Natural deaths in male prisoners: a 20-year mortality study

Background: Although morbidity is high in prisoners compared with the general population, uncertainty exists over rates for natural causes of death. We investigated natural deaths in prisons in England and Wales over a 20-year period. Methods: All men who died in English and Welsh prisons from 1978-...

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Main Authors: Fazel, S, Benning, R
Format: Journal article
Language:English
Published: Oxford University Press 2006
Subjects:
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author Fazel, S
Benning, R
author_facet Fazel, S
Benning, R
author_sort Fazel, S
collection OXFORD
description Background: Although morbidity is high in prisoners compared with the general population, uncertainty exists over rates for natural causes of death. We investigated natural deaths in prisons in England and Wales over a 20-year period. Methods: All men who died in English and Welsh prisons from 1978-1997 were identified. All deaths received a post-mortem. Death certificates were obtained to provide mortality information according to ICD-9. Standardised mortality ratios (SMRs) for major causes of natural death were calculated in those <60 years. Results: 574 male prisoners died in custody from natural deaths, of which 307 (53%) deaths were from circulatory diseases and 91 (16%) from respiratory causes. Overall, SMRs for natural deaths were significantly lower than the general population (SMR = 0.70; 95% CI = 0.65-0.76). However, SMRs from respiratory pneumonia (SMR = 2.35; 1.75-3.16) and from other infectious causes were higher (SMR = 1.52; 1.03-2.23). Conclusion: There are important methodological challenges in calculating SMRs in prisoners. Bearing these in mind, we found increased mortality ratios for respiratory pneumonia and other infections. These findings highlight the need for the screening and effective treatment of infectious diseases in prisoners.
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spelling oxford-uuid:da51606e-15d6-4c2b-8910-637eb390e07a2022-03-27T09:02:22ZNatural deaths in male prisoners: a 20-year mortality studyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:da51606e-15d6-4c2b-8910-637eb390e07aPsychiatryEnglishOxford University Research Archive - ValetOxford University Press2006Fazel, SBenning, RBackground: Although morbidity is high in prisoners compared with the general population, uncertainty exists over rates for natural causes of death. We investigated natural deaths in prisons in England and Wales over a 20-year period. Methods: All men who died in English and Welsh prisons from 1978-1997 were identified. All deaths received a post-mortem. Death certificates were obtained to provide mortality information according to ICD-9. Standardised mortality ratios (SMRs) for major causes of natural death were calculated in those <60 years. Results: 574 male prisoners died in custody from natural deaths, of which 307 (53%) deaths were from circulatory diseases and 91 (16%) from respiratory causes. Overall, SMRs for natural deaths were significantly lower than the general population (SMR = 0.70; 95% CI = 0.65-0.76). However, SMRs from respiratory pneumonia (SMR = 2.35; 1.75-3.16) and from other infectious causes were higher (SMR = 1.52; 1.03-2.23). Conclusion: There are important methodological challenges in calculating SMRs in prisoners. Bearing these in mind, we found increased mortality ratios for respiratory pneumonia and other infections. These findings highlight the need for the screening and effective treatment of infectious diseases in prisoners.
spellingShingle Psychiatry
Fazel, S
Benning, R
Natural deaths in male prisoners: a 20-year mortality study
title Natural deaths in male prisoners: a 20-year mortality study
title_full Natural deaths in male prisoners: a 20-year mortality study
title_fullStr Natural deaths in male prisoners: a 20-year mortality study
title_full_unstemmed Natural deaths in male prisoners: a 20-year mortality study
title_short Natural deaths in male prisoners: a 20-year mortality study
title_sort natural deaths in male prisoners a 20 year mortality study
topic Psychiatry
work_keys_str_mv AT fazels naturaldeathsinmaleprisonersa20yearmortalitystudy
AT benningr naturaldeathsinmaleprisonersa20yearmortalitystudy