Is the high mortality risk in sentenced offenders independent of previous imprisonment?

Eur J Epidemiol 25(4):237-43 (2010) PMID 20213341

The mortality in prisoners is high. However, our knowledge about the mortality in convicted offenders, irrespective of incarceration history, is limited. Our aim was to investigate possible predictors for over-all and cause specific mortality in a nation-wide study of convicted offenders with and without previous imprisonment. This case-control study drew random samples of deceased and living offenders (N = 1,112) from four complete cohorts of convicted offenders, two male (born 1967 and 1977, respectively), and two female (born 1967-70 and 1977-80, respectively). All criminal records were systematized and information about date and cause of death was collected on those deceased. Multivariable analyses demonstrated that age at first court conviction (OR = 0.88, 95% CI = 0.84-0.93), drug related crimes (OR = 1.99, 95% CI = 1.23-3.22), and crime diversity (1.51, 95% CI = 1.07-2.13) were significant predictors of premature death in males. In females, age at first court conviction (OR = 0.92, 95% CI = 0.88-0.97), drug related crimes (OR = 2.24, 95% CI = 1.37-3.69) and belonging to the oldest cohort (OR = 2.10, 95% CI = 1.35-3.26) were significant predictors of premature death. Age at first court conviction remained a significant predictor for death in all cause specific multivariable mortality analyses. In addition, having committed drug related crimes and high crime diversity were strong predictors for substance related deaths. Males did more often die in accidents or commit suicide. Somatic deaths were most often encountered in the oldest cohort. Incarceration did not remain a significant predictor for premature death in any of the multivariable analyses. Measures intended to prevent premature death in convicted offenders should target wider populations than hitherto acknowledged.