America’s Crisis of “Death by Incarceration”

Donald “Don” Snook, 73, has spent more than half his life behind bars, enduring a series of severe health issues while serving a life sentence without the possibility of parole. Currently incarcerated at Washington’s Stafford Creek Correctional Center, Snook suffers from multiple strokes, chronic lung disease, and an 80% blockage on the left side of his heart, which cannot be surgically corrected due to his weakened condition. His health deteriorated further after being diagnosed with colon cancer in 2019, followed by aggressive prostate cancer. Despite these challenges, Snook continues to rely on the assistance of younger inmates to perform daily tasks such as eating and walking when medical staff are unavailable. Snook's case highlights a growing crisis within the U.S. prison system, where the incarcerated population is aging rapidly and facing severe medical neglect. According to recent data, individuals aged 55 and over constitute nearly 17% of the incarcerated population, compared to just 3% in 1991. This demographic shift is attributed to longer sentences, reduced parole opportunities, and the increasing number of elderly individuals who were incarcerated decades ago and remain in custody today. Christian Gonzalez-Rivera, associate director of the Public Policy Program at the Roosevelt House Public Policy Institute, notes that people in their 50s in prison often exhibit physical and cognitive decline similar to those in their 70s and 80s in the general population. Factors contributing to this accelerated aging include the stress of incarceration, pre-existing conditions such as trauma, mental illness, and poverty, and the lack of adequate medical care within prisons. Medical care in prisons is often insufficient, leading to delayed diagnoses and treatment. Washington State prisons have an Emergency Medical Placement program allowing seriously ill inmates to serve their sentences in community-based medical facilities. However, Snook is ineligible for this program due to his life sentence without parole. As a result, he has faced long waits for medical appointments and has had to depend on younger inmates for basic assistance. The financial burden of incarcerating elderly individuals is substantial. According to a 2023 elder parole brief, the annual cost of incarcerating a young person can reach up to $70,000, while the cost for an older individual can range from $100,000 to $240,000. These expenses are fully covered by taxpayers, yet many elderly inmates do not receive the necessary healthcare. Marc Stern, a correctional physician in Washington State, emphasizes that the consequences of poor medical care in prisons can be severe. “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,” Stern said. “The sentence didn’t include losing your leg from diabetes or losing your life from poor care.” Snook's journey through the justice system began in 1975 when he was arrested for taking his aunt’s car without permission. Placed in the Washington State Penitentiary in Walla Walla, a notorious facility known for its harsh conditions, Snook claims he was subjected to torture by a fellow inmate, whom he eventually killed in self-defense. In 1977, he was charged with first-degree aggravated murder and received a life sentence without the possibility of parole. Snook's health concerns date back to early 2019 when he noticed blood in his stool. Initially dismissed by doctors as hemorrhoids, his condition worsened until he was finally diagnosed with colon cancer. By the time he received proper treatment, the cancer had already spread to his lymph nodes. His subsequent diagnosis of aggressive prostate cancer added further complications to his already dire health situation. The plight of elderly inmates like Snook underscores the urgent need for reform in the U.S. prison system. With the aging incarcerated population facing inadequate medical care, rising costs, and systemic neglect, the issue of “death by incarceration” continues to gain attention among advocates and policymakers. The challenge lies in balancing the need for public safety with the ethical obligation to provide humane treatment and appropriate medical care to all individuals, regardless of their age or criminal history.