(Credit: Tara /TWP)
Deron McDonald other inmates at the Prince William County Adult Detention Center take a class on health management. (Tara Bahrampour /The Washington Post)

John Hoch, a graying, bespectacled 51-year-old, has struggled with homelessness, alcohol and drug addiction, depression and anxiety, and has been in and out of prison for much of his adult life.

But when he is released from the Prince William County Adult Detention Center in April, he believes things will be different, in part because of a class he just completed that teaches inmates how to manage chronic health problems.

Hoch and half a dozen other soon-to-be-released prisoners have spent the past six weeks learning how to deal with insurance companies, monitor their meal portions, read food labels, interact with health-care providers, exercise, and deal with stress.

“It’s helped me to see things differently,” Hoch said. “When I get out, I want to be positive; I don’t want to do what I did the last time I got out …’cause I’m getting up in age and I’ve never been married or had any children; I’d like to at least experience getting married once in my life, or have one or two children if it’s possible.”

This is the second time the class has been offered at the jail, which is one of seven facilities in Virginia that provide it, paid for by $200,000 a year in federal grants. It is provided through a partnership of the Virginia Department of Corrections, the Virginia Department for Aging and Rehabilitative Services, area agencies on aging and regional corrections systems, and it is open to anyone with chronic health problems.

But administrators say it is especially relevant to older inmates — who make up the fastest-growing contingent of America’s prison population. Between 2003 and 2013, the imprisonment rate for people ages 55 and older nationwide shot up by 71 percent. And between 1990 and 2013, the number of Virginia inmates 50 and older increased from 822 to 6,709.

Seventy percent of prisoners over 50 have chronic health conditions, according to Sandy Markwood, chief executive of the National Association of Area Agencies on Aging. “These are people who have led traumatic lives,” she said, adding that incarceration tends to age people more quickly.

Problems related to old age — heart conditions, diabetes, weight gain, high blood pressure and joint pain — are magnified among the prison population. But inmates often miss out on services that other older people receive.  A report published Tuesday by Markwood’s organization found that only 9 percent of social service organizations that provide support for older adults have programs for older prisoners or people being released. And while many provide chronic disease self-management education to the broader aging population in their communities, few prisoners have access to it.

“We talk about aging in place, but nobody really thinks about aging in place in prison, and the prisons aren’t really prepared for that,” Markwood said. “When somebody walks out of the door of a prison and they’re 75 years old, what are they going to do? . . . Oftentimes the correctional system doesn’t even recognize or know that there are social services out there that could serve their prison population.”

[People who possess this one thing enjoy much better health as they age]

Inmate education in chronic disease self-management is relatively new, but it is growing. Twelve states offer it, including Virginia and Maryland. Virginia began providing it in 2012, and the state has given 43 classes for 438 prisoners.

“This is an opportunity to take control over something in their lives,” said Jim Rothrock, commissioner at Virginia’s Department for Aging and Rehabilitative Services.

On Thursday, during the final class at the Prince William center, a semicircle of men in forest-green jumpsuits sat and reflected on what they’d learned.

Several said they felt more aware of the importance of self-care than they did in their youth.

“Through my drug use, I didn’t really pay attention to my health, and now I’m getting a little bit older, I want to pay attention to staying on top of my diabetes, watching what I eat, exercising a little more,” said Pete Samuel Harlan, 56. “I decided to lean on this resource that’s available to me in terms of leading a productive life.”

Deron McDonald, 54, who has been in and out of prison since he was 18 and suffers from chronic back pain, said he had learned new techniques for dealing with it, such as breathing exercises. He liked the class so much that this was his second time taking it.

“I’m really not a spring chicken, so I’m pretty concerned about my health,” he said, adding that heart attacks run in his family. “When you hit the big 5-0, you be like, ‘Okay, I’ve been in this [world] for 50 years, how many more you going to give me, God?’ ”

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