A comparison of liver disease mortality with HIV and overdose mortality among Georgia prisoners and releasees: A 2-decade cohort study of prisoners incarcerated in 1991

A.C. Spaulding, A. Sharma, L.C. Messina, M. Zlotorzynska, L. Miller and I.A. Binswanger

American Journal of Public Health, 2015, vol. 105, issue 5, e51-e57

Abstract: Objectives: We investigated whether eventual causes of death among a cohort of inmates imprisoned in the southeastern United States differed from those in previous prisoner studies. Methods: Wematched 23510 prisoners in Georgia, a state with historically low levels of heroin consumption but moderate amounts of injection drug use, who were incarcerated on June 30, 1991, to death registries through 2010. Main exposure was 4-year time intervals over 2 decades of observation; main outcome was mortality from liver disease, HIV, and overdose. Results: Although the HIV-related mortality rate exceeded that from liver-related conditions before 2003, liver disease subsequently surpassed HIV as a cause of death. Among 3863 deaths, 22 (0.6%) occurred within 2 weeks after release from prison. Of these, only 2 were caused by accidental poisoning (likely drug overdose). Cardiovascular disease and cancer were the most frequent causes of death in this aging cohort. Conclusions: Our study design deemphasized immediate deaths but highlighted long-term sequelae of exposure to viral hepatitis and alcohol. Treating hepatitis C and implementing interventions to manage alcohol use disorders may improve survival among prisoners in the Southeast.

Keywords: adult; cause of death; cohort analysis; drug overdose; epidemiology; female; Georgia; heroin dependence; human; Human immunodeficiency virus infection; liver disease; male; middle aged; mortality; prisoner; socioeconomics; statistics and numerical data; young adult, Adult; Cause of Death; Cohort Studies; Drug Overdose; Female; Georgia; Heroin Dependence; HIV Infections; Humans; Liver Diseases; Male; Middle Aged; Prisoners; Socioeconomic Factors; Young Adult (search for similar items in EconPapers)
Date: 2015
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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2014.302546_2

DOI: 10.2105/AJPH.2014.302546

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