Death rates higher for recently released inmates, study finds

Newly released prisoners in Washington are more than three times as likely to die than the rest of us in their first two years of freedom, University of Washington researchers have found.

It's worse in the first two weeks: They're nearly 13 times as likely to die — mostly from overdoses — than others in their same demographic groups.

The scientists called for stepped-up programs to help prisoners, both before and after they are released.

"We were very saddened by these results," said Dr. Ingrid Binswanger, who led the research on former inmates from Washington state prisons.

"I think during this time of transition — when they're trying to get housing, a source of income and reintegrating with their families — they are particularly vulnerable."

Drug overdoses comprised nearly a quarter of the 443 deaths of former inmates over about two years, and were especially prevalent during the first two weeks. But heart disease, homicide, suicide, cancer, liver disease and accidents also were leading causes of death.

The study is the first such look at the issue in the United States. It analyzed data on virtually every state prisoner released between 1999 and 2003, a total of 30,237.

Overall, men were 87 percent of those studied, and they were 3.3 times more likely to die than the rest of the population. But women were 5.5 times more likely to die, the researchers reported in today's edition of the New England Journal of Medicine.

Binswanger, now at the University of Colorado at Denver, and her colleagues said the study points to several factors that increase risks for released prisoners:

Many haven't had drugs in prison, so they have low tolerance for them and are more vulnerable to overdose. Many are exposed to guns and violence soon after release. Lung cancer is prevalent because prisons allowed smoking until only recently. And many prisoners are mentally ill and have trouble with the stress of re-entering society.

Dr. Marc Stern, health director for the state Department of Corrections and a co-author of the study, said he wasn't surprised by the study's findings but is still troubled. "They give us a lot of food for thought," he said.

Stern said there are several programs to help the 8,000 people who come out of state prisons every year.

One, for the potentially violent mentally ill, helps find them jobs, housing and health care, including substance-abuse treatment. Others, for all inmates, offer counseling and treatment for stress, anger problems and substance abuse. Others provides medication for the first 30 days after release or help eligible people get Medicaid benefits.

Still, Stern said, the programs should expand. He said a large part of Gov. Christine Gregoire's $25 million budget proposal for prisons would be for health care, especially addiction and mental-health counseling.

A bill introduced in the Legislature would improve educational, employment and treatment opportunities for newly released inmates. It also would create county or regional networks to help them re-enter society.

Binswanger, who formerly practiced at the Veterans Affairs Medical Center in Seattle, said she hopes next to focus more on prisoners' risk factors for dying after release and how programs could help them. She'll also look at how the research will apply to county jails and prisons in other states.

Warren King: 206-464-2247 or wking@seattletimes.com