Black men are less likely to die if they are in prison

Dominika Osmolska Psy.D.'s picture
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For some people, being in prison affords a level of health protection not available in the outside world. Does it surprise us that a new study out of North Carolina found that black men were 30 to 40 percent less likely to die than their non-incarcerated counterparts?

Black prisoners seemed to be especially protected against alcohol- and drug-related deaths; they were also less likely to die of certain chronic health conditions like diabetes and cardiovascular disease.

It isn’t the first time a study has found lower death rates among certain groups of inmates -- particularly disadvantaged people, who might get protection against violent injuries and murder.

Prisons are often the only health care provider some disadvantaged populations have access to. Prison health care is often more comprehensive and thorough than anything these people have had before – sometimes in their entire lives. That is a sobering thought considering that prisons are also the focus of media attention for their sometimes spectacularly substandard level of care – not to mention the conditions under which the inmates are often placed. Those conditions in themselves should contribute to a decline in overall health. If they don’t, that fact speaks to the utterly bleak pictures the inmates face when released.

The new study involved about 100,000 men between age 20 and 79 who were held in North Carolina prisons at some point between 1995 and 2005. Sixty percent of those men were black. Researchers linked prison and state health records to determine which of the inmates died, and of what causes, during their prison stay. Then they compared those figures with expected deaths in men of the same age and race in the general population.

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Less than one percent of men died during incarceration, and there was no difference in rates of death between black and white inmates. The picture shifted dramatically, though, once the prisoners were released. For white men, the overall death rate was slightly higher -- by about 12 percent -- than in the general population, with some of that attributed to higher rates of death from infection, including HIV and hepatitis. When the researchers broke prisoners up by age, death rates were only higher for white prisoners age 50 and older.

But black men were almost twice as likely to die of diabetes, alcohol- and drug-related causes, airway diseases, accidents, suicide and murder.

The study shows up the inherent inequalities in the way our society is stratified. It is very sad that white and black men lose the equality they enjoy in health care provision once they are released. The culture of prisons affords, it seems more fairness in this regard than the culture at large.

Evelyn Patterson, who studies correctional facilities at Vanderbilt University in Nashville, Tennessee, says that if we are able to equalize or diminish the health inequalities that we see by race inside a place like prison, it should be possible to implement such stabilizing and equalizing programs in places like a poor neighborhood.

"If it can be done (in prison), then certainly it can happen outside of prison," said Patterson. The question is, how? Such programs are of necessity dubbed “entitlement” programs and have been on the front lines of budget cuts, as state after state tries to cut spending and balance the budget.

The changes, in the end, must come from the will of the people – all the people, and especially the voting public – inspired and willing to shift their priorities towards investing in their communities.

The study was published in the Annals of Epidemiology

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