U.S. Department of Justice Office of Justice Programs Bureau of Justice Statistics ------------------------------------------------- This file is text only without graphics and many of the tables. A Zip archive of the tables in this report in spreadsheet format (.csv) and the full report including tables and graphics in .pdf format are available on BJS website at http://www.bjs.gov/index.cfm?ty=pbdetail&iid=5866 This reports is one in series. More recent editions may be available. To view a list of all reports in the series go to http://www.bjs.gov/index.cfm?ty=pbse&sid=76 ------------------------------------------------- Statistical Tables Mortality in State Prisons, 2001-2014 - Statistical Tables Margaret E. Noonan, BJS Statistician In 2014, there were 3,927 inmate deaths in state (3,483) and federal (444) prisons, up slightly from 3,879 in 2013. This is the largest number of inmate deaths reported in state and federal prisons since the Deaths in Custody Reporting Program (DCRP) began collecting data in 2001. Between 2001 and 2014, there were 50,785 inmate deaths in state and federal prisons in the United States (figure 1). The number of deaths in state prison was stable between 2013 and 2014 but increased by 11% in federal prisons. Deaths in state prisons declined in both California (down 13%) and Texas (down 7%) between 2013 and 2014. Together, these states accounted for a fifth of the state prison population and a fifth of state prisoner deaths in 2014. *** Footnote 1 Carson, E. A. & Mulako-Wangato, J. Count of total custody population (including private prisons). Corrections Statistical Analysis Tool – Prisoners. Bureau of Justice Statistics, www.bjs.gov.*** While males continued to account for the majority (96%) of state prisoner deaths in 2014, the number of female deaths increased 9%. More than half of state prisoners who died in 2014 were non-Hispanic whites (55%), while nearly a third (32%) were non- Hispanic blacks and around a tenth (11%) were Hispanics. More than half (59%) of state prisoners who died were age 55 or older. Illness remained the most common cause of death in state prisons, accounting for 87% of deaths in 2014. From 2013 to 2014, the number of deaths among state prisoners due to illness declined 2%, from 3,082 to 3,031 deaths. AIDS-related deaths increased 23% during the period and respiratory disease deaths increased 20%. The number of suicides in state prisons increased by 30% from 2013 to 2014. This increase followed a 6% decrease from 2012 to 2013. Suicides represented 7% of all deaths in state prisons in 2014, the largest percentage of deaths due to suicide since 2001. Data in this report were developed from the Bureau of Justice Statistics’ (BJS) DCRP, an annual data collection of inmate deaths in local jails and state prisons. The DCRP is the only national statistical collection that obtains comprehensive information about deaths in adult correctional facilities. This report covers deaths that occurred in state prisons between 2001 and 2014. It includes information on cause of death, selected decedent characteristics, and prisoner mortality rates by state. Federal data presented in this report are based on aggregate counts from the Bureau of Prisons. Unless otherwise stated, findings pertain to state prisons only. Data on mortality in local jails are located in a separate report (Mortality in Local Jails, 2000-2014 - Statistical Tables, NCJ 250169, BJS web, December 2016). ************* Highlights ************* Inmate death in state and federal prisons ******************************************* * Between 2001 and 2014, there were 50,785 prisoner deaths in state and federal prisons. The majority (45,640) of prisoner deaths occurred in state prisons (table 1). * The state prisoner average annual mortality rate (256 per 100,000 state prisoners) was 14% higher than the federal prisoner mortality rate (225 per 100,000 federal prisoners) between 2001 and 2014. Cause of death ****************** * The number of suicides in state prisons increased 30% between 2013 and 2014 (from 192 to 249 deaths). Liver disease deaths, the third most common cause of death, declined 12% between 2013 and 2014 (from 354 to 313 deaths) (table 2). * Illness-related deaths accounted for 87% of all deaths in state prisons in 2014, with cancer (30%) and heart disease (26%) accounting for more than half (table 3). * Between 2005 and 2014, the percentage of illness-related state prisoner deaths was stable, ranging between 87% and 90% annually. * The overall mortality rate for state prisoners was stable from 2013 to 2014, from 273 to 275 per 100,000 in 2014 (table 4). Decedent characteristics *************************** More female state prisoners died in 2014 (154) than in any year since 2008 (163) (table 6). * The majority of state prisoners who died in 2014 were persons age 55 or older (59%), followed by prisoners ages 45 to 54 (24%) (table 7). * In 2014, males accounted for nearly all (96%) state prisoner deaths and non-Hispanic whites made up more than half (55%) of