Analysis of Deaths in ICE Custody over 10 Years

Since 1996, the practice of holding undocumented persons in US immigration detention has expanded dramatically. Reported health concerns for ICE detainees have included the lack of consistent access to specialty care, medications and mental health services. We have analyzed records pertaining to deaths in ICE custody between October 2003 and May 2012. Overall, 131 deaths were recorded during this period. When the partial year data from 2003 and 2012 was excluded, 117 deaths were analyzed. The highest number of deaths was recorded in 2004 (32) and the lowest in 2011 (9), with a downward trend over the 8 year period. Two methods were used to calculate crude death rates by year. First, when rates of death were computed based on annual number of detainees, the rate fell from 1.36 per 100,000 admissions in 2004 to 0.26 per 100,000 in 2011. Because average lengths of stay in ICE custody also fell significantly during this time period (resulting in more people passing through for less time) we also established a crude death rate using the number of person-years in the ICE detention system.  This rate stems from the overall ICE capacity, meaning that 1,000 beds operating per year equate to 1,000 person years of exposure. The overall ICE detention capacity has grown over time, from approximately 18,000 beds in 2004 to 34,000 beds in 2011. Assuming 80% occupancy throughout this time period, the crude death rate has dropped from 0.2 per 1000 person years in 2004 to 0.04 per 1000 person years in 2011. The leading cause of death categories were cardiovascular disease (45; 38%), cancer (19; 16%), suicide (17; 14%) and AIDS (8; 7%). The rate of death in the ICE detention system appears to have dropped significantly in the time period between 2004 and 2011, whether measured by number of admissions or person-years of exposure. Several changes in the ICE detention system may be reflected in the drop in crude death rate, including shorter stays in detention, improved medical policies, decreased reliance on small county jails as sites of detention and a changing profile of detainees. In addition, we did not have information about mortality immediately after removal by ICE or during detention by the U.S. Border Patrol. Consequently, more information is needed to judge the significance of these data.