Tuesday, January 23, 2007

Dying For Some Data

I want to thank Steve of OmniBrain for posting this information on his blog; the Bureau of Justice Statistics just released the data this month and he saw the press release.

The BJS published all-cause mortality data on American prisoners from 2001 to 2004.This is the first comprehensive report of mortality since the Death in Custody Report Act was established to set up this surveillance system. This is what they found:

Almost all (89%) of deaths were due to medical conditions and these medical conditions were present prior to incarceration. Almost all inmates had been seen by a physician and were in treatment at the time of their deaths. Almost half the deaths between 2001 to 2004 happened in five state systems: California, Florida, New York, Texas and Pennsylvania. The states with the lowest mortality rates were: Vermont, Alaska, Iowa, North Dakota and Utah.

The mortality rate for American prisoners was 19% lower than for adults in free society. For African Americans the prison mortality rate was 57% lower than free society. Prison death rates increased with age and were highest in inmates 45 years old and older. The average annual suicide rate was 15 per 100,000 (essentially unchanged over the past 20 years).


Here's the age-matched mortality rate comparison between prisoners and state residents. Mortality rates invert between the two after age 45, when mortality for prisoners is higher than among residents.

There's a lot to chew on here. This report does not include mortality data for jails, which apparently is going to be reported separately. The full report can be found here. I'm sure you were dying to know this.


Sarebear said...

I would imagine that prisons are not easy on the older population. That seems to be borne out in the statistics, but of course there could be all sorts of reasons. I'd bet that its a large factor, though.

Well, should I be incarcerated, at least I'm in the lower mortality states you list for what the stats are discussing.

NOT that I'm planning on being incarcerated!

The thing is, when manic, EXTREMELY manic, ideas of doing things run through me, and the potential thrill/charge/recklessness (ie, desirability, because when manic, the more what the hell the better is the feeling inside me) seems to be in large part measured by, do they arrest people for this . . .

So while I'm not PLANNING on ever being incarcerated, and don't ever want to be, it just may be that one of these years you hear about not so 'lil ole me, very conservative me, being arrested for, well, okay, I'm not going to say what runs through my head.

It's embarassing. Thankfully, that level of mania is pretty rare for me, I'd say not even once a year, well, it's hard to say since I've been on meds. Nothing even close since I've been on meds.

Dagnabbit I'm going on and on. And I'm NOT trying to say that the reckless crap that goes through my head when manic to that level, is desirable, at all. Just that that is my point of view in that state of mind.

Urk, you, of course, know all that, being a shrink.

ANYWAY! Should I ever be in the clink, it's nice to see my state in the more positive area of the stats. I never want to be there, though. EVER EVER!!!

Sarebear said...

Um, obviously prisons (except maybe the Martha Stewart style ones) aren't easy on anyone. I meant harder on the older people, than on the younger. you know what I mean.

I'm posting so much here, I feel like a mascot or something.


*claps hands over mouth to prevent further fowl language*

NeoNurseChic said...

So out of curiosity, do you know why some states have higher mortality rates? I'm even more curious because Pennsylvania is in the top 5 and this is where I live. So I suspect that if I'm going to get arrested, then maybe I should move elsewhere! haha j/k I mean - does that mean that in PA more older people are doing heinous crimes or that cops are picking on older people whereas in other states they'd say, "Oh it's okay - you're a little old lady - I'm gonna let you get away with that bank robbery, Mrs. Jones..." (I'm not being serious really! I can't sleep and it's 5:15am...I have only slept for about 30 minutes tonight...so forgive my brain! lol)

On a serious note, I really am curious as to why these states have such higher mortality stats... I mean, what gives? Higher prison population overall? Does that mean they are tougher on crime (red states some of them?) or that they just have "badder" citizens? It's interesting to this civilian at least!

Now - I've nearly been arrested a couple of times. The one time was when I was in Florida, and I note that's another one that made the top 5 there! I don't know if I've shared this story before, but it's funny. I was in Sarasota visiting my grandparents, and my best friend Cathy had come with me. (Cathy now lives in Maryland actually....about 30 minutes from Annapolis) So then 4 of our guy friends were down nearby on their own vacation and came up to my grandparents' place to spend the evening with us. We decided to shoot some fireworks off on the beach (I've seen this done dozens of times over the years...), but we didn't know that it was a dry season and that it's illegal to shoot fireworks off during a dry season in Florida!! (Afterall, we were shooting them over the water!!) So anyhow - this cop comes up to us and shines this bright flashlight in our faces and says, "Didn't I tell you kids not to do this before? People up the beach are complaining!" No...this was our first time ever shooting off fireworks on the beach! lol Of course, when he asked who we were with, all of my friends turned and pointed to me and said, "Her." At which point, Cathy grabbed my hand, and I was bound and determined that if I was going down, they were too!! In the end, the cop lectured us and said, "Well....since you're foreigners from Pennsylvania, I won't arrest you....this time! But don't you kids let me find you doing this again, ya hear?" Whew...close call man. Good thing I'm a foreigner...ha! Just a couple of weeks ago, I was at one of my guy friend's houses for a party and so 3 of us ended up being there from the fireworks scandal....the story came up and we all were laughing again. They were reminding me of parts I didn't even remember, and it was nice to hear it from their perspectives!!

