Release from Prison-A High Risk of Death for Former Inmates

Puget Sound Veterans Affairs Medical Center, Seattle, USA.
New England Journal of Medicine (Impact Factor: 55.87). 02/2007; 356(2):157-65. DOI: 10.1056/NEJMsa064115
Source: PubMed

ABSTRACT The U.S. population of former prison inmates is large and growing. The period immediately after release may be challenging for former inmates and may involve substantial health risks. We studied the risk of death among former inmates soon after their release from Washington State prisons.
We conducted a retrospective cohort study of all inmates released from the Washington State Department of Corrections from July 1999 through December 2003. Prison records were linked to the National Death Index. Data for comparison with Washington State residents were obtained from the Wide-ranging OnLine Data for Epidemiologic Research system of the Centers for Disease Control and Prevention. Mortality rates among former inmates were compared with those among other state residents with the use of indirect standardization and adjustment for age, sex, and race.
Of 30,237 released inmates, 443 died during a mean follow-up period of 1.9 years. The overall mortality rate was 777 deaths per 100,000 person-years. The adjusted risk of death among former inmates was 3.5 times that among other state residents (95% confidence interval [CI], 3.2 to 3.8). During the first 2 weeks after release, the risk of death among former inmates was 12.7 (95% CI, 9.2 to 17.4) times that among other state residents, with a markedly elevated relative risk of death from drug overdose (129; 95% CI, 89 to 186). The leading causes of death among former inmates were drug overdose, cardiovascular disease, homicide, and suicide.
Former prison inmates were at high risk for death after release from prison, particularly during the first 2 weeks. Interventions are necessary to reduce the risk of death after release from prison.

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Available from: Joann G Elmore, Sep 26, 2015
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    • "Little is known whether these same factors are associated with use among a criminal justice sample supervised in the community. Understanding factors associated with concurrent opioid and benzodiazepine use in this high-risk population is important as individuals under community corrections supervision are at heightened risk for overdose in the community (Binswanger et al., 2007). This high risk of overdose persists even though these individuals receive mandatory random drug testing as part of community supervision that carries the risk of sanctions, including jail or prison time, for use of illicit drugs. "
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    • "From a population health perspective, excess crime rates cause substantial harm to overall wellbeing. Offender populations typically experience many negative health outcomes including higher mortality and greater burdens of chronic disease (Binswanger et al., 2007; Herbert et al., 2012; Kendall, 2013). As well offenders tend to engage in riskier behaviours like increased substance and alcohol use once released from custody (Vaughn et al., 2012). "
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