This explainer is based on Prison Mortality & Deaths in Custody: Data Gaps, Misclassification, and Accountability Failures. All statistics and findings are drawn directly from this source.
Why This Research Matters for Advocacy
People are dying in prisons across the country, and the systems designed to count and account for those deaths are broken — by design or by neglect. This GPS analysis exposes a cascading failure of accountability: the federal government has lost track of more than 5,000 deaths, states actively misclassify how people die, and 38% of prison systems release no individual death data at all.
For advocates, this research is a weapon against institutional opacity. It provides hard evidence that:
- The federal reporting system is in collapse. The Death in Custody Reporting Act (DCRA) is not being enforced, and the data it does produce is unreliable. More than three-quarters of federal death records fail to meet the government’s own standards.
- Georgia is actively misrepresenting how people die in its prisons. GPS’s original research documents at least 44 deaths the Georgia Department of Corrections misclassified — labeling drug overdoses as “natural causes” or “undetermined.” This isn’t a clerical error. It is a pattern that conceals the true scope of the overdose crisis behind prison walls and shields GDC from accountability.
- Medical neglect is killing people. Over 20% of state prisoners with persistent medical conditions receive no care. A court-appointed expert in Illinois found that 36% of prison deaths studied were preventable, with the rate potentially reaching 73%.
- Transparency is possible — states are choosing not to provide it. Iowa proves that complete, timely death reporting can be done. The other 53 prison systems are making a choice to keep the public in the dark.
This research directly supports campaigns for independent death investigation, mandatory public reporting legislation, healthcare accountability, and federal DCRA enforcement. It arms advocates with the data to demand that Georgia — and every state — stop hiding the human cost of incarceration.
Key Takeaway: This research exposes a systemic, nationwide failure to accurately count, classify, and publicly report deaths in prisons — with Georgia’s misclassification of at least 44 deaths as a documented case study in institutional deception.
Talking Points
The federal government has lost count of who is dying in its custody. The Department of Justice’s own 2022 report identified more than 5,000 uncounted deaths in the national mortality data — people who died and were never officially recorded.
Georgia is hiding how people die in its prisons. GPS’s original research found that the Georgia Department of Corrections misclassified at least 44 deaths, labeling drug overdoses as “natural causes” or “undetermined” even after medical examiners determined the true cause.
The data we do have is unreliable. A review of approximately 1,000 DCRA entries found that more than three-quarters did not meet the federal government’s own recording standards. We cannot fix what we refuse to measure honestly.
Most prison systems operate in total darkness on death data. 21 of 54 prison systems — 38% — release no individual death data at all. Only one state, Iowa, provides complete and timely information.
People are dying from medical neglect that is both predictable and preventable. Over 20% of state prisoners with persistent medical conditions go without care. An Illinois study found that 36% of prison deaths examined were confirmed preventable, with the rate potentially reaching 73%.
Georgia’s drug overdose crisis behind bars has exploded and been concealed. Drug overdose deaths in Georgia prisons surged from 2 in 2018 to at least 49 between 2019 and 2022 — and GDC has systematically obscured these deaths through misclassification.
Only 8 states in the entire country have their own laws requiring regular reporting of deaths in custody. Georgia is not one of them. Without state-level requirements, federal mandates alone have proven toothless.
Nearly 3,000 incarcerated people died from COVID-19 since March 2020, exposing healthcare systems that were already failing people long before the pandemic arrived.
Key Takeaway: These eight talking points are ready to use in legislative testimony, press statements, coalition meetings, and written communications to officials.
Important Quotes
The following quotes are drawn directly from the GPS analysis and can be cited in advocacy materials:
“The Department of Justice published a scathing report in 2022 regarding more than 5,000 uncounted in-custody deaths in the national mortality data.”
— Section: Data Quality Crisis – Massive Underreporting“A review of a random sample of approximately 1,000 DCRA entries found that more than three-quarters did not meet the federal government’s own criteria for how a death should be recorded.”
— Section: Data Quality Crisis – Massive Underreporting“Entire states, like Mississippi, had reported almost zero deaths in their prisons or jails.”
