Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
Lancet Public Health. 2022 Jul;7(7):e583-e592. doi: 10.1016/S2468-2667(22)00107-4.
Incarceration might contribute to increased mortality in an already marginalised population. A better understanding of the prison-related factors that are associated with mortality is important for preventing the negative health consequences of incarceration. We aimed to investigate all-cause and cause-specific mortality following release from high-security and low-security prisons.
In this retrospective national cohort study, we used data from the Norwegian Prison Release study (nPRIS), which includes complete national register data for 96 859 individuals from the Norwegian Prison Register linked to the Norwegian Cause of Death Register from Jan 1, 2000, to Dec 31, 2016. The study cohort included all people in Norway released from a high-security or low-security prison unit. Cause of death was categorised into internal causes (infectious, cancerous, endocrine, circulatory, respiratory, digestive, nervous system diseases, and mental health disorders) and external causes (accidents, suicides, and homicides) according to the 10th revision of the International Classification of Diseases. We calculated crude mortality rates (CMR) and estimated Cox proportional-hazards models.
There were 151 790 releases in the study period (68·4% from low-security and 31·6% from high-security prisons) from 91 963 individuals. The overall CMR was 854·4 [95% CI 834·7-874·2] per 100 000 person-years (436·2 [422·1-450·3] per 100 000 person-years for internal causes and 358·3 [345·5-371·1] per 100 000 person-years for external causes). The overall post-release mortality rate was higher in those released from high-security prisons (1142·5 [95% CI 1102·6-1182·5] per 100 000 person-years) than in those released from low-security prisons (714·6 [692·6-736·6] per 100 000 person-years). Our results suggest an association between release from high-security prisons and elevated mortality due to both external causes (adjusted hazard ratio [aHR] 1·75 [95% CI 1·60-1·91]) and internal causes (1·45 [1·33-1·59]), compared to release from low-security prisons.
Imprisonment and the post-release period can be an important point for public health interventions. Particular attention to health is warranted for individuals incarcerated in and released from high-security prisons. The potential impact of both individual-level characteristics of people incarcerated in high-security facilities, and of the prison environment itself, on mortality outcomes, should be investigated further.
The South-Eastern Norway Regional Health Authority and The Norwegian Research Council.
监禁可能会导致已经处于边缘地位的人群死亡率上升。更好地了解与死亡率相关的监狱相关因素对于预防监禁对健康的负面影响非常重要。我们旨在调查从高度安全和低度安全监狱获释后的全因和病因特异性死亡率。
在这项回顾性全国队列研究中，我们使用了挪威监狱释放研究（nPRIS）的数据，该研究包括来自挪威监狱登记处的完整的全国登记数据，涉及从 2000 年 1 月 1 日至 2016 年 12 月 31 日与挪威死因登记处相关联的 96319 个人。研究队列包括从高度安全或低度安全监狱单位获释的所有人。死因根据《国际疾病分类》第 10 次修订版分为内部原因（传染性、癌症、内分泌、循环、呼吸、消化、神经系统疾病和心理健康障碍）和外部原因（意外、自杀和凶杀）。我们计算了粗死亡率（CMR）并估计了 Cox 比例风险模型。
在研究期间（68.4%来自低度安全监狱，31.6%来自高度安全监狱）有 151790 人获释，共有 91963 人。总体 CMR 为每 100000 人年 854.4[95%CI 834.7-874.2]（每 100000 人年 436.2[422.1-450.3]为内部原因，每 100000 人年 358.3[345.5-371.1]为外部原因）。从高度安全监狱获释的人的总体死亡率高于从低度安全监狱获释的人（每 100000 人年 1142.5[95%CI 1102.6-1182.5]）。我们的结果表明，与从低度安全监狱获释相比，从高度安全监狱获释与外部原因（调整后的危险比[aHR]1.75[95%CI 1.60-1.91]）和内部原因（1.45[1.33-1.59]）导致的死亡率升高之间存在关联。
监禁和释放后的时期可能是公共卫生干预的重要时期。需要特别注意监禁和从高度安全监狱获释的人的健康。应该进一步调查监禁在高度安全设施中的个人的个体特征以及监狱环境本身对死亡率结果的潜在影响。
南挪威地区卫生局和挪威研究理事会。