state prisoners deaths. * For cancer, heart disease, and liver disease, the mortality rate for male state prisoners was twice the rate for females. * Female and male state prisoners died from drug- alcohol intoxication at nearly equal rates between 2001 and 2014. Deaths reported by state ************************* * Texas (409), Florida (346), and California (317) had the highest number of deaths in state prisons in 2014 (table 11). * In 2014, the prisoner death rate by state varied from no deaths per 100,000 to 631 deaths per 100,000 state prisoners. The median state-level mortality rate among prisoners was 267 per 100,000 state prisoners (table 12). * Twenty-seven states accounted for 90% of all deaths in state prison from 2001 through 2014 (45,640). Texas (5,804) and California (5,102) accounted for about a quarter of all deaths in state prison between 2001 and 2014 (table 13). * Overall mortality rates and mortality rates by state and by cause of death may not be directly compared between states due to differences in age, sex, race or Hispanic origin, and other decedent characteristics (table 14). * The number of state prisoners age 55 or older increased 12%, from an estimated 58,900 prisoners in 2005 to 125,000 prisoners in 2014 (appendix table 1). Moving averages and population trends by prisoner mortality ********************************* * The mortality rate of state prisoners for illness-related deaths increased to 238 per 100,000 state prisoners in 2014, up from 235 per 100,000 in 2013 (appendix table 2). * The cancer mortality rate increased each year between 2008 (63 per 100,000 state prisoners) and 2014 (82 per 100,000) (appendix table 3). * The heart disease mortality rate among state prisoners increased between 2010 (63 per 100,000 state prisoners) and 2014 (68 per 100,000) (appendix table 4). **************** List of tables **************** Table 1. Number of state and federal prison inmate deaths, by cause of death, 2001–2014 Table 2. Number of state and federal prisoner deaths, by cause of death, 2001 and 2005–2014 Table 3. Percent of state prisoner deaths, by cause of death, 2001 and 2005–2014 Table 4. Mortality rate per 100,000 state prisoners, by cause of death, 2001 and 2005–2014 Table 5. Mortality rate per 100,000 federal prisoners, by select cause of death, 2001 and 2005–2014 Table 6. Number of state prisoner deaths, by selected decedent characteristics, 2001 and 2005– 2014 Table 7. Percent of state prisoner deaths, by selected decedent characteristics, 2001 and 2005– 2014 Table 8. Mortality rate per 100,000 state prisoners, by selected decedent characteristics, 2001 and 2005–2014 Table 9. Number of state prisoner deaths, by cause and selected decedent characteristics, 2001–2014 Table 10. Average annual mortality rate per 100,000 state prisoners, by cause of death and selected decedent characteristics, 2001–2014 Table 11. Number of state and federal prisoner deaths, by jurisdiction, 2001 and 2005–2014 Table 12. Mortality rate per 100,000 state and federal prisoners, by jurisdiction, 2001 and 2005– 2014 Table 13. Number of state and federal prisoner deaths, by cause and jurisdiction, 2001–2014 Table 14. Average annual mortality rate per 100,000 state and federal prisoners, by cause of death and location, 2001–2014 Table 15. Preliminary count of the number of deaths in state prisons, 2015 ************************** List of appendix tables ************************** Appendix table 1. Estimated number of state and federal prisoners in custody, by selected inmate characteristics, 2001 and 2005–2014 Appendix table 2. Illness mortality rate per 100,000 state prison inmates, by selected characteristics, 2003 and 2005–2014 Appendix table 3. Cancer mortality rate per 100,000 state prison inmates, by selected characteristics, 2003 and 2005–2014 Appendix table 4. Heart disease mortality rate per 100,000 state prison inmates, by selected characteristics, 2003 and 2005–2014 Appendix table 5. Liver disease mortality rate per 100,000 state prison inmates, by selected characteristics, 2003 and 2005–2014 Appendix table 6. Respiratory disease mortality rate per 100,000 state prison inmates, by selected characteristics, 2003 and 2005–2014 Appendix table 7. Mortality rate for all other illnesses per 100,000 state prison inmates, by selected characteristics, 2003 and 2005–2014 Appendix table 8. Mortality rate for unnatural deaths per 100,000 state prison inmates, by selected characteristics, 2003 and 2005–2014 ************************************************* Preliminary count of state prisoner deaths, 2015 As of October 2016, data for collection year 2015 is being processed and finalized. The response rate for collection year 2015 was 97% as of July 2016, with 49 of 50 states submitting 3,290 state prisoner death records (table 15). Finalization of the data files, which includes data cleaning and processing cause of death information, will continue into 2017. Full details on mortality of state prisoners in 2015 will be published in 