Michelle Smith, director of the Missouri Justice Coalitions, speaks during a Jan. 3, 2024, memorial service for the 364 Missourians who died in state custody in 2021, 2022 and 2023. Deaths in the Department of Corrections hit a new high of 139 in 2024 (Rudi Keller/Missouri Independent).
Deaths in Missouri prisons hit a new high in 2024.
The preliminary total, 139, is two more than the 137 recorded by the Department of Corrections in each of the previous two years and represents the fourth year in the past five where deaths behind bars have averaged 10 or more a month.
There were four executions in 2024. The other 135 fatalities in 2024 among people who were serving less than a death sentence were due to disease, overdose, violence or suicide.
“It takes about 100 days on average for county medical examiners to complete and distribute autopsy reports, so at this point we don’t know all the causes of death for 2024, but we do know that most were from natural causes,” Karen Pojmann, department spokeswoman, wrote in an email to The Independent.
Deaths in Missouri prisons have increased in number despite a drop in the number of people incarcerated.
From 2020 to 2024, the department averaged 128 deaths per year while holding an average of 23,690 people. Over the previous five years, deaths among people in state custody averaged 95 per year, while the average population in that period was 31,561.
Department data shows 89% of deaths in custody over the past 20 years are due to disease, or natural, causes, Pojmann wrote. The remainder are due to homicide, suicide, and accidents, a category that includes overdoses.
There have been a few headline-grabbing deaths in Missouri’s prisons. In the case with perhaps the most attention, the warden of the Jefferson City Corrections Center was removed in June following an investigation into the December 2023 death of Othel Moore. A little more than a week later, criminal charges were filed in Cole County against corrections officers accused of second degree murder and assault in the death of Moore.
Moore, 38, was pepper-sprayed in the face multiple times, had his face improperly covered by a hood that blocked his nose and mouth and was left unattended in a cell.
Doris Ann Scott and Oriel Moore, Othel Moore’s mother and sister, have filed a federal lawsuit against the department, its health contractor Centurion and several corrections officers and medical personnel.
Advocates for people in prison and their families say deaths are unacceptably high and question whether the department is being held accountable for the increase in mortality.
For 13 months, Trevor Foley has been acting director of the corrections department. He has been designated to take the job permanently, subject to state Senate confirmation, by Gov.-elect Mike Kehoe.
Foley has already shown a greater willingness to communicate than his predecessor, said Lori Curry, of Missouri Prison Reform, who has sources among current and former staff and inmates. Curry tracks deaths among people in custody by name, location, date and cause of death.
“Trevor Foley has a lot of work ahead of him, and we definitely need more accountability and transparency,” Curry said.
Pojmann, the department spokesperson, said the raw numbers of prison deaths are being taken out of context, “often implying cause for alarm.”
“The narrative,” she added, “that Missouri prison death rates are disproportionately high and/or are rising at a rate that’s disproportionate to the population — or the narrative that most in-custody deaths are caused by neglect or violence — is simply false and is not backed up by data.”
Causes of deaths
The advocates who track prisoner deaths have been raising alarms about health care and drug use behind bars.
Prisoner health care is a common complaint, Curry said.
Missouri contracts with Centurion Health, which was owned by St. Louis-based Centene Corp. when it won the contract in 2021 but which has since been sold to private investors.
“We have heard overwhelmingly from people that live in the prisons and the people that are supposed to be able to take care of them that they’re not able to do that,” Curry said. “The people are not receiving treatment for basic things all the way up to severe things.”
When a coroner lists a death as resulting from natural causes, it doesn’t necessarily mean the person received adequate care for the condition that resulted in their death, former Texas County Coroner Marie Lasater told The Independent.
Lasater handled cause-of-death determinations for people who died in custody at the South Central Correctional Center in Licking. In 2024, she said 19 men held there died — the second-highest total among the 19 adult prisons.
“There’s been a couple that were in diabetic ketoacidosis, which is a natural death, but it’s because they weren’t being monitored or receiving medication that they need,” Lasater said.
A coroner must choose between natural, suicide, homicide, accident or undetermined for the death certificate filed with the state Bureau of Vital Records, Lasater said. Some states have an additional category, she said, known as “medical misadventures,” which covers unexpected death for any reason from a treatable medical condition.
“So that limits us,” Lasater said.
An increasing portion of deaths in custody is drug overdose, often from the powerful opioid fentanyl. Lasater included notations in her 2023 annual report that seven of the eight fentanyl overdose deaths in Texas County were at South Central Correctional Center and eight of the 18 deaths that year in the facility were due to overdose.
The number would be much higher, she said, without the use of naloxone, also known as Narcan.
“There are several deaths daily, and the corrections officers resuscitate a lot of people every day,” Lasater said.
The department has taken several actions to block the flow of contraband. It installed body scanners, requires all personal correspondence be conducted digitally and is working to move legal mail to digital platforms only to reduce the chances for contraband entering the prison.
