Death rates for state prison inmates, especially blacks, are lower in prison on average than they are for people on the outside, according to a new report from the Bureau of Justice Statistics. Inside prison, inmates are dying at a rate of 250 per 100,000, compared to 308 per 100,000 in the free world.

For black inmates, the rate was 57 percent lower than among the overall black population - 206 versus 484 per 100,000. On the other hand, white and Hispanic prisoners both had death rates slightly above their counterparts in the overall population.

Between 2001 and 2004, State prison authorities nationwide reported a total of 12,129 State prisoner deaths to the Deaths in Custody Reporting Program (DCRP). According to the BJS press release:

Nearly 9 in 10 of these deaths (89 percent) were attributed to medical conditions. Fewer than 1 in 10 were the result of suicide (6 percent) and homicide (2 percent), while alcohol/drug intoxication and accidental injury accounted for another 1 percent each. A definitive cause could not be determined for 1 percent of these deaths.

This information was obtained from individual death records collected under the Death in Custody Reporting Act of 2000. These records provide the first national data on personal characteristics of inmates who died in custody and the circumstances of the deaths. Detailed data tables on the topics covered in this report are available as appendix tables on the BJS website.

State Prison Deaths

Among State prisoner deaths:

• Half were the result of heart diseases and cancer

• Two-thirds involved inmates age 45 or older

• Two-thirds were the result of medical problems which were present at the time of admission

• 40 percent occurred in 5 States (Texas, California, Florida, New York, and Pennsylvania)

• Over 90 percent were evaluated by medical staff for the fatal illness; 93 percent received medications for the illness.

Comparative Rates

Comparative mortality rates showed:

• Male State prisoners had a death rate 72 percent higher than female State prisoners

• State prisoners had a 19 percent lower death rate than the adult U.S. resident population; among blacks, the mortality rate was 57 percent lower among prisoners.

Heart Diseases and Cancer

Correctional authorities reported over 60 different fatal medical conditions, but prisoner deaths were heavily concentrated among a small number of diseases. Heart diseases (27 percent), including heart attacks, and cancer (23 percent) caused half of all State prisoner deaths from 2001 to 2004. When combined with liver diseases (10 percent) and AIDS-related causes (7 percent), two-thirds of all State prisoner deaths were caused by these four medical conditions.

Death Rates Higher Among Men

While the leading causes of death were the same for both men and women in State prisons, men died at a much higher rate than women. The mortality rate of men for all causes of death (257 deaths per 100,000 inmates) was 72 percent higher than that of women (149 deaths per 100,000 inmates). For the top three causes of death (heart diseases, cancer, and liver diseases), the male death rate was twice the female rate. Septicemia (for example, streptococcal and staphylococcal infection) was the lone cause of death that was higher among female State prisoners (10 deaths per 100,000) than male State prisoners (5 per 100,000).

White Death Rate Higher

Between 2001 and 2004 the mortality rates of black and Hispanic State prisoners were identical (206 deaths per 100,000 inmates), while the rate for white inmates (343 per 100,000) was 67 percent higher. For heart diseases and cancer, the mortality rate of whites was nearly twice that of blacks and Hispanics. Despite higher mortality rates for most leading causes of death, white inmates had a lower AIDS-related death rate (10 per 100,000) than black (26 per 100,000) and Hispanic (18 per 100,000) State prisoners.

Two-thirds of State prison deaths involved inmates age 45 or older.

Mortality rates rose dramatically with age. The death rate of inmates age 55 and older (1,973 per 100,000) was over 3 times higher than that of inmates age 45-54 (566 per 100,000), and 11 times higher than those age 35-44 (177 per 100,000). Inmates age 45 or older comprised 14 percent of State prisoners from 2001 to 2004, but accounted for 67 percent of all inmate deaths over the same period.

Unlike the leading fatal illnesses, suicide rates were stable across all adult age groups. While suicide was the leading cause of death for inmates under the age of 35, it fell far behind several illnesses as a cause of death for older inmates. Among inmates age 55 or older, there were 46 heart disease deaths and 42 cancer deaths for each suicide.

Elderly State Prisoners

Among older inmates, the mortality rate of those age 65 or older was particularly high. Though these elderly inmates made up 1 percent of prisoners, they accounted for 15 percent of prisoner deaths. The mortality rate of elderly prisoners was nearly 3 times higher than that of inmates age 55-64. The death rate for aortic aneurysm was 6 times higher among elderly inmates than those age 55-64; for respiratory diseases, the rate was 5 times higher.

Deaths of elderly inmates typically did not involve offenders who had been incarcerated as young adults on lengthy (or "life") sentences. A majority (59 percent) of the elderly State prisoners who died during this period were 55 or older when admitted, and 85 percent were at least 45 years old at time of admission.

Illness Increased With Time Served
The death rate from illness rose sharply for prisoners serving lengthy terms. For inmates who had served at least 10 years in State prison, the mortality rate due to illness (503 deaths per 100,000 inmates) was triple that of inmates who had served less than 5 years in prison (162 per 100,000). Long-serving inmates showed similar increases in death rates for many of the leading fatal illnesses. AIDS-related causes had the smallest increase in mortality for long-serving inmates.

See Also:
State Inmates Outlive People on Outside
Medical Causes of Death in State Prisons, 2001-2004
Prison System The Prison and Parole System