Risk of death in prisoners after release from jail

Objective: To compare the risk of death in a cohort of Western Australian released prisoners with the risk experienced by the general population of Western Australia. Methods: A cohort study of prisoners in Western Australia whose last date of release ranged from 1 January 1994 to 1 January 1999. Overall mortality and cause of death were determined by data linkage to the Registrar General's record of deaths. Results: Aboriginal prisoners had a significantly lower survival rate after release than non-Aboriginal prisoners (p<0.0001). When compared with their peers in the Western Australian community, both Aboriginal and non-Aboriginal prisoners were found to have an increased relative risk of death. Female non-Aboriginal released prisoners aged between 20 and 40 years were 17.8 (95% Cl 8.1-27.5) times more likely to die than other female non-Aboriginals in Western Australia in the same age range. Male non-Aboriginal prisoners aged 20-40 years were 6.3 (95% Cl 5.2-7.4) times more likely to die than their counterparts in the WA community. Female Aboriginal released prisoners were 3.4 (95% Cl 1.2-5.6) times more likely to die than their peers, while male Aboriginal released prisoners were 2.9 (95% Cl 2.23.5) times more likely to die. In their first six months after release, female non-Aboriginal prisoners aged 20 to 40 years were 69.1 (95% Cl 17.9-120.3) times more likely to die than their counterparts in the WA community. The main causes of excess death were related to drug and alcohol abuse. Conclusion: All prisoners were at greater than expected relative risk of death after release from prison, with female non-Aboriginal prisoners at particularly high relative risk.