Cunningham Ruth, King Paula Toko, Telfer Kendra, Crengle Sue, Carr Julia, Stanley James, Gibb Sheree, Robson Bridget
Department of Public Health, University of Otago, Wellington, New Zealand.
Te Rōpū Rangahau Hauora a Eru Pōmare, University of Otago, Wellington, New Zealand.
SSM Popul Health. 2022 Nov 1;20:101274. doi: 10.1016/j.ssmph.2022.101274. eCollection 2022 Dec.
People who enter and leave places of incarceration experience considerable health inequities and are at increased risk of premature death compared to the general population. Causes of premature death in this population vary markedly between countries and so country-specific information is needed. Additionally, there is a lack of large population-based studies which can disaggregate mortality risk based on person and incarceration factors. This study is the first examination of mortality in the period following release from incarceration in New Zealand.
We linked deidentified administrative data on incarceration and release between 1 January 1998 and 31 December 2016 with national mortality data for the same period to examine mortality after release in those who had been incarcerated for at least 1 day. Age standardised mortality rates and mortality ratios compared to the general New Zealand population were calculated separately for men and women, for releases from remand compared with prison, and by cause of death and time since release.
90,195 individuals (13% women, 49% Māori) were followed up for 9.4 years after release from incarceration, with 4,764 deaths over the follow-up period. The overall standardised mortality ratio was 3.3 (95% CI 3.2, 3.4) compared to the general population, and higher for women (3.8) than men (2.7). The most common causes of death were cardiovascular disease, cancer and suicide. Rates of death were similar following release from remand versus prison, however suicide rates were highest following release from remand. Regardless of the type of incarceration, mortality was highest in the first month after release.
Experience of incarceration in New Zealand is associated with high rates of mortality from both chronic conditions and external causes. There are urgent policy imperatives to recognise and actively address the increased health and mortality risks faced by people released from New Zealand prisons.
与普通人群相比，进出监禁场所的人面临着相当大的健康不平等，过早死亡风险也更高。该人群过早死亡的原因在不同国家之间差异显著，因此需要特定国家的信息。此外，缺乏基于大量人群的研究，无法根据个人和监禁因素对死亡风险进行分类。本研究首次对新西兰监禁释放后的死亡率进行了考察。
我们将1998年1月1日至2016年12月31日期间匿名的监禁和释放行政数据与同期的国家死亡率数据相链接，以考察至少被监禁1天的人释放后的死亡率。分别计算了男性和女性、还押释放与监狱释放相比、按死因和释放后的时间，与新西兰普通人群相比的年龄标准化死亡率和死亡率比。
90195人（13%为女性，49%为毛利人）在从监禁中释放后接受了9.4年的随访，随访期间有4764人死亡。与普通人群相比，总体标准化死亡率比为3.3（95%可信区间3.2,3.4），女性（3.8）高于男性（2.7）。最常见的死亡原因是心血管疾病、癌症和自杀。还押释放和监狱释放后的死亡率相似，然而还押释放后的自杀率最高。无论监禁类型如何，死亡率在释放后的第一个月最高。
在新西兰，监禁经历与慢性病和外部原因导致的高死亡率相关。迫切需要出台政策，以认识并积极应对从新西兰监狱释放的人所面临的健康和死亡风险增加的问题。
