Posted on 01/11/2007 1:41:59 PM PST by DogByte6RER
Release from Prison Equivalent to Death Sentence for Some
By Neil Osterweil, Senior Associate Editor, MedPage Today
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco
January 10, 2007
SEATTLE, Jan. 10 -- Persons newly released from prison, within their first two weeks of freedom, have a nearly 13-fold higher risk of death than those in the general population.
And even two years after release, former inmates have a 3.5-fold greater risk of dying than others in the community, found Ingrid A. Binswanger, M.D., of the University of Washington in Seattle, and colleagues in the Washington State Department of Corrections, and the University of Colorado in Denver.
The leading causes of death among ex-convicts were drug overdose, cardiovascular disease, murder and suicide, the investigators wrote in the Jan. 11 issue of the New England Journal of Medicine.
The findings suggest the need for planned reintegration of inmates through use of halfway houses, work-release programs, drug-treatment programs, drug abuse education, and preventive medical care to modify cardiac risk factors, the researchers wrote.
Dr. Binswanger and colleagues conducted a retrospective study of the fates of inmates released from Washington State prisons from July 1999 to December 2003. They linked prison records with the National Death Index, and compared data on the inmates to those from a CDC epidemiologic database containing information about the general population.
They compared death rates among the former inmates to those of other state residents with the use of indirect standardization.
They found that of the 30,237 inmates released during the study period, 443 died during a mean follow-up of 1.9 years. The overall mortality rate was 777 deaths per 100,000 person-years.
Adjusted for age, gender, and race, the risk of death among former inmates was 3.5 times higher than that of other state residents (95% confidence interval, 3.2 to 3.8).
During the first two 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).
Women recently released from prison had an overall relative risk for death of 5.5 (95% CI, 4.2-7.3), compared with 3.3 for men (95% CI 3.0-3.7, P=0.002).
The leading cause of death among former inmates was drug overdose (103 deaths), representing nearly a quarter of all deaths, the authors wrote. "Of the 38 deaths occurring within two weeks after release, 27 were from overdoses. Within the first two weeks after release, the rate of death from overdose was 1,840 per 100,000 person-years (95% CI, 1213 to 2677). The adjusted relative risk of death from overdose was 129 (95% CI, 89 to 186) among released inmates within 2 weeks after release, as compared with other state residents."
Other causes of death and their relative risks included cardiovascular disease, 2.1 (95% CI, 1.6-2.7); homicide, 10.4 (95% CI, 8.0-13.6); suicide 3.4 (95% CI, 2.5-4.7); cancer, 1.67 (95% CI, 1.2-2.2); motor vehicle accident 3.4 (95% CI, 2.4-4.8); and liver disease 4.7 (95% CI, 3.2-7.2).
"Possible interventions after release include providing intensive case management during the period immediately following release and improving access to and continuity of medical and mental health care," the authors recommended. "In addition to possible reductions in mortality after release, there might be secondary benefits for society from such interventions, in the form of increased public safety."
Prison authorities can also help to protect the health of inmates while they're still behind bars by allowing the distribution of condoms, and by implementing needle-exchange programs, suggested Susan Okie, M.D., a contributing editor for the NEJM, in a perspective published in the same issue.
"Critics in the public health community have been urging U.S. prison officials to do more to prevent HIV transmission, to improve diagnosis and treatment in prisons, and to expand programs for reducing high-risk behavior after release," she wrote. "The debate over such preventive strategies as providing condoms and needles reflects philosophical differences, as well as uncertainty about the frequency of HIV transmission inside prisons."
Dr. Okie pointed to the model HIV-prevention program in place in the Rhode Island state prison, in Cranston.
"At the Rhode Island prison," she wrote, "the medical program focuses on identifying HIV-infected inmates, treating them, teaching them how to avoid transmitting the virus, addressing drug dependence, and when they're released, referring them to a program that arranges for HIV care and other assistance, including methadone maintenance treatment if needed. The prison offers routine HIV testing, and 90% of inmates accept it. One third of the state's HIV cases have been diagnosed at the prison."
Susan Okie - a left-wing liberal hug-a-thug pinhead who is concerned more about prison convicts having "safe sex" than about the safety and security of her own neighbors and community.
I wonder if this fool appreciates the fact that very few sexual encounters that occur in prison involve two willing participants.
IMHO, the real answer is to be much harder on crime. Harsher life in prison, much more time for violent criminals, less paroling, more application of the death penalty for murder, kidnapping, violent rape, etc.
That's the answer as opposed to mushy-feely efforts which have shown themselves, by these very statistics, to make the problem worse rather than addressing it.
Did it occur to these oh-so-smart doctors that the behavior/decisions of these former state guests is directly involved in thier demise?
Just what occured to me. Then again I aint a doctor so what do I know.
BOO-sniggering-HOO!
They've torn down the old high-rise housing projects on the southside of Chicago and dispersed the residents to other projects in the city or the suburbs. I read the other day about increasing gang activity and crime in general in those projects when former residences of the high-rises, who are released from prison, go home to the new projects and go right back to doing what got them convicted and sent away in the first place.
So no one should be surprised that they are dying.
What the findings actually suggest is that ex-cons need to man up and get their acts together if they expect to make it in the real world.
In other words, being in prison had an anti-Darwin effect on them, and when they get out Darwin finally catches up.
In the case of Jim McDougal, he never even made it out of prison....perhaps these Doc's ought to look for other statistically significant causes of death....like relationships to the Clintons.
as a former cop, I've never understood the idea of "good" time. If they get 10 years they should do the 10 years. If they screw up they should get "bad" time like in the service. Each day in the brig added a day to your enlistment.
For the lifers, put them in a cell and don't open the door till they've been stiff for a week.
"The leading causes of death among ex-convicts were drug overdose, cardiovascular disease, murder and suicide, the investigators wrote in the Jan. 11 issue of the New England Journal of Medicine."
Well ... am I supposed to be sad when a criminal does this?
These ex-cons are merely picking up where they left off regarding their lifestyle choices. In other words, they learned nothing while in prison. Regarding prisoners, I think more pink underwear and pb&j sandwiches for dinner are in order.
I don't think it is in the interests of potential victims of crime to keep these released prisoners alive by extra and taxpaid means.
I was thinking the same thing.
Does anybody seriously think that some hard core career criminal with prison tats is going to simply start drinking green tea and take up meditation?!?!
It reminds me of the same liberal pinheads who authored the 1994 Clinton Crime Bill that featured midnight basketball for thugs...
maybe it's because they are CRIMINALS you stooopid cow you... more tax payer funded mooching from the looters.
I'd add making legislation and judicial fiat which enables these crimes to the list.
If release from prison carries such risks, maybe, prisoners should be kept in prison forever.
I don't know what the deal is with cardiovascular disease, but the other three are probably the result of really bad choices.
Now I do know someone who was in prison and is now leading a useful and civilised life (NO, it's not me). He realized that he had really screwed-up big time and resolved to live a better life. At the rate he's going I'd say he'll probably live to be a hundred.
Release from prison does not have to be a death trip.
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