This article has been peer reviewed.

Background: People in custody are more likely to die prematurely, especially of vi-olent causes, than similar people not in custody. Some of these deaths may be preventable. In this study we examined causes of death (violent and natural) among people in custody in Ontario. We also compared the causes of deaths in 3 custodial systems (federal penitentiaries, provincial prisons and police cells). Methods: We examined all available files of coroners ’ inquests into the deaths of people in custody in federal penitentiaries, provincial prisons and police cells in Ontario from 1990 to 1999. Data collected included age, cause of death, place of death, history of psychiatric illness and history of substance abuse. Causes of death were categorized as violent (accidental poisoning, suicide or homicide) or natural (cancer, cardiovascular disease or “other”). Crude death rates were esti-mated for male inmate populations in federal and provincial institutions. There were inadequate numbers for women and inadequate denominator estimates for police cells