When People Die in Prison, the State Hides the Truth: How Death Data Gets Lost, Mislabeled, and Covered Up

TL;DR

Thousands of people die in U.S. prisons and jails each year. The government fails to count or report many of these deaths. More than 5,000 deaths went uncounted in a single federal report. In Georgia, the state mislabeled at least 44 drug overdose deaths. Only one state in the whole country — Iowa — gives the public full and timely death data.

Why This Matters

If your loved one dies in prison, you deserve the truth about how and why. Right now, the system is broken. States hide death data. They label overdoses as “natural causes.” They don’t count many deaths at all.

This means families may never know what really happened. It means the state avoids blame. And it means nothing changes — more people keep dying from the same problems.

When prisons don’t track deaths honestly, they can’t fix what’s killing people. Bad health care goes on. Drug overdoses keep rising. And no one is held to account.

Key Takeaway: Families deserve honest answers about how their loved ones died. The current system denies them that truth.

The Federal Government Lost Track of Thousands of Deaths

There is a federal law called the Death in Custody Reporting Act (DCRA). It says states must report every death in their prisons and jails. But the law is barely enforced.

In 2022, the Department of Justice found more than 5,000 deaths that were never counted in the national data. That means over 5,000 families lost someone — and the government didn’t even record it.

The Marshall Project, a news group, found nearly 700 people who died in police custody. Those deaths were also missing from the federal data. Whole states, like Mississippi, reported almost zero deaths — even though they lock up thousands of people.

Even the deaths that were reported are a mess. A review of about 1,000 records found that more than three-quarters did not meet basic federal rules for how a death should be recorded.

Key Takeaway: The federal government failed to count more than 5,000 deaths in custody — and most of the records it does have don’t meet its own standards.

Most States Keep Death Data Secret

A 2024 study looked at 54 prison systems across the country. Here is what it found:

• 21 of 54 systems (38%) release NO death data at all about individual people
• 13 systems release some data, but it is incomplete and takes over a year
• 19 systems release data on time, but it is still missing key details
• Only 1 system (Iowa) gives the public complete and timely data

That means almost 4 out of 10 prison systems tell the public nothing about who is dying and why.

On top of that, only 8 states have their own laws that require prisons and jails to report deaths. The rest rely on the broken federal system — or nothing at all.

Key Takeaway: Almost 4 out of 10 prison systems share no death data with the public. Only Iowa reports fully and on time.

Georgia Mislabeled at Least 44 Deaths

GPS did its own research into deaths in Georgia prisons. What we found is alarming.

In at least 13 cases, the Georgia Department of Corrections (GDC) said people died of “natural causes.” But medical examiners — doctors who study why people die — later found these were drug overdoses.

In 31 more cases, GDC called the deaths “undetermined.” Again, medical examiners later ruled these were drug overdoses.

Combined, at least 44 deaths were mislabeled by GDC. When the state calls a drug overdose a “natural” death, it hides the real problem. It blocks action that could save lives.

Georgia saw at least 49 drug overdose deaths between 2019 and 2022. In 2018, there were just 2. That’s a massive jump. But if the state keeps hiding these deaths, it can pretend the crisis doesn’t exist.

Key Takeaway: Georgia labeled at least 44 drug overdose deaths as “natural” or “undetermined” — hiding a crisis that is killing people in its prisons.

Many Prison Deaths Could Have Been Prevented

In Illinois, a court-appointed medical expert looked at 33 prison deaths. Here is what the expert found:

• 12 deaths were preventable (could have been stopped)
• 7 deaths might have been preventable
• 5 deaths couldn’t be judged because records were too poor

That means at least 36% of deaths were preventable. If you include the ones that might have been stopped, the number rises to up to 73%.

Think about that. Up to 73% of the people who died might still be alive if they had gotten proper care. The state had a duty to keep them safe. It failed.

Key Takeaway: A study of Illinois prison deaths found that up to 73% may have been preventable with proper medical care.

Lack of Medical Care Is Killing People

The law says prisons must provide health care. The Supreme Court has ruled this is a basic right. But prisons across the country break this rule every day.

Over 20% of people in state prisons who have ongoing health problems get no care at all. That’s 1 in 5 people with real medical needs being ignored.

Medical neglect kills hundreds of people in prison every year, according to the Vera Institute (2025). And when COVID-19 hit, nearly 3,000 people in prison died from the virus since March 2020. The crisis showed what advocates already knew: prison health care was broken long before the pandemic.

Key Takeaway: One in five people in prison with ongoing health problems get no care — and medical neglect kills hundreds every year.

An Aging Population With Growing Needs

Laws that force people to serve longer sentences have filled prisons with older people. These people have more complex health needs. They need more care, more medicine, and more support.

But states are failing to meet those needs. They spend more money but deliver worse care. The result: more people dying from illnesses that could be treated.

Suicide is also a leading cause of unnatural death in custody. Rates are much higher than in the general public. Mental health care gaps, solitary confinement (being locked alone for long periods), and poor screening all play a role.

Key Takeaway: Longer sentences create an aging prison population with growing health needs that states fail to meet.

What Needs to Change

The facts are clear. People are dying in custody. The state is hiding how and why. Here is what needs to happen:

• Report every death publicly and on time. Iowa does this. Every state should.
• Require independent doctors to review all deaths in custody. Prison staff should not decide the cause of death.
• Require an autopsy for every death in custody, done by someone who does not work for the prison.
• Enforce the federal law. States that don’t report deaths should lose their federal funding.
• Pass state laws that require death reporting where none exist today.
• Create independent oversight boards with the power to investigate deaths.
• Track near-miss emergencies — not just deaths — so problems can be caught early.

Every person in state custody has a right to safety and health care. When they die and the state hides the facts, it is a failure of the most basic duty.

Key Takeaway: Every prison death should be reported publicly, reviewed by independent doctors, and investigated by independent oversight boards.

Glossary

• DCRA (Death in Custody Reporting Act): A federal law that says states must report every death in their prisons, jails, and police custody. Passed in 2000 and updated in 2013.
• GDC (Georgia Department of Corrections): The state agency that runs Georgia’s prisons.
• Medical examiner: A doctor who studies dead bodies to find out the cause of death. They are supposed to be independent from the prison.
• Misclassification: When the cause of death is labeled wrong — like calling a drug overdose a “natural” death.
• Preventable death: A death that didn’t have to happen. With the right care, the person could have lived.
• Medical neglect: When a prison fails to give needed health care to a person. This can cause serious harm or death.
• Solitary confinement (restrictive housing): When a person is locked alone in a cell for 22 or more hours a day. This raises the risk of mental illness and suicide.
• Truth in Sentencing laws: Laws that make people serve most of their sentence (often 85% or more) before they can be released. This has led to more older people in prison.
• BJA (Bureau of Justice Assistance): The federal agency now in charge of tracking death-in-custody data. It took over from BJS in 2019.
• BJS (Bureau of Justice Statistics): The federal agency that used to track prison death data until 2019.
• Autopsy: A medical exam of a dead body to find out how and why the person died.

Read the Source Document

Read the full GPS analysis: Prison Mortality & Deaths in Custody: Data Gaps, Misclassification, and Accountability Failures (PDF)

Other Versions

• Version for Legislators and Policy Makers
• Version for Media and Journalists