Every year more than 30m people are released from behind bars.
每年有3000多万人从监狱获释。
Many leave much as they enter—in very poor health.
许多囚犯健康状况非常糟糕,入狱时就去世了。
People who end up in prison have higher rates of infections such as hiv and hepatitis; cognitive disabilities; mental illness and addictions.
最终入狱的囚犯易感染艾滋病毒和肝炎,还会有认知障碍、精神疾病和成瘾问题。
Prisoners tend to have several of these problems, often rooted in abuse or other trauma.
囚犯往往会有其中一些问题,这些问题通常源于霸凌或其他创伤。
Unsurprisingly, ex-prisoners die earlier than those who have never been incarcerated.
不出所料,刑满释放人员比从未入狱的人寿命更短。
What is striking is how many deaths occur within days of release.
令人震惊的是,出狱后几天内就有多人死亡。
A paper in the Lancet on April 10th by an international research consortium led by Rohan Borschmann from the University of Melbourne and Stuart Kinner from Curtin University, in Perth, sums up an analysis of the records of nearly 1.5m prisoners released between 1980 and 2018 in America, Australia, Brazil, Canada, New Zealand, Norway, Scotland and Sweden.
4月10日,由墨尔本大学Rohan Borschmann和珀斯科廷大学Stuart Kinner领导的国际研究财团在《柳叶刀》上发表了一篇论文,总结分析了1980年至2018年间近150万名囚犯的出狱记录,涵盖美国、澳大利亚、巴西、加拿大、新西兰、挪威、苏格兰和瑞典多国的囚犯。
These ex-prisoners were followed up by consortium members for an average of seven years.
这些囚犯出狱后被该财团成员跟踪记录,时间平均来说长达七年。
The researchers found that mortality was highest in the first week following release and fell dramatically after that (see chart).
研究人员发现,出狱后第一周死亡率最高,此后急剧下降(见图表)。
In the first week it was more than twice as high as it was a month later. (The researchers excluded the spike in deaths on day one, which they discovered was partly due to recording errors for inmates who had died in custody.)
第一周的死亡人数是一个月后的两倍多。(研究人员排除了第一天死亡人数激增的情况,他们发现部分原因在于错误记录了拘留期间的死亡囚犯。)
In the first few weeks on the outside alcohol and drug poisoning represented the leading cause of death in every country except for Brazil (where deaths from violence predominated).
在最初的几周内,酒精和药物中毒是除巴西(巴西以暴力致死为主)以外的所有国家的主要原因。
One possible explanation is that enforced abstinence when in prison makes an addict's body less able to handle their usual dose, increasing the risk of fatal intoxication thereafter.
一种可能的解释是,在监狱中强制戒酒会使酒精成瘾的囚犯身体无法承受一般剂量,从而增加了出狱后酒精中毒致死的风险。
Deaths from alcohol and drugs remained high beyond the first week of freedom but were eventually overtaken by the combined deaths from suicides, accidents and disease.
在出狱第一周之后,酒精和毒品造成的死亡人数仍然很多,但自杀、事故和疾病累计造成的死亡人数会更多。
These results, if put to use, could save lives.
这些研究结果如果加以利用,可以挽救诸多生命。
Upon their release, prisoners with opioid addiction could be provided with naloxone, a drug that treats opioid overdose.
比如可以为阿片类药物成瘾的获释囚犯提供纳洛酮,用以治疗阿片类药物过量。
This has been tried in parts of Canada since 2016, with naloxone kits given to prisoners upon release, on the assumption that either they or a close contact would be likely to need it. (The consequences of this intervention were outside the scope of this week's paper.)
自2016年以来,加拿大部分地区已开始尝试这种做法,在囚犯获释后向他们提供纳洛酮等药物,如果他们或密接者有需要的话。(这种干预的结果不在该论文的讨论范围之内。)
Ensuring better access to mental-health services in the first weeks after release could also be beneficial.
确保在出狱后的头几周内更好地获得心理健康服务可能也会大有裨益。
A study from the Netherlands published in 2021 found that prison has no net effect on inmates' pre-existing health.
荷兰2021年发表的一项研究发现,监狱对囚犯原有的健康状况没有净影响。
Someone who goes in unwell, in other words, comes out unwell.
换句话说,入狱的时候身体不好,出狱的时候身体也会不好。
Appropriate care behind bars could change that, helping prisoners better face what awaits them outside.
监狱内适当的照顾可能会改善健康状况,帮助囚犯更好地面对出狱后的生活。