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. 2007 Jan 11;356(2):157-65.
doi: 10.1056/NEJMsa064115.

Release from prison--a high risk of death for former inmates

Ingrid A Binswanger  1 , Marc F Stern, Richard A Deyo, Patrick J Heagerty, Allen Cheadle, Joann G Elmore, Thomas D Koepsell
Affiliations

Release from prison--a high risk of death for former inmates

Ingrid A Binswanger et al. N Engl J Med. .

Erratum in

  • N Engl J Med. 2007 Feb 1;356(5):536

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1. Mortality Rates among Former Inmates of the Washington State Department of Corrections during the Study Follow-up (Overall) and According to 2-Week Periods after Release from Prison
The dashed line represents the adjusted mortality rate for residents of the State of Washington (223 deaths per 100,000 person-years), and the solid line represents the crude mortality rate among inmates of the state prison system during incarceration (201 deaths per 100,000 inmate person-years).
See this image and copyright information in PMC

Comment in

  • Mortality after release from prison.
    Spaulding AC, Allen SA, Stone A. Spaulding AC, et al. N Engl J Med. 2007 Apr 26;356(17):1785; author reply 1786-7. doi: 10.1056/NEJMc070267. N Engl J Med. 2007. PMID: 17460238 No abstract available.
  • Mortality after release from prison.
    Coffin PO. Coffin PO. N Engl J Med. 2007 Apr 26;356(17):1785; author reply 1786-7. N Engl J Med. 2007. PMID: 17465043 No abstract available.
  • Mortality after release from prison.
    Wines JD Jr, Saitz R, Samet JH. Wines JD Jr, et al. N Engl J Med. 2007 Apr 26;356(17):1785-6; author reply 1786-7. N Engl J Med. 2007. PMID: 17465044 No abstract available.

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