2017. ************************************************** ************* Methodology ************* Data collection coverage ************************* The Deaths in Custody Reporting Program (DCRP) is an annual Bureau of Justice Statistics (BJS) data collection that obtains national, state, and incident-level data on persons who died while in the physical custody of the 50 state departments of corrections or the approximately 2,800 local adult jail jurisdictions nationwide. This methodology pertains to the prison portion of the DCRP collection only. See Mortality in Local Jails, 2000–2014 - Statistical Tables (NCJ 250169, BJS web, December 2016) for data and the methodology on deaths occurring in local jails. The DCRP began in 2000 in response to the Death in Custody Reporting Act of 2000 (P.L. 106-297) and is the only national statistical collection that obtains comprehensive information about deaths in adult correctional facilities. Starting in 2001 and annually thereafter, BJS has collected DCRP data directly from state prison systems, maintaining a 100% response rate. BJS uses this data to track national trends in the number and cause (or manner) of death occurring in state prisons. Mortality data measured by the DCRP include the location and type of facility where the inmate died, decedent characteristics (such as age, sex, race or Hispanic origin), date of admission, conviction status, and admission offense. The DCRP also collects data about circumstances surrounding the death, including the cause, time, and location where the death occurred, and information on whether an autopsy was conducted and the availability of autopsy results to the respondent. Data on executions are excluded from this report but are accessible on the BJS website (see Capital Punishment in the United States, 2013, NCJ 248448, BJS web, December 2014). Statistics presented in this report are current as of September 26, 2016. For more information on mortality in correctional settings, see Assessing Inmate Cause of Death: Deaths in Custody Reporting Program and National Death Index (NCJ 249568, BJS web, April 2016), Mortality in Local Jails, 2000–2007 (NCJ 222988, BJS web, July 2010); Medical Causes of Death in State Prisons, 2001–2004 (NCJ 216340, BJS web, January 2007); and Suicide and Homicide in State Prisons and Local Jails (NCJ 210036, BJS web, August 2005). The DCRP state prison data collection instruments are administered annually to state departments of corrections. Respondents provide an aggregate count of the number of deaths that occurred during the referenced calendar year (NPS-4), as well as individual death forms (NPS-4A). The prison survey instruments are available on the BJS website at www.bjs.gov. State prison respondents can submit individual records on decedents at any time during a collection cycle through a BJS web-based collection system. Determining eligibility for reporting to the DCRP ************************************************* In the DCRP, custody refers to the physical holding of an inmate in a facility or to the period during which a correctional authority maintains a chain of custody over an inmate. A death that occurs when an inmate is not in the custody of a correctional authority is considered beyond the scope of the DCRP. Out-of-scope deaths include inmates on escape status or under the supervision of community corrections, such as on probation, parole, or home-electronic monitoring. For state prisons responding to the survey, inmates in physical custody include those held in any private prison facility under contract to the responding state’s department of corrections or in any of their state-operated facilities, including halfway houses, prison camps or farms, training or treatment centers, and prison hospitals. BJS instructs state prison officials to exclude deaths of inmates who were transferred to local jails while still serving a prison term because the DCRP obtains information about such deaths through the jail reports. Identifying and excluding duplicate records ********************************************* Duplicate and out-of-scope records are excluded from the analysis. Duplicate death records may occur in the DCRP due to overlapping correctional populations and overlapping duties within correctional facilities. For example, a state prison system may report the death of an inmate who was transferred to a local jail while serving a prison sentence. The death is considered part of the count of the correctional facility that had custody of the inmate at the time of death (in this case, the jail), and the duplicate record (in this case, from the prison facility) is deleted. To identify duplicate death records, BJS reconciles the aggregate summary counts of deaths occurring during a calendar year with the number of individual death records obtained from a reporting prison system. When discrepancies are identified, BJS contacts reporting prison systems for clarification. Cause-of-death information ****************************** DCRP respondents are instructed to report death information as