Violence-related deaths among people released from incarceration: systematic review and meta-analysis of cohort studies

Melissa Willoughby, BA(Hons); Jesse T. Young, PhD; Matthew J. Spittal, PhD; Rohan Borschmann, PhD; Emilia Janca, MPH; Prof Stuart A. Kinner, PhD

EClinicalMedicine (Nov 2021)

Violence-related deaths among people released from incarceration: systematic review and meta-analysis of cohort studies

Melissa Willoughby, BA(Hons),
Jesse T. Young, PhD,
Matthew J. Spittal, PhD,
Rohan Borschmann, PhD,
Emilia Janca, MPH,
Prof Stuart A. Kinner, PhD

Affiliations

Melissa Willoughby, BA(Hons): Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, Victoria, 3053, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Victoria, 3052, Australia; Corresponding author: Melissa Willoughby, Justice Health Unit, Level 4, 207 Bouverie Street, Carlton, The University of Melbourne, Victoria, 3053, Australia. ORCID ID: 0000-0002-4360-2605
Jesse T. Young, PhD: Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, Victoria, 3053, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Victoria, 3052, Australia; School of Population and Global Health, The University of Western Australia, 35 Stirling Highway, Perth, Western Australia, 6009, Australia; National Drug Research Institute, Curtin University, 7 Parker Place, Bentley, Western Australia, 6102, Australia
Matthew J. Spittal, PhD: Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, Victoria, 3053, Australia
Rohan Borschmann, PhD: Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, Victoria, 3053, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Victoria, 3052, Australia; Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, Camberwell, London SE5 8AF, United Kingdom; Melbourne School of Psychological Sciences, The University of Melbourne, Grattan Street, Parkville, Victoria, Australia
Emilia Janca, MPH: Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, Victoria, 3053, Australia
Prof Stuart A. Kinner, PhD: Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, Victoria, 3053, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Victoria, 3052, Australia; Mater Research Institute-UQ, University of Queensland, Mater Hospital, Raymond Terrace, South Brisbane, Queensland, 4101, Australia; Griffith Criminology Institute, Griffith University, 176 Messines Ridge Road, Mount Gravatt, Queensland, 4122, Australia; School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia

Journal volume & issue: Vol. 41
p. 101162

Abstract

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Background: People released from incarceration have an increased risk of violence-related death. As deaths from violence are a rare event, meta-analysis is needed to calculate reliable estimates of this risk. We examined the crude mortality rates (CMRs), standardised mortality ratios (SMRs), and predictive factors for violence-related deaths among people released from incarceration. Methods: In this systematic review and meta-analysis, we searched MEDLINE, PubMed, PsycINFO, Scopus, Web of Science, CINCH, and Criminal Justice Abstracts from inception to 14 September 2020 for cohort studies published in English that examined violence-related deaths occurring in the community following release from adult or youth incarceration. We used the Methodological Standard for Epidemiological Research (MASTER) scale to assess the quality of included studies. We conducted a random-effects meta-analysis to calculate pooled estimates of the CMRs and SMRs. Heterogeneity was assessed using univariable meta-regression. This review was registered with the International Prospective Register of Systematic Reviews (PROSPERO; CRD42020209422). Findings: Our search identified 2,489 records, from which 11 studies met the eligibility criteria. The pooled CMR for violence-related deaths after release from incarceration was 78·7 per 100,000 person-years (95%CI 58·0-99·5). The pooled SMR was 7·6 (95%CI 2·4-12·8). The estimate of heterogeneity was high (I2≥99%) and the Cochran's Q test was significant (p<0·001) for the pooled CMR and SMR. Study design (prospective vs. retrospective; p=0·001) and type of incarceration facility (youth detention vs. prison; p=0·006) were identified as possible sources of heterogeneity for CMRs. Risk factors for violence-related death after release were reported in only five studies. These included being male (n=3), Black or Hispanic in the United States (n=3), and younger age at release from incarceration (n=2). Interpretation: People released from incarceration are almost eight times more likely to die from violence than the general population. Violence-related deaths are preventable, and the high rate at which they occur after release from incarceration represents an important public health issue requiring targeted, evidence-based response. Funding: None

Published in EClinicalMedicine

ISSN: 2589-5370 (Online)
Publisher: Elsevier
Country of publisher: United Kingdom
LCC subjects: Medicine: Medicine (General)
Website: https://www.thelancet.com/journals/eclinm/home

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