The University of Melbourne, Parkville, Victoria, Australia.
Murdoch Children's Research Institute, Parkville, Victoria, Australia.
J Interpers Violence. 2021 Dec;36(23-24):NP13229-NP13253. doi: 10.1177/0886260520905546. Epub 2020 Feb 13.
People released from prison are a socially marginalized group and are at high risk of death from preventable causes, including violence. Despite this, little is known about the epidemiology of violence-related death (VRD) after release from prison. This knowledge is essential for developing targeted, evidence-informed violence prevention strategies. We examined VRDs among a representative sample of people released from prisons in Queensland, Australia, by sex and Indigenous status. Correctional records for all people (aged ≥17 years) released from prisons from January 1994 until December 2007 ( = 41,970) were linked probabilistically with the National Death Index. The primary outcome was VRD following release from prison. We calculated crude mortality rates (CMRs) and standardized mortality ratios (SMRs) standardized by age and sex to the Australian population. We used Cox regression to identify predictors of VRD. Of 2,158 deaths after release from prison, 3% ( = 68) were violence-related. The SMR for VRD was 10.0 (95% confidence interval (CI): [7.9, 12.7]) and was greatest for women (SMR = 16.3, 95% CI: [8.2, 32.7]). The rate of VRD was 2.5 deaths per 10,000 person-years (95% CI: [2.0, 3.2]) and was highest between 2 and 6 months after release from prison (CMR = 6.3, 95% CI: [3.4, 11.6]). Risk factors for VRD included short sentences (<90 days; for males and non-Indigenous people) and experiencing two or more imprisonments (for non-Indigenous people). No significant risk factors for VRD were identified for women or Indigenous people. People released from prison die from violence at a rate that is greatly elevated compared with the general population, with women experiencing the greatest elevation in risk. Reducing the number of VRDs in this population could improve the health and wellbeing of some of our most marginalized community members.
从监狱获释的人是一个社会边缘化群体，他们因可预防的原因（包括暴力）而死亡的风险很高。尽管如此，人们对从监狱获释后的与暴力相关的死亡（VRD）的流行病学知之甚少。这种知识对于制定有针对性的、基于证据的暴力预防策略至关重要。我们按性别和土著身份检查了澳大利亚昆士兰州从监狱获释的代表性人群中的 VRD。从 1994 年 1 月至 2007 年 12 月（= 41,970），对所有（年龄≥17 岁）从监狱获释的人的惩教记录进行了概率链接，并与国家死亡索引进行了链接。主要结果是从监狱获释后的 VRD。我们计算了粗死亡率（CMR）和标准化死亡率比（SMR），并根据年龄和性别对澳大利亚人口进行了标准化。我们使用 Cox 回归来确定 VRD 的预测因素。在从监狱获释后的 2158 例死亡中，有 3%（= 68）与暴力有关。VRD 的 SMR 为 10.0（95%置信区间（CI）：[7.9，12.7]），女性的 SMR 最高（16.3，95%CI：[8.2，32.7]）。VRD 的发生率为每 10000 人年 2.5 例死亡（95%CI：[2.0，3.2]），在从监狱获释后 2 至 6 个月之间最高（CMR = 6.3，95%CI：[3.4，11.6]）。VRD 的危险因素包括短期徒刑（<90 天；男性和非土著人）和两次或多次监禁（非土著人）。对于女性或土著人，没有发现 VRD 的显著危险因素。与普通人群相比，从监狱获释的人死于暴力的比率大大提高，其中女性的风险最高。减少这一人群中的 VRD 数量可以改善我们一些最边缘化社区成员的健康和福祉。