determined by autopsy or other official medical death investigation. For this collection, intoxication deaths, accidents, suicides, and homicides are considered discrete causes of death. Although there is a distinction between manner and cause of death from a medico- legal standpoint, no such distinction is made in the DCRP. When reporting a death due to illness, accident, suicide, intoxication, or homicide, BJS requests that respondents describe the events surrounding these deaths. Clinical data specialists convert illness-related death text entries into standard medical codes from the World Health Organization’s International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10). Homicides include all types of intentional homicide and involuntary manslaughter as ruled by a medical examiner or pathologist at autopsy. For example, an inmate may die of positional asphyxia (suffocation caused by body position) while being removed from a cell. A legal-intervention homicide committed while the inmate is trying to escape is included in the homicide count. Homicides also encompass cases that are ruled a homicide at autopsy when events that led to the death occurred prior to incarceration, such as an inmate previously shot in the community who later died from complications of the gunshot wound while in custody. Other BJS sources of correctional mortality data ************************************************** BJS collects other data reported to the DCRP on prisoner mortality. These other collections include-- Capital punishment, which provides data on legal executions. Additional details on executions are available on the BJS website. The National Prisoner Statistics (NPS) program collected counts of deaths by cause of death, including deaths due to execution, illness, AIDS (and AIDS-related causes, such as HIV), suicide, accident, homicide, and other causes. Detailed death counts were dropped in 2007. The NPS currently collects a total count of deaths, because it is a type of prison release. After 2006, the Federal Bureau of Prisons submitted counts of deaths by cause of death to the DCRP, but discontinued submitting counts to the NPS. Additional details of the NPS are available on the BJS website. Reported statistics ********************* Mortality data shown in statistical tables include the number of deaths and mortality rates by year, cause of death, selected decedent characteristics, and the state where the death occurred. Mortality rates are calculated per 100,000 inmates, with the denominators providing estimates of the number of person-years of exposure in custody in institutional corrections. Until 2010, the mortality rate for state prisons was calculated as the number of deaths per year divided by the midyear state prison population in custody multiplied by 100,000. Starting in 2011, the rate was calculated using yearend custody counts because BJS shifted the reference period for its prison collections to December 31. For more information on the NPS, see the BJS website. Denominators allow for annual mortality rates, which are calculated separately by group or by characteristic. The National Center for Health Statistics (NCHS) calculates crude mortality rates as the number of events for a period, (e.g., a year), divided by the population estimate at the midpoint of the period. For general population mortality statistics, the NCHS employs the midyear population as an approximation of the average population exposed to risk of death during any given year.***Footnote 2 See Siegal, J. & Swanson, D. (2004). The Methods and Materials of Demography, Second Edition. San Diego, CA: Elsevier Academic Press, 269.*** The crude mortality rates reported in the DCRP annual statistical tables are not directly comparable to the crude mortality rates of the non-incarcerated general population, because the composition of the general population (age, sex, and race or Hispanic origin) differs from the population in state prisons and federal prisons. Preliminary 2015 numbers *************************** The 2015 number of death is preliminary as of August 1, 2016. At that time, 49 of the 50 state departments of correction had reported both a summary count of deaths and provided the corresponding individual death records. As of August 1, 2016, one state had submitted a summary count of deaths, but was still finalizing the individual death records. BJS does not consider a submission complete until the summary count and the individual records have both been submitted and the summary and individual death counts match. The 2015 DCRP prison file is currently being finalized and is scheduled to be delivered to BJS in the final quarter of 2016. Final data for 2015 is scheduled to be published in 2017. Estimating inmate population characteristics to calculate mortality rates by demographic subgroups ********************************************* BJS estimated the demographic distribution of the state prison population using the NPS and National Corrections Reporting Program (NCRP) collections. For