Research Activities, November 2012: Disparities/Minority Health: Studies find emotional and health problems and elevated deaths among recently released prisoners

Research Activities, November 2012: Disparities/Minority Health: Studies find emotional and health problems and elevated deaths among recently released prisoners

Studies find emotional and health problems and elevated deaths among recently released prisoners

Two studies by Ingrid A. Binswanger, M.D., M.P.H, of the University of Colorado School or Medicine, and colleagues reveal that recently released inmates face considerable health problems and risk of early death following release from prison. The studies, supported by the Agency for Healthcare Research and Quality (HS19464), are briefly described here.


Binswanger, I.A., Nowels, C., Corsi, K.F., and others (2011). "From the prison door right to the sidewalk, everything went downhill. A qualitative study of the health experiences of recently released inmates." International Journal of Law and Psychiatry 34, pp. 249-255.

In this study, the researchers investigated the transition from prison to the community and its health consequences as perceived by individual prisoners. International studies have demonstrated a high risk of death after release from prison. To better understand this risk, the researchers created a conceptual model of the transitional experience focusing on four elements: (1) transitional challenges, (2) cognitive responses to these challenges, (3) emotional elements of responses to the transition, and (4) the health behaviors and outcomes that occurred during or as a result of the transitional period. The interviews with 29 recently released inmates from Colorado prisons revealed that the former inmates faced multiple systems challenges such as difficulties in locating jobs, places to live, and health care providers.
This struggle was combined with negative emotional reactions, which were likely contributors to poor health outcomes, including suicidality and worsened medical conditions. Health-related behavior occurred in the context of a complex life experience, with logistical problems exacerbated by emotional distress. Furthermore, a lack of medication continuity likely contributed to significant worsening in psychiatric symptoms. The researchers recommend that correctional medical and mental health providers develop and implement structured transition plans for patients being released in consultation with the providers who will assume their care in the community.


Binswanger, I.A., Blatchford, P.J., Lindsay, R.G., and Stern, M.F. (2011). "Risk factors for all-cause, overdose and early deaths after release from prison in Washington state." Drug and Alcohol Dependence 117, pp. 1-6.

To understand the epidemiology of death after release from prison, the researchers examined the risk factors for all-cause mortality, overdose mortality, and early deaths after prison release. Although high mortality rates after release from prison have been well-documented, little is known about the risk factors for these deaths. The researchers found that older age contributed to a higher risk of all-cause mortality, whereas longer incarceration time was associated with a lower risk of death. Among recently released inmates under age 50, the danger of overdose death and death within 30 days was higher for each additional decade of age. Gender and community supervision (e.g., parole) were not significantly associated with risk of death in this study. The researchers call for intervention to reduce deaths among former inmates.

— MWS