Newly Released Prisoners At High Risk Of Death

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Main Category: Public Health
Also Included In: Rehabilitation / Physical Therapy;  Psychology / Psychiatry
Article Date: 11 Jan 2007 - 5:00 PST

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Inmates from Washington state prisons in the US are 13 times more likely to die within the first two weeks of their release than other people of similar age, sex and race. The most likely cause of death at this vulnerable period of a former inmate's life is drug overdose, followed by suicide, heart disease, and homicide.

This research is published in the latest edition of the New England Journal of Medicine.

The study was led by Dr. Ingrid Binswanger of the Department of Medicine, Division of General Internal Medicine, University of Colorado at Denver, and the team included Dr. Marc Stern of the Washington State Department of Corrections, and other scientists from Seattle.

The scientists conducted a retrospective cohort study on 30,237 former inmates who left prison in the period July 1999 to December 2003. They used data from prison records and linked it to the National Death Index. They compared the figures with those on Washington State residents, using data from the large epidemiological databases at the Centers for Disease Control and Prevention.

The results showed that 443 of the former inmates had died during a mean follow-up period of 1.9 years after release, equivalent to an overall mortality rate of 777 deaths per 100,000 person-years. This yielded an adjusted risk of death of 3.5 times higher than that of state residents of similar age, race and sex. This risk rose to 12.7 times for the first 2 weeks of release, with drug overdose being markedly significant as the main risk of death during this period.

The researchers suggest that the reasons for the high death rates could be linked with an existing mental illness coupled with the stress of adapting to a life in society ("re-entry stress").

Dr. Binswanger says that if these results are replicated in other states, the implications would be "staggering". She suggests this may well point to a need for boosting support for former inmates while they adapt to life outside prison, for example by increasing availability of half-way houses and drug rehabilitation.

The study was prompted by a concern for the large and growing number of former prisoners in the US population and the recognition that the period following release may present them with substantial health risks.

According to the Commission on Safety and Abuse in America's Prisons (CSAAP), on any given day there are 2.2 million people in prison in the US (about 1 in 140 of the population), at an annual cost of 60 billion dollars a year.

"Release from Prison - A High Risk of Death for Former Inmates."
Ingrid A. Binswanger, M.D., Marc F. Stern, M.D., Richard A. Deyo, M.D., Patrick J. Heagerty, Ph.D., Allen Cheadle, Ph.D., Joann G. Elmore, M.D., and Thomas D. Koepsell, M.D.
NEJM Volume 356:157-165, January 11, 2007, Number 2

Commission on Safety and Abuse in America's Prisons

Written by: Catharine Paddock
Writer: Medical News Today
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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