Skip Navigation


IJE Advance Access first published online on December 8, 2006
This version published online on April 26, 2007
International Journal of Epidemiology, doi:10.1093/ije/dyl225
This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
36/2/310    most recent
dyl225v2
dyl225v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Kariminia, A
Right arrow Articles by Law, M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kariminia, A
Right arrow Articles by Law, M.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2007; all rights reserved.

Extreme cause-specific mortality in a cohort of adult prisoners—1988 to 2002: a data-linkage study

A Kariminia1,2,*, TG Butler1,2, SP Corben3, MH Levy1,4, L Grant3, JM Kaldor5 and MG Law5

1Centre for Health Research in Criminal Justice, Sydney, Australia.
2School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
3NSW Department of Corrective Services, Sydney, Australia.
4School of Public Health and Community Medicine, University of Sydney, Sydney, Australia.
5National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, Australia.

*Corresponding author. Azar Kariminia Centre for Health Research in Criminal Justice, Suite 302, 152 Bunnerong Road Eastgardens NSW 2035, Australia. E-mail: azar.kariminia{at}justicehealth.nsw.gov.au


  Abstract

Objectives: Describe the standardized mortality ratio (SMR) and its trend in adults who have served time in prison.

Design: A retrospective cohort study of 85 203 adults imprisoned in New South Wales (NSW), Australia, between 1 January 1988 and 31 December 2002.

Methods: We obtained information on deaths by record linkage with the Australian National Death Index (NDI). Mortality rates were estimated using the person-time method. SMRs were calculated using sex, age, and calendar-specific death rates from the NSW population. Time trends in SMRs were assessed using the test for linear trends.

Results: The median overall follow-up of the cohort was 7.7 years. We identified 5137 deaths (4714 men, 423 women) among the cohort of which the vast majority (4834, 94%) occurred following release from custody. All-cause SMR was 3.7 (95% CI: 3.6–3.8) in men and 7.8 (95% CI: 7.1–8.5) in women. SMRs were substantially raised for deaths due to mental and behavioural disorders (men: 13.2, 95% CI: 12.3–14.0; women: 62.8, 95% CI: 52.7–74.9) and drug-related deaths (men: 12.8, 95% CI: 12.2–13.5; women: 50.3, 95% CI: 43.7–57.8). The SMR for death by homicide was 10.2 (95% CI: 8.9–11.7) in men and 26.3 (95% CI: 17.8–39.0) in women. Aboriginal men were 4.8 times, and Aboriginal women 12.6 times, more likely to die than the general NSW population. Over the study period on average all-cause SMR decreased significantly in men (p = 0.003) and women (p = 0.05) largely due to the decline in SMRs for drug-related deaths and suicide.

Conclusion: In the largest study so far reported, mortality of male and female offenders was far greater than expected for all major causes, especially deaths caused by drug overdose. Despite some indication of a reduction in excess mortality in recent years, there remains an overwhelming need for enhanced responses to mental health and drug problems for people who have been in prison.

Keywords Australia, cohort study, linkage, mortality, prisoners, standardized mortality ratio, suicide, trend

Accepted 2 October 2006


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Tobacco ControlHome page
R Richmond, T Butler, K Wilhelm, A Wodak, M Cunningham, and I Anderson
Tobacco in prisons: a focus group study
Tob. Control, June 1, 2009; 18(3): 176 - 182.
[Abstract] [Full Text] [PDF]

Home page
 AJPHHome page
D. L. Rosen, V. J. Schoenbach, and D. A. Wohl
All-Cause and Cause-Specific Mortality Among Men Released From State Prison, 1980-2005
Am J Public Health, December 1, 2008; 98(12): 2278 - 2284.
[Abstract] [Full Text] [PDF]

Home page
 BMJHome page
A. Frater
Deaths in custody
BMJ, April 19, 2008; 336(7649): 845 - 846.
[Full Text] [PDF]

Home page
 Tobacco ControlHome page
T Butler, R Richmond, J Belcher, K Wilhelm, and A Wodak
Should smoking be banned in prisons?
Tob. Control, October 1, 2007; 16(5): 291 - 293.
[Full Text] [PDF]

Home page
 Int J EpidemiolHome page
P. Christensen
Commentary: Extreme cause-specific mortality in a cohort of adult prisoners--1988 to 2002: a data-linkage study
Int. J. Epidemiol., April 1, 2007; 36(2): 317 - 318.
[Full Text] [PDF]

Home page
 Int J EpidemiolHome page
S. Ebrahim
Prostate cancer, Cochrane, Durkheim and Beer Lao
Int. J. Epidemiol., April 1, 2007; 36(2): 263 - 264.
[Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.