Understanding extreme mortality among prisoners: a national cohort study in Scotland using data linkage

Graham, L., Fischbacher, C. M., Stockton, D., Fraser, A., Fleming, M. and Greig, K. (2015) Understanding extreme mortality among prisoners: a national cohort study in Scotland using data linkage. European Journal of Public Health, 25(5), pp. 879-885. (doi: 10.1093/eurpub/cku252) (PMID:25678604)

Full text not currently available from Enlighten.

Abstract

Background: Mortality is known to be extremely high among people who have been imprisoned, but there is limited information about the factors that explain this increased risk. Methods: Standard record linkage methods were used to link Scottish prison records and mortality data for all individuals imprisoned in Scotland for the first time between 1 January 1996 and 31 December 2007. Results: Among 76 627 individuals there were 4414 deaths (3982 in men). When compared with the general population, the age-standardized mortality rate ratio for those imprisoned was 3.3 (95% CI: 3.2, 3.4) for men and 7.6 (6.9, 8.3) for women. Further adjustment for an area measure of deprivation accounted for part but not all of this excess risk [adjusted rate ratio 2.3 (2.2, 2.4) and 5.7 (5.1, 6.2) for men and women, respectively]. Relative risks were highest for drug and alcohol related causes, suicide and homicide and were markedly higher among women than men. Out of prison deaths were most frequent in the first 2 weeks after release from prison. Mortality rates were lower in those with longer total duration in prison and higher in those with multiple short episodes in prison. Conclusion: People who have been imprisoned in Scotland experience substantial excess mortality from a range of causes that is only partly explained by deprivation. The association of increased mortality with multiple periods in prison and the concentration of deaths in the early period after prison release both have implications for policy and practice.

Item Type:Articles
Additional Information:This work was supported by the Scottish Chief Scientist Office (CZG/2/282).
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Fleming, Dr Michael
Authors: Graham, L., Fischbacher, C. M., Stockton, D., Fraser, A., Fleming, M., and Greig, K.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
Journal Name:European Journal of Public Health
Publisher:Oxford University Press
ISSN:1101-1262
ISSN (Online):1464-360X
Published Online:11 February 2015

University Staff: Request a correction | Enlighten Editors: Update this record