Key takeaways
- Deaths in the Los Angeles County Jail have increased over the last 15 years, driven by longer periods of jail time and higher rates of substance abuse fatalities, a UCLA study has found.
- Of those who died while in the county jail, the median time from arrest to death was 57.5 days.
- Findings indicated that only 4.1% of deaths occurred within one day of arrest, 16.7% within one week, and 24.4% within two weeks, contradicting the belief that most jail deaths occur shortly after a person is jailed and are the result of an overdose around the time of arrest or withdrawal from prescribed medications or illicit drugs.
- The data suggests that among the best ways to improve the survival of people in the LA County Jail are reducing the number of people detained, improving medical care, reducing the influx of drugs and shortening how long people stay.
The effects of stress, depression and inadequate healthcare in the Los Angeles County Jail — a blanket term widely used for the county's eight facilities — build up into lethal risk, a new study led by UCLA researchers has found. The researchers discovered that most deaths in the LA County Jail occur after a person has been in jail for several weeks. This contradicts a common belief that most jail deaths occur shortly after a jail stay begins and are the result of a sudden overdose around the time of arrest or withdrawal from prescribed medications or illicit drugs.
The new research, which was just published in the journal PLOS One, found instead that deaths in the LA County Jail have increased over the last 15 years, driven by longer periods of jail time and higher rates of substance abuse-caused fatalities that occur deep into a person's time behind bars. Chronic conditions, such as heart disease, for which effective interventions exist, are also a significant cause of mortality.
"We found that most people are not dying at the transition to jail," said corresponding author and UCLA environmental scientist Nicholas Shapiro. "The greatest mortality risk comes after longer in-jail [time] and is more likely to be caused by drug overdoses and preventable or treatable conditions like gastrointestinal bleeding, infections and heart disease."
Additionally, of those who died in the LA County Jail, most were never convicted of anything. More than two-thirds were being held pretrial, researchers discovered.
Analysis of mortality data in the county jail found that mortality in general, and substance-related deaths specifically, increased from 2008 to 2023, peaking during the COVID-19 pandemic. The median time from arrest to death was 57.5 days. Only 21 (4.1%) of deaths occurred within one day of arrest, 85 (16.7%) within one week and 124 (24.4%) within two weeks. For people who died in custody, the median time from arrest to death was over five times longer (59 days vs. 11 days) than the median duration of stay for all arrest bookings. This means that most people are dying multiple months into their time in the county jail.
"Our findings tell a very different story concerning the timing of LA County Jail deaths than the prevailing understanding of jail deaths nationally," said Sharon Dolovich, a professor of law at UCLA and co-author on the paper. "Since the pandemic, many people have died well into their stays in the LA County Jail from drug overdoses, suicides and other preventable causes, making the jail a site of countless deaths of despair."
Previous studies have found that in jail, people die from overdoses early in their confinement, with federal data suggesting that the median time from arrest to overdose death nationally is a single day. Overall, the UCLA study found that, during the years studied, only about 17% of deaths in the LA County Jail occurred within the first week.
"People are dying of overdoses, not from substances they imbibed around the time of arrest, but from drugs they had access to in jail," said Shapiro, who is an associate professor in the UCLA Institute for Society and Genetics. "To us, this suggests that people in the LA County Jail are self-medicating because of dismal conditions, and that they're also a captive market for people who get drugs into the Jail."
What factors are responsible for in-jail deaths?
The data suggested that the opioid crisis was responsible for much of the increase in mortality over the study period. Acute substance-related deaths accounted for just 4% of deaths in 2008 but nearly 26.5% in 2023 — a more than sixfold rise.
Analysis of public records from the LA Sheriff's Department, the LA Department of the Medical Examiner, the California Department of Justice, and the LA County Office of the Inspector General showed that of in-jail deaths, people are 13% more likely to die of any cause compared to the general California population after adjusting for differences in age.
Death from drug overdose was 50% more likely in the county jail, while death due to heart disease was 86% more likely. But the highest relative risk condition was a surprise — in the LA County Jail, people suffering from pulmonary embolisms were 1,109% more likely to die. The risk of death from gastrointestinal bleeding, septicemia and suicide was also higher in the county jail. However, for some chronic conditions, such as cancerous tumors, diabetes and liver disease, the likelihood of death was lower.
Suicide was among the most striking risks. After adjusting for age, the risk of suicide in the LA County Jail was nearly three times that of California's population as a whole, and suicide accounted for 15% of the deaths examined in the study.
"People are dying of preventable deaths. We know that people going into jail tend to have poorer health to begin with, but our study shows that, even though in jail people are more likely to have diabetes, for example, they're less likely to die of it in the LA County Jail than is the general public, which shows that when the jail system invests in healthcare, it can reduce mortality," Shapiro said. "Stronger measures to prevent drugs from entering the LA County Jail is also needed."
What the findings reveal
The authors' findings suggest that jail restrictions on free movement have led to a sedentary lifestyle that contributes to heart disease and makes pulmonary embolisms more common, while stress, despair and loneliness drive substance use. Surprisingly, the findings also suggested that the county jail healthcare manages some chronic conditions, such as diabetes, as well as or better than being uninsured or low-income in the free world.
Researchers' recommendations to combat deaths in jail
The data, according to the research team, suggests that among the best ways to improve the survival of people in jail are:
- Reducing the number of people in jail
- Improving medical care
- Reducing the influx of drugs
- Shortening how long people stay in jail
Reducing jail time may be especially urgent for those still awaiting their day in court: more than two-thirds of the people who died had not been convicted of the charges for which they were being held, underscoring the potentially lethal consequences of lengthy pretrial detention.
"There are alternatives, such as diversion," Shapiro said. "These programs reduce exposure to dangerous jail environments and keep the public safer through reduced recidivism and often cost much less than jailing."
Additionally, the researchers posit that reducing these deaths from drug overdoses will require both keeping deadly substances out of the jails and expanding access to evidence-based treatment for substance use disorder, including medications for opioid use disorder.
In 2025, the LA County Jail reported 46 deaths, more than all but the highest year examined in the study, 2021, when COVID-19 deaths spiked.
"These deaths have not receded since the end of the pandemic and still maintain near record levels. This study can help LA County decide how to better invest in public health to prevent these losses of life," Shapiro said.
How researchers studied in-jail deaths
The UCLA Carceral Ecologies Lab, which Shapiro directs, scraped websites and requested public records to compile a database of mortality data from 2008-2023. Public records data came from local and state agencies. Web scrapers collected publicly available data from the LA Department of the Medical Examiner website, and abstracted data from autopsies were obtained via a pay-per-record fee. Information on deaths in the LA County Jail was also linked to death certificates via the National Death Index.
Shapiro, his UCLA colleagues, including members of the UCLA Law Behind Bars Data Project, and co-authors at Yale and the University of Washington analyzed this data and compared it to nationwide mortality data produced by the Department of Justice and with mortality data for the wider US and California populations. They compared the age profiles and causes of death that occurred in the LA County Jail to national and state deaths.
