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Previous Volume 356:157-165 January 11, 2007 Number 2 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Perspective by Okie, S. Perspective by Gibney, E. M. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear Related Article PubMed Citation

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.

Source Information

From the Puget Sound Veterans Affairs Medical Center, Seattle (I.A.B., T.D.K.); the Departments of Medicine (I.A.B., R.A.D., J.G.E.), Health Services (I.A.B., R.A.D., A.C., T.D.K.), Biostatistics (P.J.H.), and Epidemiology (J.G.E., T.D.K.), University of Washington, Seattle; the Department of Medicine, University of Colorado at Denver and the Health Sciences Center, Denver (I.A.B.); and the Washington State Department of Corrections, Olympia (M.F.S.).

Address reprint requests to Dr. Binswanger at the Department of Medicine, Division of General Internal Medicine, University of Colorado at Denver and the Health Sciences Center, 4200 E. Ninth Ave., B180, Denver, CO 80262, or at ingrid.binswanger{at}uchsc.edu.

Full Text of this Article

Related Letters:

Mortality after Release from Prison
Spaulding A. C., Allen S. A., Stone A., Coffin P. O., Wines J. D. Jr., Saitz R., Samet J. H., Binswanger I., Stern M. F., Elmore J. G.
Extract | Full Text | PDF  
N Engl J Med 2007; 356:1785-1787, Apr 26, 2007. Correspondence

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