Planning for the 10% of Inmates Who Don’t Leave Corrections

Photo: An aging population often requires more specialized healthcare services, such as dialysis care. | Photo Credit: Dewberry Architects Inc. 

By Rosalie Howell and Brooke Martin 

As of spring 2024, 1.8 million people were incarcerated in the U.S., according to data from The Sentencing Project, an increase of 400,000 people since 2019 according to numbers from the Vera Institute for Justice. Approximately 200,000 — or just more than 10% — of those incarcerated are serving life sentences. For perspective, the U.S. makes up only 4% of the world’s population, but accounts for 40% of the world’s life-sentenced population, including 83% of persons serving life without the opportunity of parole. 

The socio-economic implications of these statistics are overwhelming and illuminate the need for accountability from stakeholders regarding the systemic changes required to address this imbalance in holistic and intentional ways. Legislators, operators and designers are critically responsible for providing spaces that accommodate the life-sentenced community in ways that restore and reinforce each individual’s dignity and humanity. 

Understanding the Problem 

To best understand the issue, it is important to examine the cycle experienced by those entering the justice system. One tool for this is the Sequential Intercept Model (SIM) developed by Policy Research Associates. SIM is a conceptual framework that identifies key points in the justice system where individuals with mental and/or substance use disorders can be diverted away from further involvement and linked to appropriate behavioral health services. It focuses on intervening at various stages to prevent or reduce criminal justice system involvement. 

The SIM helps communities identify resources and gaps in services at each intercept point and develop local strategic action plans. The SIM mapping process brings together leaders and different agencies to work together to identify strategies to divert people with mental and substance use disorders away from the justice system into treatment. A SIM mapping workshop is available through PRA’s website. Similar to models that focus on trauma-informed design, SIM seeks to change the fundamental question from “What’s wrong with you?” to “What happened to you?” This approach more comprehensively and holistically moves justice-involved individuals towards healing, rehabilitation and restoration. 

Understanding the Population 

Those serving life sentences exist at the intersection of various marginalized identities, especially with regards to race, age, gender and mental health status. One historically problematic example within the U.S. justice system: Black men serving life sentences are overrepresented by 48%, though they account for only 11% of the total male-identifying population in the U.S. Similarly, Black women serving life sentences account for 32% of incarcerated women but comprise only 13% of the entire population of women in the U.S., according to The Sentencing Project. 

Adverse childhood experiences (ACE) are also prevalent and overrepresented among incarcerated populations. A 2018 study sample of two prison populations found 58% of all inmate respondents reported four or more types of childhood trauma, compared with about 12% of the general population, according to “The Childhood to Prison Pipeline: Early Childhood Trauma as Reported by a Prison Population.” This rate rises to 64% of incarcerated individuals who identify as women, and 90% for those facing capital punishment. Another study reports that up to 90% of incarcerated women have experienced intimate partner violence (IPV) in their lifetime, compared to 25% of women in the general population. Researchers found that 50% of incarcerated women experience ongoing IPV from their outside partners, a figure that researcher say increases for incarcerated mothers. The New England Journal of Medicine notes that more than 50% of the incarcerated population have a mental health problem, substance use disorder or both. Studies show there is a correlation between the experience of childhood trauma and the incidence of violent behavior within prison facilities, decreasing safety and wellbeing. 

According to The Sentencing Project, 35% of people serving life sentences are aged 55 or older — the geriatric threshold in correctional facilities. A 2024 Virginia Department of Corrections report found that 47% of those incarcerated in Virginia over age 50 are Black. Black individuals experience higher rates of cancer diagnoses, mortality and dialysis needs with chronic conditions intensifying with age, according to the American Cancer Society. A study by the Vera Institute of Justice found that each year spent in prison cuts a person’s life expectancy by two years: “If not for incarceration, the U.S. life expectancy would be five years higher.” It’s important to note here that Virginia DOC studies have shown the risk of self-harm doubles in populations serving life sentence. 

The Centers for Disease Control and Prevention finds that the justice-involved community experiences a higher prevalence than the general population of multiple risk factors, including HIV, viral hepatitis, sexually transmitted infections, tuberculosis (TB), traumatic brain injuries and concussions. 

To learn more about why this is important, and how architects can help design solutions centered on dignity and equity, read the rest of the article in the September/October 2025 edition of Correctional News.