Newly Released Prisoners At High Risk For Death

Prisoners who have been recently released from prison have a high death rate, especially in the first two weeks after release, a new study finds. The findings will be published in the Jan. 11 issue of The New England Journal of Medicine.

The study was conducted by Ingrid Binswanger, MD, of the University of Colorado at Denver and Health Sciences Center's School of Medicine, Marc Stern, MD, health services director of the Washington State Department of Corrections, and other researchers at the University of Washington and Harborview Medical Center in Seattle. Binswanger conducted the research while taking part in the Robert Wood Johnson Clinical Scholars Program at the University of Washington and the VA Puget Sound Health Care System.

In the first study of its kind in the U.S., Binswanger analyzed data from 30,237 inmates released from prison between 1999 and 2003 in Washington state. The sample represented almost all prisoners released during that time. Of those individuals, 443 died during an average follow-up time of 1.9 years.

The death rates of the released prisoners were compared to the death rates of other Washington residents of the same age, gender, and race. The study found that newly released prisoners were 12.7 times as likely to die in the two weeks following their release compared to other state residents in the same demographic groups. Over the whole study, the former inmates were 3.5 times more likely to die than other state residents. The death rate among former inmates was considerably higher than the death rate among inmates in prison.

"These striking findings suggest that former inmates are at high risk for death following their release from prison," said Binswanger. "These results, along with findings from studies done in other countries, underscore the need for novel programs to reduce the risk of death in former inmates."

The leading causes of death were drug overdose, cardiovascular disease, homicide and suicide. Nearly one quarter of the deaths were a result of drug overdose, and half of these deaths resulted from cocaine. After cocaine, most overdose deaths were caused by methamphetamine and opiates like heroin. Lung cancer represented half of all the cancer deaths in this population.

Younger individuals tended to die from overdose, homicide and suicide, whereas older individuals tended to die from cardiovascular disease and cancer. Binswanger recommends programs targeted by age to address this difference.

"The U.S. has exceptionally high rates of incarceration," said Binswanger. "When a released prisoner dies, it may have an impact beyond his own life, affecting families and communities. These findings suggest that we need programs and policies targeted at decreasing the risk of death as former inmates transition back into their communities."

Binswanger is a physician researcher and an assistant professor in the Division of General Internal Medicine at UCDHSC's School of Medicine. Her research focuses on health, the criminal justice system, and vulnerable populations.

The School of Medicine faculty work to advance science and improve care as the physicians, educators and scientists at University of Colorado Hospital, The Children's Hospital, Denver Health, National Jewish Medical and Research Center and the Veterans Administration Medical Center. The School is part of the University of Colorado at Denver and Health Sciences Center, one of three universities in the University of Colorado system. For more information, visit the Web site at http://www.uchsc.edu or the UCDHSC Newsroom at http://www.uchsc.edu/news.

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