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ObjectiveTo assess the causes of death for people in police or prison custody in Australia, with particular attention to the differences between Aboriginal and non‐Aboriginal deaths. Design, setting and participantsRetrospective collection and analysis of data about deaths occurring in police or prison custody in Australia in the 10‐year period 1980‐1989. ResultsIn the period 1980‐1989, 527 deaths are known to have occurred in police or prison custody. About half these deaths were due to self‐harmful behaviour, including hanging. The next most frequent causes of death were diseases of the circulatory system, injuries and diseases of the respiratory system. ConclusionThe high number of deaths in custody resulting from self‐harmful behaviour has important implications for the criminal justice and corrections systems. Minimisation of the number of people held in police and prison custody is important in preventing such deaths. Close attention needs to be paid to ensuring the safety of lock‐ups and prisons and to the screening of people likely to be at risk of death from self‐harmful behaviour. Custodial authorities have a clear responsibility to provide quality preventive and clinical health services to all people in custody. Special attention needs to be directed to the specific health needs of Aborigines, many of whom are at much greater health risk than are non‐Aborigines. (Med J Aust 1993; 159: 581‐585)

ObjectiveTo assess the risks of death in police or prison custody in Australia for Aborigines and non‐Aborigines. Design, setting and participantsRetrospective collection and analysis of data about deaths occurring in police or prison custody in Australia in the 10‐year period 1980‐1989. ResultsFor the period 1980‐1989, Aboriginal and non‐Aboriginal people in prison had risks of death similar to those of the total Australian population, but the risks of death in police custody for both Aborigines and non‐Aborigines were between 10 and 20 times the risks of death experienced by the general population. Within each type of custody, there were no significant differences in the risks of death experienced by Aboriginal and non‐Aboriginal people. ConclusionAlthough some deaths in custody are inevitable, the very much higher risks of death in police custody for both Aborigines and non‐Aborigines has implications for custodial authorities in terms of preventive and remedial action. Reduction of the excess of Aboriginal over non‐Aboriginal deaths in police and prison custody relative to general population figures requires action to reduce the over‐representation of Aboriginal people in custody and to improve the general well‐being and health status of Aboriginal people in the community. (Med J Aust 1993; 159: 577‐581)

The establishment of the Royal Commission into Aboriginal Deaths in Custody prompted a number of questions about the incidence of non-Aboriginal as well as Aboriginal deaths in both police custody and prisons. And examination of all such deaths from 1980 to 1988 shows that there were four times as many non-Aboriginal deaths as Aboriginal deaths, but, based on their numbers in the general community, Aborigines were 23 times more likely to die in custody than were non-Aborigines. About two-thirds of the black deaths occurred in police custody and two-thirds of the white deaths occurred in prisons. Suicide or self-inflicted harm was the most common reported cause of death for non-Aborigines, but death by natural causes was more frequently reported among Aborigines. The most serious offence leading either to detention or imprisonment for all the deceased persons revealed only small differences between the Aboriginal and non-Aboriginal groups, but those who died in prison were generally more serious offenders than those who died in police custody. Proportionately more of the Aboriginal deaths occurred in hospitals than was the case for non-Aborigines. A dramatic and unexpectedly high number of custodial deaths occurred in 1987, and the possible explanations for this are explored. It is suggested that the findings of this study relate to the over-representation of Aborigines in custody, the need for improved health programs for Aborigines, and the need for permanent monitoring on a national basis of all deaths in custody.

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