Article

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: 54.42). 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.

0 Followers
 · 
182 Views
  • Source
    01/2014; 1(1):9. DOI:10.1186/2197-1714-1-9
  • [Show abstract] [Hide abstract]
    ABSTRACT: We investigated whether eventual causes of death among a cohort of inmates imprisoned in the southeastern United States differed from those in previous prisoner studies. We matched 23 510 prisoners in Georgia, a state with historically low levels of heroin consumption but moderate amounts of injection drug use, who were incarcerated on June 30, 1991, to death registries through 2010. Main exposure was 4-year time intervals over 2 decades of observation; main outcome was mortality from liver disease, HIV, and overdose. Although the HIV-related mortality rate exceeded that from liver-related conditions before 2003, liver disease subsequently surpassed HIV as a cause of death. Among 3863 deaths, 22 (0.6%) occurred within 2 weeks after release from prison. Of these, only 2 were caused by accidental poisoning (likely drug overdose). Cardiovascular disease and cancer were the most frequent causes of death in this aging cohort. Our study design deemphasized immediate deaths but highlighted long-term sequelae of exposure to viral hepatitis and alcohol. Treating hepatitis C and implementing interventions to manage alcohol use disorders may improve survival among prisoners in the Southeast. (Am J Public Health. Published online ahead of print March 19, 2015: e1-e7. doi:10.2105/AJPH.2014.302546).
    American Journal of Public Health 03/2015; 105(5):e1-e7. DOI:10.2105/AJPH.2014.302546 · 4.23 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: This study provides insight into the postrelease performance of all former inmates with available data who were released from a prison in New Jersey in 2006 (N = 12,187). Three indicators of recidivism are considered: (a) an arrest for a new crime, (b) a conviction for a new crime, and (c) a technical parole violation. Individuals are categorized into groups according to the release mechanism that they experienced: discretionary parole, mandatory parole, or unconditional release. Multivariate analyses utilize Cox proportional hazards survival tests. Results indicate that after approximately 3 years of follow-up time, those released to supervision were generally less involved in new crimes when compared with those who were released unconditionally. However, a high proportion of those who were paroled recidivated shortly after release, and the predicted probability that a former inmate would recidivate did not substantially differ between release groups in the presence of statistical controls.
    Crime &amp Delinquency 02/2011; 61(2):163-187. DOI:10.1177/0011128710396425 · 1.75 Impact Factor