Reentry into the community can be an extraordinarily difficult process for the over 1 million adults incarcerated in U.S. prisons. These individuals face substantial barriers and strained social and familial relationships when returning to life outside of jail or prison that contribute to an increased risk of morbidity and mortality. Notably, people with substance use disorders are particularly vulnerable following release, with several studies showing drug overdose to be the leading cause of death after release from prison.
Yale researchers Katherine Hill, MPH, PhD candidate in Epidemiology of Microbial Diseases, Yale School of Public Health, and Benjamin Howell, MD, MPH, MHS, assistant professor of medicine (general medicine), Yale School of Medicine, collaborated with Peter J. Bodurtha, MPP, and Tyler Winkelman, MD, MSc, with the Health, Homelessness, and Criminal Justice Lab at Hennepin Healthcare Research Institute to investigate the mortality risk among individuals recently released from Minnesota jails and prisons.
Their findings were published on July 18, 2024 in the American Journal of Public Health.
"We've known for a while that people released from prison have a very high risk of death, but most of those studies are older, before the current era of fentanyl, and didn't factor in release from jail. What we found was striking - risk of death following release from either prison or jail was more than 10-fold higher than the general population in Minnesota,” said Dr. Howell. “Furthermore, the risk of overdose death was extremely high, and even higher than what was seen in previous studies. This continues to highlight the importance of providing the best treatments for opioid use disorder in prisons and jails and supporting continued treatment after release."
The team conducted a study of over 99,000 individuals released from Minnesota jails and prisons between 2020 and 2021, drawing on data from the Minnesota Department of Corrections, the Minnesota Department of Health’s Office of Vital Records, and the U.S. Census American Community Survey.
The study identified people released from prison or jail, reviewed their causes of death, and compared results to the wider Minnesota population.
Substance use was the main driver of high death rates for people who were recently incarcerated. Death due to substance use disorder occurred in 35.9% and 33.1% of deaths for people released from jail and prison, respectively. In comparison, 1.7% of deaths in the general population of Minnesota were attributed to the same cause.
Based on these findings, the authors indicated the need for more research on how post-release mortality differs based on carceral setting and time, noting that this work is the first known study of its kind comprising a time period after the start of the COVID-19 pandemic.
“Substance use is clearly the main driver of death after release from both jail and prison. This is likely driven, in part, by the high-risk substance use profiles of individuals who are incarcerated. The important question now is how can we use this work to improve treatment during incarceration and after release to bring these death rates down in Minnesota and across the U.S.” said Dr. Winkelman.
Learn more about “Postrelease Risk of Overdose and All-Cause Death Among Persons Released From Jail or Prison: Minnesota, March 2020–December 2021” in the American Journal of Public Health.
Hill K, Bodurtha PJ, Winkelman TNA, Howell BA. Postrelease Risk of Overdose and All-Cause Death Among Persons Released From Jail or Prison: Minnesota, March 2020-December 2021. Am J Public Health. Published online July 18, 2024. doi:10.2105/AJPH.2024.307723
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