NEW YORK (Reuters Health) - Former prison inmates have a high risk of dying after being released from prison, a study shows. The risk of death is greatest in the first 14 days after release, suggesting that the reentry process is especially difficult for many ex-inmates.

"The US population of former prison inmates is large and growing," notes the study team in The New England Journal of Medicine this week. "The period immediately after release may be challenging for former inmates and may involve substantial health risks."

Among the 30,237 inmates released from the Washington State Department of Corrections from July 1999 through December 2003, records showed that 443 died during an average follow up of 1.9 years.

According to Dr. Ingrid A. Binswanger from the University of Colorado Health Sciences Center, Denver and colleagues, the risk of death, factoring in the effect of age, gender and race, among former prison inmates was 3.5 times higher than that of other state residents.

During the first 2 weeks after release, the risk of death among former prison inmates was 12.7 times that of other state residents.

By far, drug overdose was the leading cause of death in newly released prisoners, followed by heart disease, homicide and suicide.

Interventions aimed at decreasing the risk of death among ex-inmates are needed, Binswanger and colleagues conclude.

These could include "planning for the transition from prison to the community, including use of halfway houses, work-release programs, drug-treatment programs, education about susceptibility to overdose after relative abstinence during incarceration, and preventive care to modify cardiac risk factors."