Medical Health

Deaths in Custody Resulting from Illnesses

What should you know?

According to 2019 data from the Bureau of Justice Statistics, 553 people incarcerated in jail died from illness while in jail, making deaths due to illness the leading cause of death in custody (46.1 percent). People entering jails report high rates of chronic conditions at admission. These preexisting conditions may contribute to an individual’s risk of mortality. The most common chronic condition reported by people incarcerated in jail from 2011–2012 (the most current available data) was high blood pressure. More than a quarter (26 percent) of those incarcerated in jail reported high blood pressure compared to 13.9 percent of the general population. Jail populations also have higher rates of diabetes or high blood sugar (7.2 percent compared to 4.5 percent in the general population) and higher rates of heart conditions (10.4 percent compared to 1.9 percent). In addition, rates of active conditions such as hypertension, stroke-related conditions, and liver cirrhosis are also more prevalent among people held in local jails.

What works to reduce deaths in custody due to illness?

Systematic screening at intake and conduct follow-up

Given the short stays of many people in jail, screening may be the only opportunity jail staff have to identify an individual’s health needs and prevent death in custody. Screening during jail intake provides a critical opportunity to determine the health needs of newly incarcerated individuals. The courts have repeatedly upheld the importance of prompt medical screening.

Protocols to ensure an appropriate level of care, including proper medication

Protocols should address a) instances in which high-risk medical conditions or symptoms are identified at screening, b) how an individual makes requests for medical attention, c) how fellow incarcerated people alert jail personnel of an individual’s medical needs, and d) procedures when there are clear indications of health distress (including incoherence, non-responsiveness, vomiting, shaking, or convulsions). Internal policies and procedures should also address cases in which there is a presence of medical history, but the correctional medical staff provided no follow-up care. Facilities should also have written protocols for managing infectious diseases and responding to medical emergencies.

Appropriate infrastructure of the jail

Many jails across the country have outdated and decaying infrastructure, resulting in poor ventilation, lighting, and climate control. One emerging issue is the lack of air conditioning in many facilities with warmer climates. Older people and those with chronic conditions are at heightened risk of mortality due to heatstroke, which has already caused several recorded deaths in jails. As U.S. jail populations increasingly consist of chronically ill and aging people, the risk of mortality due to conditions in these facilities may also rise.

What are some resources available to support jails in reducing mortality for incarcerated individuals?

Caring for Those in Custody: Identifying High-Priority Needs to Reduce Mortality in Correctional Facilities 2017

https://www.rand.org/content/dam/rand/pubs/research_reports/RR1900/RR1967/RAND_RR1967.pdf

Although some number of in-custody deaths is inevitable—for example, the passing of elderly people from old age—certain types of mortality are highly preventable with the proper interventions. A panel of prison and jail administrators, researchers, and health care professionals convened to consider the challenges of incarcerated individual mortality in correctional facilities and opportunities for improved outcomes. Through structured brainstorming and prioritization of the results, the panel identified a series of needs that, if addressed, could significantly reduce incarcerated individual mortality rates.