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Postrelease mortality among persons hospitalized during their incarceration
David L Rosen1, Andrew L Kavee2, Lauren Brinkley-Rubinstein3
1Division of Infectious Diseases, Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill.
Annals of Epidemiology
|April 25, 2020
Summary
People hospitalized during incarceration face higher postrelease mortality. This vulnerable group, identified by prison hospitalization, requires targeted health interventions for continuity of care after release.
Area of Science:
- Public Health
- Health Services Research
- Corrections Health
Background:
- Postrelease health and mortality of incarcerated individuals are gaining attention.
- Limited data exists on the postrelease outcomes of those hospitalized during incarceration.
Purpose of the Study:
- To examine postrelease mortality among individuals released from the North Carolina (NC) state prison system.
- To investigate the association between history of prison hospitalization and postrelease mortality.
Main Methods:
- A cohort study of individuals released from NC state prisons between January 1, 2008, and June 30, 2015.
- Follow-up for mortality occurred from 2008 to 2016, comparing those with and without a history of prison hospitalization.
Main Results:
- Among 111,479 released individuals, 0.9% (1010) were hospitalized during incarceration.
- Those hospitalized in prison had a significantly higher postrelease death rate (aHR: 2.44) and were more likely to die from chronic causes (79.2%) compared to others (51.0%).
- The postrelease mortality rate for men hospitalized in prison was 3.1 times higher than for non-hospitalized men and 7.1 times the rate of all NC men.
Conclusions:
- Individuals hospitalized during incarceration represent a vulnerable, identifiable population for targeted postrelease health interventions.
- Ensuring continuity of care for this group is crucial but may be challenging in states like NC that have not expanded Medicaid.
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