Solitary Confinement Tied to Greater Risk of Death After Prison Release

Prisoners who are held in restrictive housing (i.e., solitary confinement) face an increased risk of death after their release, according to a new study led by researchers from the University of North Carolina (UNC) at Chapel Hill.

The findings show that incarcerated individuals who were placed in restrictive housing in North Carolina from 2000 to 2015 were 24% more likely to die in the first year after their release, compared to those who were not held in restrictive housing.

In addition, those held in restrictive housing were 78% more likely to die from suicide, 54% more likely to die from homicide, and 127% more likely to die from an opioid overdose in the first two weeks after their release.

Further, the number of restrictive housing placements and spending more than 14 consecutive days in restrictive housing were associated with an even greater increase in the risk of death and reincarceration.

“For the first time ever, using data shared with us from our partners at the North Carolina Department of Public Safety, we’ve been able to demonstrate a connection between restrictive housing during incarceration and increased risk of death when people return to the community,” said lead author Lauren Brinkley-Rubinstein, PhD, an assistant professor of social medicine in the UNC School of Medicine.

“In addition, our study found that the more time people spent in restrictive housing the higher the risk of mortality after release. This study provides empirical evidence to support ongoing nationwide reforms that limit the use of restrictive housing.”

“North Carolina is a leader in this thinking as the Department of Public Safety has preemptively implemented multiple reforms that have resulted in the limited use of restrictive housing.”

“We appreciate this research collaboration and recognize the importance of these results in shaping policy and practice,” said Gary Junker, PhD, Director of Behavioral Health for the N.C. Department of Public Safety Adult Correction and Juvenile Justice.

“Since 2015, the department has initiated several programs to divert people from restrictive housing, including Therapeutic Diversion Units for those with mental illness. While safety and security must remain our top priority, we recognize that reduced use of restrictive housing will likely improve post-release outcome.”

These findings, published in the journal JAMA Network Open, are from a retrospective cohort study conducted by Brinkley-Rubinstein and co-authors from UNC, Emory University, the N.C. Department of Public Safety and the N.C. Department of Public Health.

Incarceration data for people who were confined in North Carolina between 2000 and 2015 were matched with death records from 2000 to 2016.

“We also found that non-white individuals were disproportionately more likely to be assigned to restrictive housing than their white counterparts,” said co-author Shabbar Ranapurwala, PhD, MPH, an assistant professor of epidemiology in the UNC Gillings School of Global Public Health and a core faculty member of the UNC Injury Prevention Research Center.

“In fact, the mortality and reincarceration outcomes after release were also quite different between these racial groups. The post-release opioid overdose and suicide death outcomes among those receiving restrictive housing were more pronounced among white individuals compared to non-whites, while the all-cause and homicide death and reincarceration outcomes were higher among non-white Americans compared to whites.”

Given the observational nature of the study, establishing cause and effect may be difficult, yet, the strength and consistency of the findings points to the fact that restrictive housing is an important marker of increased mortality risk among formerly incarcerated individuals.

Source: University of North Carolina Health Care

Happy Spouse = Longer Life

Good news for many people as emerging research suggests that having a happy spouse leads to a longer marriage and a longer life. Notably, investigators discovered a spouses’ life satisfaction was an even better predictor of participants’ mortality than participants’ own life satisfaction.

Specifically, participants who had a happy partner at the beginning of the study were less likely to pass away over the next 8 years compared with participants who had less happy partners.

“The data show that spousal life satisfaction was associated with mortality, regardless of individuals’ socioeconomic and demographic characteristics, or their physical health status,” says study author Olga Stavrova, a researcher at Tilburg University in the Netherlands.

The study appears in Psychological Science, a journal of the Association for Psychological Science.

“The findings underscore the role of individuals’ immediate social environment in their health outcomes. Most importantly, it has the potential to extend our understanding of what makes up individuals’ ‘social environment’ by including the personality and well-being of individuals’ close ones,” says Stavrova.

Life satisfaction is known to be associated with behaviors that can affect health, including diet and exercise, and people who have a happy, active spouse, for example, are likely to have an active lifestyle themselves. The opposite is also likely to be true, says Stavrova:

“If your partner is depressed and wants to spend the evening eating chips in front of the TV — that’s how your evening will probably end up looking, as well.”

Researchers used United States data as Stavrova reviewed a nationally representative survey of about 4,400 couples who were over the age of 50. The survey, funded by the National Institute on Aging, collected data on participants who had spouses or live-in partners; 99 percent of the sampled couples were heterosexual.

For up to 8 years, participants and their spouses reported on life satisfaction and various factors hypothesized to be related to mortality, including perceived partner support and frequency of physical activity. They also completed a self-rated health measure and provided information related to their morbidity.

The information included the number of doctor-diagnosed chronic conditions, gender, age at the beginning of the study, ethnicity, education, household income, and partner mortality. Participant deaths over the course of the study were tracked using the National Death Index from the Centers for Disease Control and Prevention or spouses’ reports.

At the end of 8 years, about 16 percent of participants had died. Those who died tended to be older, male, less educated, less wealthy, less physically active, and in poorer health than those who were still alive; those who died also tended to report lower relationship satisfaction, lower life satisfaction, and having a partner who also reported lower life satisfaction.

The spouses of participants who died were also more likely to pass away within the 8-year observation period than were spouses of participants who were still living.

The findings suggest that greater partner life satisfaction at the beginning of the study was associated with lower participant mortality risk. Specifically, the risk of mortality for participants with a happy spouse increased more slowly than mortality risk for participants with an unhappy spouse.

The association between partner life satisfaction and mortality risk held even after accounting for major sociodemographic variables, self-rated health and morbidity, and partner mortality.

Exploring plausible explanations for these findings, Stavrova found that perceived partner support was not related to lower participant mortality. However, higher partner life satisfaction was related to more partner physical activity, which corresponded to higher participant physical activity, and lower participant mortality.

This research demonstrates that partner life satisfaction may have important consequences for health and longevity. Although the participants in this study were American, Stavrova believes the results are likely to apply to couples outside of the United States, as well.

“This research might have implications for questions such as what attributes we should pay attention to when selecting our spouse or partner and whether healthy lifestyle recommendations should target couples (or households) rather than individuals,” says Stavrova.

Future research could also investigate larger social networks to see if the same pattern of results emerges in the context of other relationships.

Source: Association for Psychological Science