Bureau of Epidemiology Services, Division of Epidemiology, New York City Department of Health and Mental Hygiene, Queens, NY, USA.
Am J Epidemiol. 2012 Mar 15;175(6):519-26. doi: 10.1093/aje/kwr327. Epub 2012 Feb 13.
The authors assessed the risks of drug-related death, suicide, and homicide after release from New York City jails in 155,272 people who were incarcerated anytime from 2001 through 2005 and examined whether the mortality rate was associated with homelessness. Using jail records matched with death and single-adult homeless registries in New York City, they calculated standardized mortality ratios (SMRs) and relative risks. After adjustment for age, sex, race, and neighborhood, the risks of drug-related death and homicide in formerly incarcerated persons were 2 times higher than those of New York City residents who had not been incarcerated in New York City jails during the study period. These relative risks were greatly elevated during the first 2 weeks after release (for drug-related causes, SMR = 8.0, 95% confidence interval (CI): 5.2, 11.8; for homicide, SMR = 5.1, 95% CI: 3.2, 7.8). Formerly incarcerated people with histories of homelessness had higher rates of drug-related death (RR = 3.4, 95% CI: 2.1, 5.5) and suicide (RR = 2.1, 95% CI: 1.2, 3.4) than did persons without such histories. For individuals who died of drug-related causes, longer jail stays were associated with a shorter time until death after release. These results suggest that jail- and community-based interventions are needed to reduce the excess mortality risk among formerly incarcerated people.
作者评估了 155272 名在 2001 年至 2005 年期间任何时间被监禁的人从纽约市监狱获释后的与药物相关的死亡、自杀和杀人风险,并检查死亡率是否与无家可归有关。他们使用监狱记录与纽约市的死亡和单身成年人无家可归者登记处相匹配,计算了标准化死亡率比(SMR)和相对风险。在调整年龄、性别、种族和社区后,以前被监禁的人的与药物相关的死亡和杀人风险是同期未在纽约市监狱被监禁的纽约市居民的 2 倍。这些相对风险在释放后的头两周内大大升高(与药物相关的原因,SMR = 8.0,95%置信区间(CI):5.2,11.8;杀人,SMR = 5.1,95%CI:3.2,7.8)。有过无家可归史的以前被监禁的人因药物相关原因死亡的比率更高(RR = 3.4,95%CI:2.1,5.5)和自杀(RR = 2.1,95%CI:1.2,3.4)比没有这种病史的人。对于因药物相关原因死亡的个体,在监狱中停留的时间越长,释放后死亡的时间就越短。这些结果表明,需要在监狱和社区中进行干预,以降低以前被监禁的人的过度死亡率风险。