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Death in prison: changing mortality patterns among male prisoners in Maryland, 1979-87

M E Salive1, G S Smith, T F Brewer

  • 1Department of Health Policy and Management Johns Hopkins School of Hygiene and Public Health.

Insights

Leading causes of death in Maryland prisons from 1979-87 included circulatory disease and suicide. Acquired immunodeficiency syndrome (AIDS) emerged as the top cause by 1987, while homicides and drug overdose deaths decreased.

Area of Science:

  • Public Health
  • Epidemiology
  • Criminology

Background:

  • Understanding mortality trends in correctional facilities is crucial for public health policy.
  • Previous data on leading causes of death in Maryland state prisons during the specified period is limited.
  • The emergence of Acquired immunodeficiency syndrome (AIDS) presented a significant challenge to healthcare within prisons.

Purpose of the Study:

  • To identify the primary causes of mortality among inmates in Maryland state prisons between 1979 and 1987.
  • To analyze trends in specific causes of death, including infectious diseases, suicide, and drug-related fatalities.
  • To compare all-cause mortality rates in male inmates to the general male population in Maryland.

Main Methods:

  • Retrospective analysis of mortality data from Maryland state prisons spanning 1979-1987.
  • Calculation of death rates per 100,000 prisoner-years for various causes.
  • Age and race adjustment for comparing inmate mortality to the general population.

Main Results:

  • Circulatory system disease (59 per 100,000 prisoner-years), suicide (40), and homicide/legal intervention (30) were the leading causes of death.
  • Acquired immunodeficiency syndrome (AIDS) became the leading cause of death by 1987.
  • Homicides declined post-1980, and drug overdose deaths peaked in 1981 before disappearing; male inmates showed lower age/race-adjusted all-cause mortality than the general population.

Conclusions:

  • Mortality profiles in Maryland prisons evolved significantly during the 1980s, with AIDS becoming a dominant cause.
  • Specific causes like homicide and drug overdose showed declining or transient trends.
  • Male inmates exhibited a lower overall mortality rate compared to the general population when adjusted for age and race.

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