The other time was actually just the other day!! I haven't seen Cathy in quite awhile now - can't even remember when the last time was. She was coming up, and I was going to meet her for lunch. A fire alarm had gone off here in my apartment building that morning, so I was running late, but Cathy couldn't budge on the time to meet me, so I tell her I'll make it - I'll just drive faster. (Famous last words...) So I get nailed doing 85mph on 202S... The cop pulls me over, and I'm shaking like a leaf trying to pull my license out and find my registration and insurance stuff. To make matters worse, I had an old registration in my car...not the current one, even though the stickers were up to date. I think he saw what a nervous wreck I was becoming (and I was dressed nicely and had Tony in his crate in the passenger seat...), and he kept saying over and over how he wasn't going to yell at me. Then finally he points out how badly I'm shaking and says, "Are you just nervous? Are you okay?" I could barely squeak out that I was just nervous... He again reassures me that I'm going to be fine and he's not going to yell at me, and takes my things. I call Cath on the phone and tell her (she's now sitting in her car at my house) to go in and sit with the dog - that I've been pulled over for speeding. I told her how fast I was going and then started musing about possibly losing my license and getting arrested for going over 25mph above the legal limit. I gave Cathy our garage door code, and after I got off the phone, I burst into tears. She later told me she was stressing that I wouldn't call back and she was imagining me getting led off in handcuffs... I was crying with the same worry, even though at that point, I didn't think the cop would do it to me. But still - I have the worst luck! He came back and handed me my papers (by this time, I've gotten out a pack of tissues and mascara is running down my cheeks...). He said he wrote me the ticket for 60mph...just 5mph above, so I wouldn't get any points, but I'd still have to pay the fine. (Around $117 I think...) I thanked him, apologized for speeding, thanked him again, and slowly drove the rest of the way home... I told the 'rents I was only going 70. Hope they never read this!! If I post the story on my blog, it's gonna say 70 or 75! lol

And if I had been arrested, I would have told them that I needed psychiatric services, and they had better call my buddy clinkshrink! haha ;)

Sorry for the long, really off topic tale... I can't sleep and my brain is wandering and in that overtired comical mode. Gonna try to get some shuteye - at least I have today off - just have my own psychiatry appt at 1:30 or something like that. Take care!

And I truly am interested in your theories on why states have higher and lower mortality rates...

Carrie :)

ClinkShrink said...

My guess is the difference between states is due to the rates of disease in the populations they're coming from. If you look at the overall numbers (the PDF link has the full report) what you see is that the southern prisons systems tend to have higher mortality rates than the western prison systems, which is kind of what you see when you look at national health patterns for things like obesity. The exciting thing though is that now we actually have some data that we can use to start thinking about this stuff---something is happening here that decreases mortality substantially for blacks. We need to figure out what it is and replicate it in free society.

SareBear, I doubt you'll ever end up in jail. But if you end up in my jail I'll get you a good cellmate. They have pretty pink jumpers.

Midwife with a Knife said...

I suspect that the decreased mortality (especially in aftrican americans) is going to end up being due to their actually getting health care and getting routine meds like antihypertensives.

If we could test this hypothesis by providing routine preventative health care for a free (non-imprisioned population and follow mortality rates, that would be great. Expensive study, though.

(I suppose there's the lack of things like car accidents too.. not that accidental death is impossible in prison, it just seems like it would be less likely in a controlled environment).

Did they do any stratification by cause of death for the different populations?

ClinkShrink said...

Great question MWAK, and yes they did stratify cause by race. I read it pretty fast but I recall whites were more likely to die of cancer and heart disease and non-whites from other causes (the cause list for all deaths was quite long).

I'd guess part of the longevity was also due to something stupidly simple and inexpensive, like basic patient education about the disease and the purpose of the treatment. A huge number of folks I see don't have basic information about hypertension & diabetes (eg. "I know I don't have high blood pressure because I feel alright so why should I take this medicine? I never took medicine on the outside.").

My folks need education on their psych disorders too. Some of them have never been told (or didn't remember) info like the natural course of the disease without treatment & usual length of time for maintenance therapy. A little information goes a long way.

NeoNurseChic said...

I think one other area to consider is that when you've got the inmates in prison, each one is one less person who is out there on the streets - especially when it comes to gang populations or those who might have ended up staring down the barrel of a gun. I don't know how much those numbers have an effect here - but I can say that last year, Philadelphia had over 400 murders. This year, we've had more murders than days of the year. But imagine if some of the guys (and gals? but more likely guys here...) in prison were out on the streets. Perhaps some are protected from death simply because they're out of that environment.

I know that is just one very small sect of the population, but I would think those numbers would matter when you're considering large city populations...

Any thoughts on that? I know gang deaths are still possible on the inside, but I would still think that perhaps the risk is less....

Take care!
Carrie :)

ClinkShrink said...

I think you're right Carrie, it's probably a combination of being in a (relatively) safer environment and being offered healthcare. I'm not sure how you'd sort out the two, except to maybe compare longevity between healthy inmates and healthy free society age cohorts.