Factors associated with mortality in The Norwegian Offender Mental Health and Addiction (NorMA)- cohort
The disproportionate rates of premature mortality experienced by people released from incarceration is well known, and this excess mortality may be due to individual along with situational factors.
In this prospective cohort study, inmates interviewed in Norwegian prisons in 2013/2014 have been followed up by register linkage over 7 years. The extensive questionnaire data linked with Norwegian national registers has given us a unique opportunity to examine how both individual and situational factors are associated with mortality on an individual level.
We used baseline data from the Norwegian Offender Mental Health and Addiction Study (NorMA; N=733) linked with data from The Norwegian Death Registry, The Norwegian Offence Registry and The Norwegian Patient Registry during the 7 years follow-up (2013-2020).
At end of 2020, 51 persons had died (CMR = 1187 pr 100 000 PY; 95% CI [1138, 1236]); 65% due to external causes including three homicides, four suicides, two deaths from alcohol poisoning, and 20 drug overdoses. Death occurred at a mean age of 46, and on average 32 months after release from baseline imprisonment. Half of the deceased served in high security wards. Between January 1st 2000 and time of death, the deceased had served on average 6 times, with range between 1 and 15 sentences.
In general, poor mental health (mean HSCL-10=1.99) and high prevalence of problematic alcohol and drug use (mean AUDIT=12.44 (n=41); mean DUDIT=29.80 (n=35)) was associated with mortality. The majority (77%) reported lifetime drug-use, with over 70% reporting use of cannabis; 69% amphetamine; 69% benzodiazepines, and 59% heroine. Fifty-three percent were lifetime users of syringes, and 20% were in opioid-maintenance treatment (OMT)-programs at the time of the interview.
These preliminary results suggest a high mortality rate among the NorMa cohort with both situational and individual factors contributing to premature death.