Understanding mortality in state prison

Abstract

While most prisoners serve their time and are released without incident, approximately 3,000 state prisoners (less than 1%) die annually. The mortality rate of state prisoners (259 per 100,000) between 2001and 2010 was considerably lower than the mortality rate of the U.S. resident population (826 per 100,000), despite the disadvantaged social and economic background of prisoners prior to incarceration. Using data from the Deaths in Custody Reporting Program and the Center for Disease Control and Prevention’s Wide-ranging Online Data for Epidemiologic Research model, we compared state prisoner deaths to deaths of their U.S. resident counterparts through direct standardization to determine differences in the mortality rates after adjusting for demographic differences between the two populations. Our findings show that male prisoners between the age of 18 and 75 have a lower overall mortality rate (248 per 100,000) than their counterparts in the adjusted resident population (325 per 100,000). With a few exceptions, gaps observed in cause-specific mortality rates between male prisoners and their U.S. resident counterparts shrink or disappear once the resident population is adjusted for demographic differences. This finding suggests that mortality outcomes may be the function of being an adult male between the ages of 18 and 75 rather than being a prisoner. However, mortality rates related to liver disease, septicemia, and AIDS-related causes were higher among males in prison than among males in the adjusted resident population. These higher rates suggest that these deaths may be linked to the social and economic disadvantages of prisoners and to their risky lifestyles prior to incarceration.