— Section: Data Quality Crisis – Massive Underreporting“21 of 54 prison systems (38%) release NO individual death data.”
— Section: State-Level Reporting Failures“Combined, at least 44 deaths were misclassified by GDC.”
— Section: Georgia-Specific Misclassification“In at least 13 cases, GDC reported prisoners died of ‘natural causes’ while medical examiners later determined the deaths were accidental drug overdoses.”
— Section: Georgia-Specific Misclassification“This roughly 36% confirmed preventable rate and up to 73% potentially preventable rate suggests the scale of medical neglect’s contribution to prison mortality.”
— Section: Preventable Deaths“Medical neglect kills hundreds of incarcerated people every year despite the constitutional standard.”
— Section: Healthcare Deficiency“Over 20% of state prisoners with persistent medical conditions go without care.”
— Section: Healthcare Deficiency“Only 1 system (Iowa) releases complete and timely data.”
— Section: State-Level Reporting Failures
Key Takeaway: These direct quotes provide authoritative, citable language for testimony, letters, and media materials.
How to Use This in Your Advocacy
Legislative Testimony
This research supports testimony for bills mandating independent death investigation, public death reporting, and healthcare accountability in Georgia’s prisons.
- Lead with Georgia-specific evidence. At least 44 deaths misclassified by GDC is a concrete, documented failure that legislators can act on. Frame it as a credibility crisis: if GDC cannot be trusted to accurately report how people die, what else is being concealed?
- Use the Iowa comparison. Iowa proves that complete, timely death data reporting is achievable. Georgia’s failure is a policy choice, not an operational impossibility.
- Cite the preventability data. The Illinois finding that 36% of prison deaths were confirmed preventable — and up to 73% potentially preventable — makes the case that lives can be saved through legislative action on healthcare standards.
- Demand state-level reporting laws. Only 8 states have their own death reporting laws. Urge Georgia to join them. Federal DCRA requirements have proven insufficient without state reinforcement.
Public Comment
During public comment periods on corrections budgets, healthcare contracts, or oversight mechanisms:
- Emphasize that over 20% of state prisoners with persistent medical conditions go without care, and that this directly contributes to preventable deaths.
- Note that drug overdose deaths in Georgia surged from 2 in 2018 to at least 49 between 2019 and 2022, and that GDC concealed this surge by misclassifying deaths.
- Ask pointed questions: How many people died in GDC custody last year? What were the independently verified causes of death? How many autopsies were conducted by independent medical examiners?
Media Pitches
- Investigative angle: “Georgia’s prison system labeled at least 44 drug overdose deaths as ‘natural causes’ or ‘undetermined.’ A GPS analysis shows how systematic misclassification hides the true death toll behind bars.”
- National accountability angle: “The federal government lost track of more than 5,000 people who died in custody. A new analysis shows the reporting system meant to count those deaths has collapsed.”
- Local healthcare angle: “One in five state prisoners with chronic illnesses gets no medical care. In one state, a court-appointed expert found up to 73% of prison deaths may have been preventable.”
- Data transparency angle: “Only one state in America fully and promptly reports how people die in its prisons. An analysis of 54 prison systems reveals a nationwide culture of secrecy around custodial death.”
Coalition Building
This research creates natural alliances with:
- Public health organizations — Prison mortality is a public health issue. The data gaps documented here undermine epidemiological research and disease surveillance.
- Drug policy reform groups — The misclassification of 44 drug overdose deaths in Georgia directly connects to opioid crisis advocacy and harm reduction campaigns.
- Open government and transparency advocates — 38% of prison systems releasing no death data is a transparency crisis that resonates beyond the prison reform community.
- Medical and nursing associations — Over 20% of people with persistent conditions going untreated, and the 36-73% preventable death rate, speak to professional ethics concerns.
- Families of incarcerated people — This research validates what families already know: they cannot trust official accounts of how their loved ones died.
Written Communications
In letters to the Governor, GDC Commissioner, state legislators, and federal representatives:
- Open with the specific number: at least 44 deaths misclassified by GDC. This is not an abstract policy concern — it is a documented pattern of concealment.
