Causes of Death: Prison vs. the Free World

(Published on Huffington Post)

Prison is a violent and dirty place, full of violent and diseased people. With such a concentration, we may assume that violence or diseases such as AIDS or hepatitis, may be the leading causes of death behind bars. Is this the case? How does the cause of death in prison compare with that of free society in the U.S.?

Causes of Death Prison U.S.

cause of death prisoners

Natural causes

1.      Cancer 27.3% - 22.5%

2.      Heart disease 23.4% - 23.5%

3.      Respiratory disease 6% - 5.7%

4.      Liver disease 5.1% - <1%

5.      AIDS-related 3.3% - <1%

Unnatural causes

1.      Suicide 6.1% - 1.6%

2.      Homicide 1.7% - 0.61%

3.      Accident 1.1% 5%

 It may surprise some that the leading causes of death behind prison walls are identical to those outside the walls, namely cancer, heart disease and respiratory illness. But it likely does not shock those same people to learn that other causes of death are much more prevalent in prison than they are in the free world.

For instance, liver disease. Over 5% of all deaths behind bars is attributed to liver problems. This makes sense, as some have guesstimated that the rate of hepatitis, the main contributor to liver disease, is 30 percent higher in prison than it is in the rest of the U.S. The same goes for AIDS-related deaths. Up until recently, the ratio of AIDS behind bars was roughly 2-to-1 over those in the U.S. population. As a consequence, both diseases cause a much higher percentage of deaths in prison.

Prison life can be the most depressing existence on the planet, so it's no wonder that suicide rates behind bars are much higher, almost four times so. One phenomenon, however, is that the suicide rate in county jails is even far higher than it is in prison. While the rate of suicide in prison is roughly 6 percent, an astonishing THIRTY percent of all deaths in county jails are attributed to suicide, with an additional 6 percent of deaths there caused by alcohol and drug overdoses.

And yes, violence does play a significant role in prison fatalities as well. Roughly three times the amount of murders occur behind prison walls as do on the streets. However, homicide is by no means a common cause of death in prison. At six percent, that accounts for about 250 fatalities out of the more than 4,000 prisoners who die annually.

The one rate-of-death statistic that is greater in the outside world than in prison is that of death caused by accident. Since two of the top three leading causes of accidents are poisoning and motor vehicles, neither of which is readily accessible in lockup, this is not much of a shocker.

While more deaths occur in prison due to violence and disease than across the entire U.S. population, these rates are actually less than those that occur in most major metropolitan cities. What's more, the overall mortality rate is actually lower behind bars by nearly a third -- roughly 250 per 100,000 prisoners versus 730 per 100,000 citizens. With those numbers, perhaps life behind bars equates to a better chance at survival.

[Prison figures are averages between the two death reporting programs, the Deaths in Custody reporting Program (DCRP) and the National Death Index (NDI).]

Prison Lives ( is a 501(C)(3) non-profit organization established to educate and enable prisoners to be productive individuals while incarcerated for a positive existence both inside and outside of prison life.

Prison Lives provides prisoners and their families with access to information and resources specific to their circumstances through 500+ page publications, including prisoner resource guides, prisoner education guides and prisoner entertainment guides.


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