All-cause and cause-specific mortality among men released from state prison, 1980-2005

Am J Public Health. 2008 Dec;98(12):2278-84. doi: 10.2105/AJPH.2007.121855. Epub 2008 Oct 15.


Objectives: We compared mortality of ex-prisoners and other state residents to identify unmet health care needs among former prisoners.

Methods: We linked North Carolina prison records with state death records for 1980 to 2005 to estimate the number of overall and cause-specific deaths among male ex-prisoners aged 20 to 69 years and used standardized mortality ratios (SMRs) to compare these observed deaths with the number of expected deaths had they experienced the same age-, race-, and cause-specific death rates as other state residents.

Results: All-cause mortality among White (SMR = 2.08; 95% confidence interval [CI] = 2.04, 2.13) and Black (SMR = 1.03; 95% CI = 1.01, 1.05) ex-prisoners was greater than for other male NC residents. Ex-prisoners' deaths from homicide, accidents, substance use, HIV, liver disease, and liver cancer were greater than the expected number of deaths estimated using death rates among other NC residents. Deaths from cardiovascular disease, lung cancer, respiratory diseases, and diabetes were at least 30% greater than expected for White ex-prisoners, but less than expected for Black ex-prisoners.

Conclusions: Ex-prisoners experienced more deaths than would have been expected among other NC residents. Excess deaths from injuries and medical conditions common to prison populations highlight ex-prisoners' medical vulnerability and the need to improve correctional and community preventive health services.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Black or African American / statistics & numerical data
  • Cause of Death / trends*
  • Continuity of Patient Care / organization & administration
  • Death Certificates
  • Follow-Up Studies
  • Health Status Disparities
  • Humans
  • International Classification of Diseases / statistics & numerical data
  • Male
  • Medical Record Linkage
  • Men* / education
  • Middle Aged
  • Needs Assessment
  • North Carolina / epidemiology
  • Population Surveillance
  • Prisoners / education
  • Prisoners / statistics & numerical data*
  • Risk Assessment
  • Risk Factors
  • Socioeconomic Factors
  • Time Factors
  • Vulnerable Populations / statistics & numerical data
  • White People / statistics & numerical data