US prisoners have high death rates in the weeks after release

doi:10.1136/bmj.334.7585.119-a

BMJ 2007;334:119 (20 January), doi:10.1136/bmj.334.7585.119-a

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US prisoners have high death rates in the weeks after release

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Convicts released from Washington State prisonsare nearly 13 times more likely to die during their first twoweeks of freedom than other residents of the state (relativerisk 12.7, 95% CI 9.2 to 17.4), according to a new study

Among the 30 237 inmates released during thestudy, 38 died within two weeks, 27 of them from a drugs overdose.In total, 443 died in the first two years after release. Thismortality was more than three times the expected rate in a populationof similar age, sex, and cultural heritage. Again, a drugs overdosewas the leading cause of death (103 deaths, relative risk 12.2,95% CI 10.2 to 14.9), and cocaine was the most common drug.Homicide (55 deaths, 10.4, 8.0 to 13.6), suicide (40 deaths,3.4, 2.5 to 4.7), road traffic incidents (35 deaths, 3.4, 2.4to 4.8), and cardiovascular disease (57 deaths, 2.1, 1.6 to2.7) were other important causes of death in recently releasedprisoners.

These values are consistent with findings fromsimilar studies outside the US. They confirm that the transitionperiod immediately after release is stressful, and ex prisonersare at high risk as they struggle to reintegrate with theirfamilies and communities, find work and housing, and accesshealth care—including mental health care—write theauthors. Nationally, millions of people are at risk. At theend of 2004, 3% of the adult population was in prison, on probation,or on parole.