Risk of death during the immediate post-release period among people released from New York City jails, 2001-2005

Several studies have identified a high risk of death among people recently released from prisons. Similar studies have not been conducted among jail populations. In the United States, nearly 7 million people are released from jails to the community annually; however, their risk of death upon release from jails is unknown. The purpose of this study is to assess the risk of suicide, homicide, and drug-related deaths during the post-release period among people released from New York City (NYC) jails.

This retrospective study included people who were released from NYC jails to the community between 2001 and 2005. NYC jail records were matched to the NYC death registry to identify deaths among people released from NYC jails. Mortality rates among formerly-incarcerated people were compared with those among other NYC residents using the Standardized Mortality Ratio (SMR). In addition, we conducted multivariate regression analysis to test whether any demographic or incarceration characteristics of the study cohort were associated with risk of death.

The cohort of 155,272 people was followed for an average of 2.5 years. We identified 219 drug-related deaths, 219 homicides, and 35 suicides. After adjusting for age, sex, race, and neighborhood characteristics, the relative risk of drug-related death and homicide among formerly-incarcerated people were 2 times higher than among other NYC residents. This high risk was greatly elevated during the first 2 weeks after release (SMR for drug-related causes = 8.0; 95% confidence interval (CI) = 5.2-11.8; SMR for homicide = 5.1; 95% CI = 3.2-7.8). No excess risk of suicide was seen during this time period. People living in low-income neighborhoods, relative to high-income neighborhoods, had higher rates of homicide. For those who died of drug-related causes, time detained in jail was negatively associated with time between jail release and death. An additional one-month stay in jail was expected to decrease the time between release and death by approximately 15 days.

Formerly-incarcerated people in NYC were at high risk of drug-related death and homicide, especially during the first 2 weeks after jail release. Further study is warranted to identify potential jail- and community-based interventions for formerly-incarcerated people at higher risk for death immediately post-release.