Death Rate Among ICE Detainees Surging in 2026

Deaths among people detained by Immigration and Customs Enforcement (ICE) have increased in recent years after a long decline, and better monitoring of medical care and mortality rates in this population is needed, said researchers of a retrospective study.

From fiscal year (FY) 2004 through January 19 (a fiscal year was defined as October 1 through September 30), there were 272 deaths in ICE custody, with the annual mortality rate hitting 88.9 per 100,000 person-years in the partial FY 2026, reported Sanjay Basu, MD, PhD, of the University of California San Francisco, and colleagues in a research letter published in JAMA.

Annual deaths ranged from 3 in FY 2022 to 28 in FY 2004, and annual mortality rates per 100,000 person-years ranged from 13.0 in FY 2023 to 127.7 in FY 2004. Although there was an extended decline in mortality rates from the early study years, the rate then increased to 75.6 in FY 2020, which included the first year of the COVID pandemic, and then dropped again for a few years before eventually rising in the partial FY 2026.

“The decline in deaths from FY 2004 to FY 2011 (127.7 to 30.0) might reflect both expanded medical standards under the Performance-Based National Detention Standards and shifts in detainee composition,” Basu and team noted. “The standards, introduced in 2008 and revised in 2011, stipulated improved screening, triage, and continuity of care, while the population shift included fewer individuals entering detainment via border arrest and more transfers from local jail or prison settings that had already completed initial health screening.”

“Recent increases in mortality occurred alongside major operational changes reported in 2025, including disrupted or terminated oversight mechanisms, rapid detention expansion with reports of overcrowding, and potentially delayed medical care (e.g., prescription payment processing) associated with the termination of Department of Veterans Affairs’ claims-processing support,” they continued. “These fluctuations raise questions regarding the consistent implementation of existing standards for health services in these facilities.”

The median age at death was 45 years and remained similar over time, and those who died were mostly male (91.5%).

The major causes of death varied over time, with infections (including COVID-19) representing 8.8% of deaths in FY 2004-2008 and tripling to 31.8% in FY 2017-2020. There were no suicides in FY 2004-2008, while 22.7% of deaths were suicides in FY 2017-2020.

Cardiovascular causes were common across periods (18.5% to 22.7%), as were deaths from unclassified or undetermined causes (18.2% to 60.4%). Deaths in hospitals or medical facilities accounted for 12.9% of deaths overall, ranging from 4.5% to 18.5%.

In an accompanying editorial, Michele Heisler, MD, MPA, of the University of Michigan Medical School in Ann Arbor, and Katherine Peeler, MD, MA, of Harvard Medical School in Boston, noted that these findings “raise clinical and ethical concerns,” adding that the median age of death of 45 years “underscor[es] the prematurity of many deaths in custody.”

They pointed out that the increase over time in suicide deaths suggests “serious gaps in mental health screening, treatment, and suicide prevention,” and the small percentage of deaths occurring in a hospital or medical facility indicates “that some detained individuals with life-threatening illness may not have reached a higher level of care in time.”

Furthermore, the fact that 48.9% of all deaths remained undetermined or unclassified is a big concern, Heisler and Peeler argued. “This is a surveillance failure that may obscure preventable causes and impede the clinical learning and accountability needed to prevent recurrence. Together, these patterns suggest not isolated lapses but systemic weaknesses in medical care, mental health protection, and mortality review in a population wholly dependent on the state.”

For this retrospective repeated cross-sectional study, Basu and colleagues obtained detainee death and population data from public and official sources for FY 2004 through partial FY 2026.

Information on deaths was obtained via a Freedom of Information Act request for FY 2004 through FY 2017 and ICE Detainee Death Reporting for FY 2018 to FY 2025. For FY 2026, deaths were identified from official ICE Detainee Death Reporting postings and official ICE Newsroom detainee death notifications; data were censored as of Jan. 19, 2026.

Deaths after transfer to a hospital were included if they occurred while the person was still in ICE custody, while deaths that occurred after ICE custody ended were excluded. Mortality rates were annualized using the FY mean daily population in the detention centers.

The study had several limitations, including a reliance on publicly reported deaths and denominators, no adjustment for individual-level comorbidities or facility-level case mix, possible under-ascertainment of deaths occurring after transfer to a hospital if ICE custody had ended before death, and exclusion of ICE-involved deaths outside custody, Basu and team wrote.

In addition, denominator information by age, sex, and facility type was not available. Overall, “more complete, auditable mortality surveillance in ICE detention is needed, including standardized follow-up after hospital transfer and after release, routine public release of denominator details for key clinical strata, and independent validation of reported causes of death,” they concluded.