Norwegian Centre for Addiction Research, SERAF, University of Oslo, Oslo, Norway.
Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
Int J Epidemiol. 2024 Feb 14;53(2). doi: 10.1093/ije/dyae032.
Women carry a substantial burden of psychiatric, somatic and lifestyle-related morbidity in the prison context. By describing causes of death and estimating the risk and burden of mortality compared with the general population, this study investigates how mortality operates in this highly marginalized and under-researched population.
In this registry-based study of all women incarcerated in Norwegian prisons from 2000 to 2019 (N = 11 313), we calculated crude mortality rates, years of lost life and, by using mortality in age-matched women from the general population as a reference, age-standardized mortality ratios and years of lost life rates.
Over a mean follow-up time of 10.7 years, at a median age of 50 years, 9% of the population had died (n = 1005). Most deaths (80%) were premature deaths from an avoidable cause. Drug-induced causes and deaths from major non-communicable diseases (NCDs) were most frequent (both 32%). Compared with women in the general population, women with a history of incarceration were more likely to die from any cause. Trends in annual age-standardized years of lost life rates suggest that the mortality burden associated with major NCDs has gradually replaced drug-induced causes.
Women with a history of incarceration die at a greater rate than their peers and largely from avoidable causes. The profile of causes contributing to the substantial burden of mortality placed on this population has changed over time and has important implications for future efforts to reduce morbidity and the risk of premature death following release from prison.
在监狱环境中，女性承受着大量的精神疾病、躯体疾病和与生活方式相关的发病负担。通过描述死因，并估计与普通人群相比的死亡风险和负担，本研究调查了在这个高度边缘化和研究不足的人群中，死亡率是如何运作的。
在这项针对 2000 年至 2019 年期间所有被监禁在挪威监狱的女性（N=11313）的基于登记的研究中，我们计算了粗死亡率、生命损失年数，并通过将年龄匹配的普通人群中女性的死亡率作为参照，计算了年龄标准化死亡率比和生命损失年率。
在平均 10.7 年的随访期间，在中位数年龄为 50 岁时，9%的人群死亡（n=1005）。大多数死亡（80%）是可避免的原因导致的过早死亡。药物引起的原因和主要非传染性疾病（NCD）的死亡最为常见（均为 32%）。与普通人群中的女性相比，有监禁史的女性更有可能死于任何原因。年年龄标准化生命损失年率的趋势表明，与主要 NCD 相关的死亡负担逐渐取代了药物引起的原因。
有监禁史的女性的死亡率高于同龄人，且主要死于可避免的原因。导致这一人群死亡率负担巨大的原因的构成已经随着时间的推移而发生了变化，这对未来减少发病率和出狱后过早死亡风险的努力具有重要意义。
