Forensic Science International 100 (1999) 187–191

Mortality among habitually violent offenders

*Jarmo Paanila , Panu Hakola, Jari Tiihonen

Department of Forensic Psychiatry, University of Kuopio, Niuvanniemi Hospital, FIN-70240 Kuopio,Finland

Received 23 August 1998; received in revised form 2 November 1998; accepted 30 November 1998

Abstract

There are no published studies about mortality among habitually violent offenders, although itwould be essential to take into account the possibly higher mortality rate of this population, whenthe incidence of committing violent offenders is calculated as a function of age. We studiedmortality during the age range 30–50 years among 102 habitually violent male offenders, whowere considered to be dangerous to the lives of other people, during the 24.5-year period1971–1995 (in the range 3.5 months–24.5 years, the average prison time was 6 years, 7 monthsand 11 days). In Finland, the deathrate in the group of men aged 30–50 years is 3.7 /1000/year,but among these habitually violent male criminals, the mortality rate was observed to be18.1 /1000/year. Therefore, the relative risk for dying in this age group was 4.9-fold whencompared with the normal male population aged 30–50 years. A finding of this magnitude has asubstantial effect, when the real incidence of committing homicides or other violent offenses iscalculated as a function of age. This is an important issue in forensic psychiatry, since it isgenerally believed that the incidence of committing violent crimes is decreased between the agesof 30 and 50 years, and age is used as one predictive factor when the risk of forthcoming violentbehavior is assessed. 1999 Elsevier Science Ireland Ltd. All rights reserved.

Keywords: Mortality; Prisoner; Violence

1. Introduction

It has been suggested that there is an increased mortality rate in criminals mainly due

*Corresponding author. Tel.: 1358-17-203-111; fax: 1358-17-203-494.E-mail address: helena.hartikainen@niuva.fi (J. Paanila)

0379-0738/99/$ – see front matter 1999 Elsevier Science Ireland Ltd. All rights reserved.PI I : S0379-0738( 98 )00209-6

188 J. Paanila et al. / Forensic Science International 100 (1999) 187 –191

to violent deaths such as suicides and accidents and diseases related to alcohol abuse [1].Mortality rates are especially high among released general prisoner population in all agegroups [2].

In Finland, there are about 3500 prisoners in institutions yearly. Many of thesepersons (19%) are sentenced to 2–12 years imprisonment because of violent crimes.Among these persons there is a small group of men called ‘prisoners held in preventivedetention for dangerous recidivists’ (‘Pakkolaitos’ in Finnish). Each of them hascommitted several serious crimes of violence. These men are not numerous, and only13–17 persons have been held in special security sections each year under the lawrelating to incarceration in preventive detention for dangerous recidivists.

The aim of this study was to compare differences in mortality between habituallyviolent criminals and the normal male population. In this study we investigated themortality rate among habitual violent offenders in the age range 30–50 years of age,which is important to know, for example when studying the real relationship betweenage and violent behavior.

2. Material and methods

The material consisted of 102 male criminals. During the years 1971–1995, 42 ofthem were sentenced by the Prison Court to detention in an institution called the ‘specialsecurity section’. These criminals are called ‘prisoners held in preventive detention fordangerous recidivists’. They are considered very dangerous to other people’s lives and,according to the law, they are not allowed to be set free ‘until they are harmless’according to investigations by the Prison Court. At the same time there were 60 men,who were suggested for convict imprisonment in the special security section by theprosecutors, but in the proceedings of the Prison Court they were allowed to carry outtheir sentences in a normal prison. The difference between the sentences in a normalprison and those in the security section is that in the security section prisoners alwaysserve 100% of their prison sentences before release, and thus they are not allowed to beset free from their sentence when they have served three quarters of their imprisonment,which normally happens according to Finnish law concerning other habitually violentcriminals. Also, they can be separated from other prisoners because of the danger theypose.

At first, the names of these men were collected from the records of the Prison Court.Being dead or alive was checked using the registers of the Finnish population registercentre. If the person was not alive, the cause and place of death was obtained from theStatistics Centre of Finland. After that, the essential data, such as dates and durations ofimprisonment, age when presented for convict imprisonment in the special securitysection, and dates when persons were released from normal prison or special section,were included in their prison files (from the Ministry of Justice, Department of PrisonAdministration), and were collected using a questionnaire, which was made for thispurpose by the investigator.

