title: Influence of offence type and prior imprisonment on risk of death following release from prison: a whole-population linked data study.
abstract: OBJECTIVE
  The purpose of this paper is to examine the influence of offence type, prior imprisonment and various socio-demographic characteristics on mortality at 28 and 365 days following prison release.
  
  
  METHODS
  Using whole-population linked, routinely collected administrative state-based imprisonment and mortality data, the authors conducted a retrospective study of 12,677 offenders released from Western Australian prisons in the period 1994-2003. Cox proportional hazards regression was used to examine the association between mortality at 28 and 365 days post-release and offence type, prior imprisonment, and a range of socio-demographic characteristics (age, gender, social disadvantage and Indigenous status).
  
  
  RESULTS
  Overall, 135 (1.1 per cent) died during the 365 days follow-up period, of these, 17.8 per cent (n=24) died within the first 28 days (four weeks) of their index release. Ex-prisoners who had committed drug-related offences had significantly higher risk of 28-day post-release mortality (HR=28.4; 95 per cent CI: 1.3-615.3, p=0.033), than those who had committed violent (non-sexual) offences. A significant association was also found between the number of previous incarcerations and post-release mortality at 28 days post-release, with three prior prison terms carrying the highest mortality risk (HR=73.8; 95 per cent CI: 1.8-3,092.5, p=0.024). No association between mortality and either offence type or prior imprisonment was seen at 365 days post-release.
  
  
  CONCLUSIONS
  Post-release mortality at 28 days was significantly associated with offence type (with drug-related offences carrying the greatest risk) and with prior imprisonment, but associations did not persist to 365 days after release. Targeting of short-term transitional programmes to reduce preventable deaths after return to the community could be tailored to these high-risk ex-prisoners.
authors.affiliation: School of Population Health, The University of Western Australia, Crawley, Australia.
authors.forename: Khadra Abdi
authors.initials: KA
authors.lastname: Jama-Alol
authors.forename: Eva
authors.initials: E
authors.lastname: Malacova
authors.forename: Anna
authors.initials: A
authors.lastname: Ferrante
authors.forename: Janine
authors.initials: J
authors.lastname: Alan
authors.forename: Louise
authors.initials: L
authors.lastname: Stewart
authors.forename: David
authors.initials: D
authors.lastname: Preen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003415:Crime / Q000145:classification* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D011329:Prisoners / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D014904:Western Australia / Q000453:epidemiology; D044465:White People; D055815:Young Adult
keywords: Elderly prisoners; Illicit drugs; Offender health; Prison; Prisoners; Recidivism