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Age-specific incidence of injury-related hospital contact after release from prison: a prospective data-linkage study
  1. Jesse T Young1,2,3,4,
  2. Rohan Borschmann1,2,5,6,
  3. David B Preen3,
  4. Matthew J Spittal7,
  5. Lisa Brophy7,8,9,
  6. Emily A Wang10,
  7. Ed Heffernan11,
  8. Stuart A Kinner1,2,12,13,14
  1. 1 Justice Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
  2. 2 Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
  3. 3 School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
  4. 4 National Drug Research Institute, Curtin University, Perth, Western Australia, Australia
  5. 5 Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
  6. 6 School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia
  7. 7 Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
  8. 8 Mind Australia, Heidelberg, Victoria, Australia
  9. 9 School of Allied Health, La Trobe University, Bundoora, Victoria, Australia
  10. 10 Yale School of Medicine, Yale University, New Haven, Connecticut, United States
  11. 11 School of Medicine, University of Queensland, Brisbane, Queensland, Australia
  12. 12 Mater Research Institute-UQ, University of Queensland, South Brisbane, Queensland, Australia
  13. 13 Griffith Criminology Institute, Griffith University, Mt Gravatt, Queensland, Australia
  14. 14 School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  1. Correspondence to Jesse T Young, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3010, Australia; jesse.young{at}


Background In population studies, the risk of injury declines after early adulthood. It is unclear if a similar age difference in the risk of injury exists among people released from prison.

Methods Prerelease survey data collected between 1 August 2008 and 31 July 2010, from a representative cohort of sentenced adults (≥18 years) in Queensland, Australia, were linked prospectively and retrospectively to person-level emergency department, inpatient hospital and correctional records. To ascertain predictors of injury-related hospital contact, we fit a multivariate Andersen-Gill model and tested the interactions between age group (<25 years, ≥25 years) and each variable.

Results In 1307 adults released from prison, there were 3804 person-years of follow-up. The crude injury rate was 385 (95% CI 364 to 407) per 1000 person-years and did not differ according to age group. Factors associated with increased injury-related hospital contact included a history of mental illness, preincarceration injury, a history of incarceration, release from a short prison sentence (<90 days), being reincarcerated during follow-up and identifying as Indigenous. The effect of mental illness, risky alcohol use, prior incarceration and intellectual disability differed across age group and predicted increased risk of injury among people aged ≥25 years compared with their counterparts without these characteristics.

Conclusions Unlike in the general population where the risk of injury declines with age, older adults released from prison are at similar risk compared with their younger peers. Adults released from prison with mental illness, a history of injury-related hospital contact and who identify as Indigenous are particularly indicated groups for injury prevention.

  • injury diagnosis
  • prisoners
  • cohort study
  • mental health
  • hospital care
  • epidemiology

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  • Contributors SK and EH developed the original research proposal and methodology. JY developed and conducted the statistical analysis. JY wrote the initial draft manuscript. All authors contributed significantly to the interpretation and synthesis of the results, and were involved in the development of the final manuscript submitted. JY had full access to the data used in this study and takes responsibility for the integrity of the data and accuracy of the data analysis.

  • Funding The Passports study was funded by National Health and Medical Research Council (NHMRC) Strategic Award APP409966 and NHMRC Project Grant APP1002463. SK is supported by NHMRC Senior Research Fellowship APP1078168. RB is supported by NHMRC Early Career Fellowship APP1104644. MS is a recipient of an Australian Research Council Future Fellowship (project number FT180100075) funded by the Australian Government. LB receives salary support from Mind Australia. JY is supported by a Melbourne Research Scholarship (PhD) from The University of Melbourne. The funding source had no additional role in the research design; data collection, analysis or interpretation; the writing of the manuscript; or the decision to submit the article for publication.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The Passports study received approval from the Queensland Corrective Services Research Committee, the Queensland Health Human Research Ethics Committee (HREC/11/QHC/40), the University of Queensland Behavioural and Social Sciences Ethical Review Committee (#2007000607), and the Australian Institute of Health and Welfare Ethics Committee (EC2012/4/58).

  • Provenance and peer review Not commissioned; externally peer reviewed.