Citation

Kinner SA, Borschmann R. JAMA Netw. Open 2024; 7(5): e249951.

Copyright

(Copyright © 2024, American Medical Association)

DOI

10.1001/jamanetworkopen.2024.9951

PMID

38728039

Abstract

Miller and colleagues1 applied national and international data on the suicide rate after release from incarceration to national jail releases to estimate the proportion of suicide deaths in the US that were among people recently released from jail. From an estimated 7.1 million jail releases in 2019, the authors estimated that 9121 people died by suicide within a year of release, accounting for 19.9% of all suicide deaths nationally. A further 7.3% of suicides were estimated to be among people in their second year after release from jail. These findings simultaneously highlight the extraordinary concentration of disease burden, including suicide deaths, among people who have experienced incarceration, and the need for greater investment in improving the health of this population.

Evidence of the exceptionally poor health outcomes among people who have experienced incarceration has been rapidly accumulating in the US and elsewhere.2,3 This population is distinguished by a high prevalence of complex, co-occurring health problems, typically set against a backdrop of entrenched social and economic disadvantage.3 Internationally, the rate of death due to many preventable causes appears to be elevated after release from incarceration, although to date prevention efforts have focused primarily on opioid overdose deaths. This focus is reasonable; our recent meta-analysis of linked incarceration and mortality records from 1.4 million individuals in 8 countries demonstrated that alcohol and other drug poisoning was the leading cause of death after release from incarceration, accounting for 21.4% of all deaths.4 Nevertheless, Miller and colleagues'1 focus on suicide, which also accounts for a large proportion of preventable deaths after incarceration in many countries, including 8.2% of the 75 427 recorded deaths in our meta-analysis,4 is commendable.

Although it is abundantly clear that people released from incarceration are at an increased risk of death from a range of preventable causes, including suicide, identifying the most effective ways of improving the health of these individuals is complex. Ongoing efforts to reverse mass incarceration in the US undoubtedly play a part, but given that incarceration appears to be primarily a marker for, rather than a cause of, preventable disease in at-risk populations,5 reducing incarceration alone will not be sufficient to prevent further untimely deaths. Commensurate efforts to achieve better health outcomes for people who experience incarceration are also essential. ...

Language: en

Keywords

*Prisoners/psychology/statistics & numerical data; *Suicide Prevention; Female; Humans; Incarceration; Male; Prisons; Suicide/statistics & numerical data/psychology; United States