Study finds high death rate among people who are or have been incarcerated

People recently released from correctional facilities in Ontario had a risk of dying from a drug overdose 56 times greater than the general population, a new study has found.

The life expectancy of people who are or have been incarcerated was also shorter than the general Canadian population, by 10.6 years for women and 4.2 years for men, according to the study published today in CMAJ Open.

"This is the first Canadian study to examine mortality rates in this population both during incarceration and after release," said Dr. Fiona Kouyoumdjian, a public health physician and post-doctoral fellow with the Centre for Research on Inner City Health of St. Michael's Hospital. "This study reveals a very high death rate in people who spend any time in provincial custody."

The study obtained data from the Ontario Ministry of Community Safety and Correctional Services on the nearly 50,000 people admitted to Ontario provincial correctional facilities in 2000, and then looked at death records at the Institute for Clinical Evaluative Sciences to determine how many of these people died between 2000 and 2012 and what they died of.

Dr. Kouyoumdjian said there may be opportunities to intervene during incarceration to prevent people from dying from causes such as overdose. These may include initiatives to divert people from incarceration to treatment programs, better access to drug substitution therapies and treatment programs, overdose prevention training and access to naloxone, which can reverse overdoses when they occur.

Dr. Kouyoumdjian said her study also found that the death rate for this population between 2000 and 2012 was four times as high as the rate for the general population over age 15. Of the 48,166 prisoners studied, 4,126 died, or 8.6 per cent.

While in custody, the death rate was double that of the general population.

Dr. Kouyoumdjian said the consistently high death rate, both in custody and after release to the community, suggests that it is not simply the experience of incarceration that increases the risk of death, but rather that this population is likely at high risk of death due to complex social, medical, and behavioural factors.

The most common cause of death among people who experienced incarceration was injury (which includes overdoses and suicides), diseases of the circulatory system and cancer.

In Canada there are more than 250,000 admissions to correctional facilities each year and about 40,000 people in correctional facilities on any given day - about one in every 250 people.