In prison, any sentence can be a death sentence

November 11, 2002

Peter Ford and colleagues report in this issue of CMAJ that male prison inmates in either provincial or federal prisons in Ontario have a "significantly higher" rate of death than those not in custody.

Wobeser and colleagues examined causes of death (violent and natural) among people in custody in Ontario and compared those findings across 3 custodial systems (federal penitentiaries, provincial prisons and police cells). The authors found that a total of 308 inmates died in custody between 1990 and 1999. Of the 283 deaths involving men, well over half (168) were due to violent causes: suicide by strangulation (90), poisoning or toxic effect (48), and homicide (16). Natural causes accounted for 115 of the deaths, with cardiovascular disease being the most common cause (62) followed distantly by cancer (18 cases).

"The most striking difference was with violent deaths, with overdose being 50 and 20 times more common in the federal and provincial inmate populations, respectively, than in the general male population," write the authors.

In a related editorial, Stefan Fruehwald and Patrick Frottier compare the findings of Wobeser et al with previous findings from around the world and recommend further work be done to find out more about individual risk factors, precursors of deaths and preventive factors.
p. 1109 Causes of death among people in custody in Ontario, 1990-1999 -- W.L. Wobeser et al
p. 1127 Death behind bars -- S. Fruehwald, P. Frottier

Canadian Medical Association Journal

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