more information on the methodology for obtaining state prisoner population estimates by age, sex, and race or Hispanic origin, see Prisoners in 2014 (NCJ 248955, BJS web, September 2015). Prior to using the NPS and NCRP to estimate demographic distributions, reports of mortality rates for state prison inmates used demographic distributions derived from BJS’s 2004 Survey of Inmates in State and Federal Correctional Facilities (SISFCF). As a result, the state prison mortality rates shown in these tables may differ from rates published prior to 2008. A comparison between the two sources showed very little differences in the rates. In most instances, the rates either matched or nearly matched. They differed in only three instances: Hispanics in 2001, females in 2002, and inmates age 55 or older in 2002. In each case, the rates calculated using population data from the NCRP and NPS were slightly higher (by less than 1%) than those using population data from the SISFCF. Moving averages ****************** Moving averages were used to smooth short-term irregularities and to estimate long-term trends. For example, moving averages were computed to examine data trends for certain causes of death in prisons while smoothing short-term fluctuations. The data were cut into several 2-year overlapping periods spanning 11 years of prison data. The moving averages in this report describe some changes in cause-specific mortality rates over time, such as whether the overall decline in the AIDS-related mortality rate was steady or the increase of suicides in jails was recent. Moving averages were not computed for all causes of death in custody because the resultant rates would have been unstable and therefore statistically meaningless due to small cell sizes. Random error and suppression ****************************** The DCRP data on deaths in state prisons are not subject to sampling error because it is a full enumeration of deaths. However, according to Brillinger and NCHS, mortality data from a complete enumeration may be subject to random error, because “the number of deaths that actually occurred may be considered as one of a large series of possible results that could have arisen under the same set of circumstances”—or, death occurs at random. ***Footnote 3 See Brillinger, D.R. (1986). The Natural Variability of Vital Rates and Associated Statistics. Biometrics, 42: 693–734.*** ***Footnote 4 See Xu, J. et al. (2010). Deaths: Final Data for 2007. National Vital Statistics Report, 58(19). Retrieved from http://www.cdc.gov/nchs/data/nvsr/nvsr58/nvsr58_19 .pdf. The random variation can be large when the number of deaths is small. Therefore, caution is warranted when interpreting statistics based on small numbers of deaths. According to NCHS standards, mortality rates based on fewer than 100 deaths per year should be interpreted with caution. Continuing to use the NCHS and Brillinger methods, BJS quantified random variation by assuming that the appropriate underlying probability distribution for the number of deaths is a Poisson distribution. This provides a computationally simple and reasonable approach for estimating variances in mortality statistics when the probability of dying is low. BJS calculated variances based on the assumption of a Poisson process. From these variances, BJS calculated relative random error estimates, which are comparable to relative standard error since the relative random error is the ratio of random error derived from the Poisson variance, to the number of deaths. Following NCHS practice, when the relative random error exceeded 30%, BJS flags estimated mortality rates with a “!” symbol due to the instability of the rate (interpret with caution, there are too few sample cases to provide a reliable rate). ************************************************* The Bureau of Justice Statistics of the U.S. Department of Justice is the principal federal agency responsible for measuring crime, criminal victimization, criminal offenders, victims of crime, correlates of crime, and the operation of criminal and civil justice systems at the federal, state, tribal, and local levels. BJS collects, analyzes, and disseminates reliable and valid statistics on crime and justice systems in the United States, supports improvements to state and local criminal justice information systems, and participates with national and international organizations to develop and recommend national standards for justice statistics. Jeri M. Mulrow is acting director. This report was written by Margaret Noonan. Zhen Zeng verified the report. Monika Potemra and Brigitte Coulton edited the report. Tina Dorsey and Barbara Quinn produced the report. December 2016, NCJ 250150 ************************************************** ************************************************** Office of Justice Programs Building Solutions • Supporting Communities • Advancing Justice www.ojp.usdoj.gov ************************************************** ************************** 12/5/2016 JER 11:10am *************************