D013557:Switzerland; D013997:Time Factors