J. Paanila et al. / Forensic Science International 100 (1999) 187 –191 189

3. Results

Among the seclusion group, 11 men of 42 had died (26.2%), and in the other group,the mortality rate was 35% (21 of 60). All deaths occurred between the ages of 30 and50 years (range 34–49 years). Among 30–50 year-old men in Finland, the averageyearly death rate is 3.7 /1000/year [3]. Among habitually violent male criminals, themortality rate was 12 deaths /662 person years, equivalent to 18.1 /1000/year in thesame age group. Therefore, the mortality rate was 4.9-fold greater than among thenormal male population, even though some of these men were still in prison (RR 4.9,95% C.I. 2.5–9.4).

During the follow-up (in the range 3.5 months–24.5 years, the average prison timewas 6 years, 7 months and 11 days) 32 men of the total sample of 102 subjects died.Two percent of the subjects died as a result of suicide, and 6% were victims ofhomicide. Eighteen percent of the sample died violently. In this total sample of 102males, seven out of 32 died in prison and 25 outside prison. Prison deaths consisted ofthree suicides and three homicides, and one death occurred due to somatic disease.

In the special security section, six men of 11 died violently and five of this group diedas a result of coronary heart disease or cancer; only one of them died in prison. Threepersons hanged themselves (all in prison). Two offenders were stabbed with a knife (onein prison). One man died due to an accidental overdose of medicine after release.

In the other group, consisting of 60 violent offenders not imprisoned in the specialsecurity section, there were seven deaths because of somatic disease, and 14 died as aresult of violence. In this group, three men committed suicide by drug overdose and onehung himself. Five men had died as victims of homicide, all outside the prison. Two ofthem were stabbed with knives, one was drowned, one was beaten to death, and one wasshot. Five deaths were classified as accidental and one remains unclassified. There werefive accidents, one drowning, one freezing to death, one intoxication by alcohol, oneburning (with his home) and one traffic accident. All of these accidents were indirectlyassociated with known heavy abuse of alcohol and drugs, and happened after release.

The total number of deaths in both groups is seen in Fig. 1.

4. Discussion

The mortality rate in this sample was about five-fold when compared with the normalmale population in the age range 30–50 years. Compared with general the Finnish prisonpopulation [2] death occurred twice as often. The suicide rate was the same as amongunselected prisoners [2], but accidental and homicidal deaths happened nearly four timesmore often than in the general prison population (20% vs. 5%). Among the normal malepopulation aged 25–65 years in Finland, the most important causes of death in the year1995 were diseases of the circulatory system (especially ischaemic heart diseases), andthe second most important were malignant neoplasmas [3]. These two causes of deathwere about five times (5.18) as common in the normal population as violent and

190 J. Paanila et al. / Forensic Science International 100 (1999) 187 –191

Fig. 1. The total number of deaths in both offender groups.

accidental deaths. In our study population, violent and accidental deaths were morecommon than dying from heart disease and malignant tumors combined, which indicatesa marked difference between these populations concerning the cause of death.

The observed overmortality is quite high when compared with the mortality amongsubjects with other medical conditions such as mental disorders. In the Lundby studyamong men with a background of mental disorder, but without psychiatric care, therelative violent deathrate was 2.4 times higher than that of the standard population [4].The incidence rate of suicide in Oregon’s state mental and correctional facilities for theperiod 1983–1987 was 8.2 /1000/year. It was 51 times higher than the rate for the localcountry population. This rate is said to be one of the highest ever reported [5]. In along-term follow-up study of 620 Swedish criminals, whose follow-up period was 13–16years, the total mortality was 17% [1]. However, in those studies [1,5], no data wereavailable from the overall mortality and the age of the population, which makes itdifficult to compare those data with our results.

In conclusion, in this study we report the mortality rate for habitually violent criminalsfor the first time. The rate was five-fold that of the normal male population aged 30–50years. A finding of this magnitude has a substantial effect, when the real incidence ofcommitting homicides or other violent offenses is calculated as a function of age. This isan important issue in forensic psychiatry, since it is generally believed that the incidenceof committing violent crimes decreases markedly between the age of 30 and 50 years(although no methodologically sound data have been published as yet), and because ageis used as one predictive factor when the risk of forthcoming violent behavior is assessed[6].

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