Families and friends cannot mail books or other goods directly to people who are incarcerated.
The warden and a top supervisor at the South Central Correctional Center were removed amid reports that an investigation showed contraband was entering the prison through a poorly screened gate.
“From everything that we hear from people that live inside prisons and work in prisons, it’s easier to get drugs in prison than it is outside, and it should not be that way,” Curry said.
Missouri’s 19 adult prisons — 17 for men and two for women — held 24,133 people on Friday. Over the course of a year, Pojmann wrote, 35,000 people are incarcerated, with constant arrival of new inmates and departure of those who have died, been paroled or completed their sentence.
The slight increase of about 1% in 2024 reflected a slight increase in the average daily census in the system, she said.
The death rate among people incarcerated for all or part of 2023 was 3.89 per thousand, while the general rate among the state population was 10.7 per thousand, Pojmann said.
People in prison, however, are not susceptible to many accidental causes of death, such as the automobile accidents that killed almost 1,000 people in 2024.
“While the incarcerated population may not be perfectly analogous to the state population as a whole, the comparison does provide some relevant context, particularly for people who assume that all in-custody deaths are suspect or are preventable,” Pojmann wrote.
Health issues among prisoners are increasing as the population trends older, Pojmann wrote. The average age for people in a state prison is 41.7 years, compared to the state average age of 38.8. The share of the prison population over 50 has increased to 25% from 18.7% in the past 10 years, she wrote.
More than half have at least one chronic health condition.
“Missouri’s prison population is older and sicker than it was 10 years ago,” Pojmann wrote.
The death rate among people in the custody of the corrections department is similar to the national average and lower than five of eight surrounding states, Pojmann wrote.
The largest number of deaths in a single prison in 2024 was 23 in the Eastern Reception and Diagnostic Center, a prison that includes an initial intake facility that houses about 2,350 people.
The second largest was 18 at the South Central Correctional Center in Licking, which has a population of 1,600, followed by 16 deaths at the Jefferson City Correctional Center, which holds about 1,700.
There were no inmate deaths at the Boonville Correctional Center, which houses 828, the Ozark Correctional Center in Webster County, where 663 are held, or at the Women’s Eastern Reception and Diagnostic Center in Audrain County, which had 773 women in custody.
Only three of the deaths occurred at the other prison housing women, the Chillicothe Correctional Center, which has a population of 1,256.
Informing families
Last year, Willa Hynes won a $60,000 Sunshine Law judgment against the department for withholding records related to the death of her son, Jahi Hynes, who took his own life on April 4, 2021, in his cell at the Southeast Missouri Correctional Center in Charleston.
Hynes has also filed a wrongful death suit against the department and Corizon Health, the prison medical contractor at the time of his death.
Another case in the courts is the federal lawsuit filed by Tammy Reed, the mother of Brandon Pace, who died April 7, 2023, at the Tipton Correctional Center. The 11 counts in the lawsuit seek damages for wrongful death, civil rights violations and Missouri Sunshine Law violations for refusing to turn over any of the records, including video recordings, of the events prior to Pace’s death.
According to the lawsuit, when Pace refused to give up what corrections officers believed to be methamphetamine, they put him in a holding cell and ordered him to strip for a search. When he refused, the officers called the Correctional Emergency Response Team.
Members of that team sprayed Pace with “an excessive dose” of pepper spray while “Mr. Pace’s hands were restrained behind his back and his legs shackled,” the lawsuit states.
Videos record almost all activity in Missouri prisons but a common complaint in the lawsuits is the department refuses requests from family members for the records. The attorneys for Othel Moore’s family in October released the recording of his final moments of life obtained through their efforts in the lawsuit.
Déna Notz, who worked as a corrections officer in South Central Correctional Center during 2022, is an advocate with Collectively Changing Corrections. They have a special focus on the prison at Licking.
Lasater, she said, used her expertise as a registered nurse and trained forensic scientist to obtain answers for the families of men who died in the prison.
“She’s gone through a lot to try to be as transparent as possible with the families and with the news and everything,” Notz said.
Lasater made monthly social media posts summarizing her office’s work that included causes of death for cases from the prison. The men sent to her were patients, and the family members deserve to know all the information she can provide, Lasater said.
“I feel terrible for the families,” Lasater said. “They can get no information out of the prison about what happened. They get false information, and have a hard time getting the personal belongings back.
“I don’t have any restrictions,” she added. “I give the families what information I have.”
Because of the lengthy time it takes to get autopsy results, Lasater collected blood samples for toxicology analysis. That information is included in her reports, she said.
The administration at South Central did not like her insistence on receiving full medical reports and video of the inmate at the time of their death and then reporting what she found, Lasater said.
“I’ve been blocked, blockaded, insulted and threatened for trying to do my job,” Lasater said.
Every coroner serving a county where there is a prison should push to get information for families, she said.
“There’s no reason to hold it back,” Lasater said. “There’s no such thing as HIPAA in a death investigation. It’s open.”
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