Beyond Risk Level: Timing and Change in Risk Factors as Predictors of Early Mortality Among Formerly Incarcerated Youth

Objectives The current study examined whether risk factors associated with recidivism also influence likelihood of early mortality. The baseline model and shelf-life models assess whether the level and timing of risk factor measurement is associated with differential mortality risk. The dynamic change model assesses whether within-individual change provides explanatory information beyond that obtained from single timepoint measures. Methods A cohort of 1,155 formerly incarcerated Canadian youth were followed into adulthood. Items from recidivism risk assessment tools (interpersonal support, antisocial attitudes, academic/vocational skills, substance use, and mental health instability) were used in a series of Cox proportional hazard models. Results Earlier baseline measurements of risk factors did not predict mortality, while those assessed closer to the time of death were significantly associated with increased mortality risk. Greater substance use increased mortality risk, while mental health instability unexpectedly decreased mortality risk. The dynamic change model found that within-individual increases in antisocial attitudes were associated with elevated mortality risk. Conclusions Timing and change in risk factors are more predictive of early mortality than static measures from adolescence. Future research should consider both community risk factors and correctional system monitoring to better understand the contribution of individual-level risk.