Risk factors for all-cause, overdose and early deaths after release from prison in Washington state

Drug Alcohol Depend. 2011 Aug 1;117(1):1-6. doi: 10.1016/j.drugalcdep.2010.11.029. Epub 2011 Feb 3.

Abstract

Background: High mortality rates after release from prison have been well-documented, particularly from overdose. However, little is known about the risk factors for death after release from prison. Therefore, the objective of this study was to determine the demographic and incarceration-related risk factors for all-cause, overdose and early mortality after release from prison.

Methods: We conducted a retrospective cohort study of inmates released from a state prison system from 1999 through 2003. The cohort included 30,237 who had a total of 38,809 releases from prison. Potential risk factors included gender, race/ethnicity, age, length of incarceration, and community supervision. Cox proportional hazards regression was used to determine risk factors for all-cause, overdose and early (within 30 days of release) death after release from prison.

Results: Age over 50 was associated with an increased risk for all-cause mortality (hazard ratio [HR] 2.67 for each decade increase, 95% confidence interval [CI] 2.23, 3.20) but not for overdose deaths or early deaths. Latinos were at decreased risk of death compared to Whites only for all-cause mortality (HR 0.61, 95% CI 0.42, 0.87). Increasing years of incarceration were associated with a decreased risk of all-cause mortality (HR 0.95, 95% CI 0.91, 0.99) and overdose deaths (HR 0.80, 95% CI 0.68, 0.95), but not early deaths. Gender and type of release were not significantly associated with all-cause, overdose or early deaths.

Conclusions: Age, ethnicity and length of incarceration were associated with mortality after release from prison. Interventions to reduce mortality among former inmates are needed.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Age Factors
  • Cause of Death*
  • Cohort Studies
  • Drug Overdose / mortality*
  • Ethnicity
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prisoners / psychology*
  • Prisoners / statistics & numerical data
  • Prisons
  • Retrospective Studies
  • Risk Factors
  • Suicide / statistics & numerical data*
  • Time Factors
  • Washington