- Reference the federal reporting collapse: more than 5,000 uncounted deaths nationwide, with more than three-quarters of federal records failing to meet basic standards.
- Demand specific action: independent medical examiner review of all custodial deaths, mandatory public reporting with individual-level detail, and state legislation requiring death-in-custody reporting.
- Close with the human cost: nearly 3,000 people died from COVID-19 in custody, hundreds die annually from medical neglect, and the true numbers are hidden from the public.
Key Takeaway: This section provides concrete, context-specific strategies for deploying this research across every major advocacy channel.
Use Impact Justice AI
Need help turning this research into a letter to your legislator, testimony for a committee hearing, a public comment submission, or a media pitch? Impact Justice AI can help you generate advocacy materials using this research and other GPS data.
Visit https://impactjustice.ai to:
- Draft legislative testimony citing these findings
- Generate letters to officials about death reporting failures in Georgia
- Create public comment submissions for corrections oversight hearings
- Build media pitches focused on prison mortality and data transparency
- Develop coalition outreach materials grounded in this evidence
The tool is designed to help advocates move from research to action quickly and effectively.
Key Takeaway: Impact Justice AI at https://impactjustice.ai helps advocates generate letters, testimony, and other materials using GPS research.
Key Statistics
The following statistics are drawn directly from the GPS analysis and are formatted for easy use in testimony, letters, and reports.
More than 5,000 uncounted deaths in custody were identified by the Department of Justice in a 2022 report — deaths that occurred but were never recorded in the national mortality database.
(Section: Massive Underreporting)
More than three-quarters of approximately 1,000 randomly sampled DCRA entries did not meet the federal government’s own criteria for how a death should be recorded.
(Section: Massive Underreporting)
Nearly 700 people who died in law enforcement custody were absent from the DCRA dataset, according to a Marshall Project investigation.
(Section: Massive Underreporting)
21 of 54 prison systems (38%) release no individual death data whatsoever.
(Section: State-Level Reporting Failures)
Only 1 system (Iowa) releases complete and timely death data out of 54 prison systems nationwide.
(Section: State-Level Reporting Failures)
Only 8 states have their own laws requiring regular reporting of deaths in custody to state authorities.
(Section: State-Level Reporting Failures)
At least 44 deaths were misclassified by the Georgia Department of Corrections — 13 labeled “natural causes” and 31 labeled “undetermined” when medical examiners determined they were accidental drug overdoses.
(Section: Georgia-Specific Misclassification)
At least 49 drug overdose deaths occurred in Georgia prisons between 2019 and 2022, up from just 2 in 2018.
(Section: Drug Overdoses)
36% confirmed preventable, up to 73% potentially preventable — rates found when a court-appointed medical expert studied 33 prison deaths in Illinois (12 preventable, 7 possibly preventable, 5 undeterminable due to inadequate documentation).
(Section: Preventable Deaths)
Over 20% of state prisoners with persistent medical conditions go without care.
(Section: Healthcare Deficiency)
Nearly 3,000 incarcerated people died from COVID-19 since March 2020.
(Section: COVID-19 Impact)
6,725 deaths were reported under DCRA for fiscal year 2023, widely understood to be a significant undercount.
(Section: Total Deaths Reported Under DCRA)
Approximately 418 deaths per 100,000 — the mortality rate in Virginia state prisons in 2024, providing a state-level benchmark.
(Section: Comparison: Prison vs. General Population Mortality)
Key Takeaway: These statistics are verified against the source document and ready for direct use in advocacy materials.
Read the Source Document
The complete document includes detailed federal reporting framework analysis, national mortality statistics from BJS data (2001-2019), cause-of-death misclassification patterns, key mortality drivers, state-level reporting assessments, legal frameworks, and comprehensive recommendations for reform.
Other Versions
This analysis is available in versions tailored to different audiences:
- 📢 Public Version — For community members, families, and the general public
- 🏛️ Legislator Version — For elected officials, legislative staff, and policymakers
- 📰 Media Version — For journalists, editors, and news organizations