Does Prison Crowding Predict Higher Rates of Substance Use Related Parole Violations? A Recurrent Events Multi-Level Survival Analysis.
OBJECTIVE
This administrative data-linkage cohort study examines the association between prison crowding and the rate of post-release parole violations in a random sample of prisoners released with parole conditions in California, for an observation period of two years (January 2003 through December 2004).


BACKGROUND
Crowding overextends prison resources needed to adequately protect inmates and provide drug rehabilitation services. Violence and lack of access to treatment are known risk factors for drug use and substance use disorders. These and other psychosocial effects of crowding may lead to higher rates of recidivism in California parolees.


METHODS
Rates of parole violation for parolees exposed to high and medium levels of prison crowding were compared to parolees with low prison crowding exposure. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using a Cox model for recurrent events. Our dataset included 13070 parolees in California, combining individual level parolee data with aggregate level crowding data for multilevel analysis.


RESULTS
Comparing parolees exposed to high crowding with those exposed to low crowding, the effect sizes from greatest to least were absconding violations (HR 3.56 95% CI: 3.05-4.17), drug violations (HR 2.44 95% CI: 2.00-2.98), non-violent violations (HR 2.14 95% CI: 1.73-2.64), violent and serious violations (HR 1.88 95% CI: 1.45-2.43), and technical violations (HR 1.86 95% CI: 1.37-2.53).


CONCLUSIONS
Prison crowding predicted higher rates of parole violations after release from prison. The effect was magnitude-dependent and particularly strong for drug charges. Further research into whether adverse prison experiences, such as crowding, are associated with recidivism and drug use in particular may be warranted.
College of Osteopathic Medicine, Touro University California, Vallejo, California, United States of America; Public Health Program, Touro University California, Vallejo, California, United States of America.
Michael A
MA
Ruderman
Public Health Program, Touro University California, Vallejo, California, United States of America.
Deirdra F
DF
Wilson
Department of Epidemiology, University of Nevada, Las Vegas, Nevada, United States of America.
Savanna
S
Reid
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult; D002140:California / Q000453:epidemiology; D003441:Crowding / Q000523:psychology; D015995:Prevalence; D011329:Prisoners / Q000523:psychology / Q000706:statistics & numerical data; D011330:Prisons; D012112:Residential Facilities; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology; D016019:Survival Analysis; D014754:Violence / Q000523:psychology / Q000706:statistics & numerical data