Epidemiologists reveal that black men in America have a better survival rate in prison than outside

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Being in prison could save your life - depending on your racial background. A group of epidemiologists studying patterns of death among prisoners have discovered that black men in prison die at much lower rates than black men outside.

There are a number of possible causes for this discrepancy.

Public health professor Anne Spaulding and colleagues gathered these statistics in part to understand what happens to people after they leave prison. Often ex-prisoners have a much greater likelihood of dying in the months after their release. What they discovered was that comparing survival rates in and outside prison revealed racial differences that were stark. Writing in the American Journal of Epidemiology, they assert:

Based on the relatively poor health of incarcerated populations and the high mortality rates seen after release, one might predict that inmates would also suffer from high mortality while incarcerated. A recent Bureau of Justice Statistics report, however, showed that while incarcerated, inmates aged 15–64 years experience 19% lower mortality than comparably aged controls in the general population; among blacks, mortality for prisoners is 43% lower than age-adjusted mortality for the general black population.


Why might this be? There are a lot of possibilities — one of which is that whites are such a minority in American prisons that they are statistical outliers. Another possibility is that the statistics are skewed because many prisons in Georgia, where the researchers worked, release prisoners who are dying. So their deaths are officially taking place outside prison. And finally, people are obviously at risk for things like shootings and car accidents outside prison. So prisons are safer in some ways.


Even adjusting for these possibilities, however, the researchers found that the death rates for black men in prison were still significantly lower than for black men outside. And that left one strong possibility: Health care for many black men in America is so poor that they actually get better care in prison.

A study published last year in the journal Demography backed up this finding. Sociologist Evelyn J. Patterson studied US Bureau of Justice statistics and census data and concluded:

White male prisoners had higher death rates than white males who were not in prison. Black male prisoners, however, consistently exhibited lower death rates than black male nonprisoners did. Additionally, the findings indicate that while the relative difference in mortality levels of white and black males was quite high outside of prison, it essentially disappeared in prison. Notably, removing deaths caused by firearms and motor vehicles in the nonprison population accounted for some of the mortality differential between black prisoners and nonprisoners. The death rates of the other groups analyzed suggest that prison is an unhealthy environment; yet, prison appears to be a healthier place than the typical environment of the nonincarcerated black male population. These findings suggest that firearms and motor vehicle accidents do not sufficiently explain the higher death rates of black males, and they indicate that a lack of basic healthcare may be implicated in the death rates of black males not incarcerated.


In other words, it's not just car accidents and shootings that are to blame for these racial discrepancies. It may be that black men survive better in prison because they get better health care behind bars than they do in their communities.

Read Spaulding et. al.'s paper for free online, via PubMed

Additional reporting by Robert T. Gonzalez

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