Death in Custody Book

Death in Custody:

How America Ignores the Truth and What We Can Do about It

By Roger A. Mitchell Jr, MD and Jay D. Aronson, PhD

The United States significantly undercounts the number of people who die in law enforcement custody each year. How can we fix this?


Deaths resulting from interactions with the US criminal legal system are a public health emergency, but the scope of this issue is intentionally ignored by the very systems that are supposed to be tracking these fatalities. We don't know how many people die in custody each year, whether in an encounter with police on the street, during transport, or while in jails, prisons, or detention centers. In order to make a real difference and address this human rights problem, researchers and policy makers need reliable data.

In Death in Custody, Roger A. Mitchell Jr., MD, and Jay D. Aronson, PhD, share the stories of individuals who died in custody and chronicle the efforts of activists and journalists to uncover the true scope of deaths in custody. From Ida B. Wells's enumeration of extrajudicial lynchings more than a century ago to the Washington Post's current effort to count police shootings, the work of journalists and independent groups has always been more reliable than the state's official reports. Through historical analysis, Mitchell and Aronson demonstrate how government at all levels has intentionally avoided reporting death in custody data.

Mitchell and Aronson outline a practical, achievable system for accurately recording and investigating these deaths. They argue for a straightforward public health solution: adding a simple checkbox to the US Standard Death Certificate that would create an objective way of recording whether a death occurred in custody. They also propose the development of national standards for investigating deaths in custody and the creation of independent regional and federal custodial death review panels. These tangible solutions would allow us to see the full scope of the problem and give us the chance to truly address it.

Dr. Roger Mitchell Jr on Meet the Press

About the Authors

Roger A. Mitchell Jr., MD, (WASHINGTON, DC) is a professor and chair of pathology at the Howard University College of Medicine. He is a forensic pathologist who previously served as the Chief Medical Examiner and Deputy Mayor for Public Safety and Justice of Washington, DC. He is the author of The Price of Freedom: A Son’s Journey.

Roger Mitchell, Jr

Jay D. Aronson (PITTSBURGH, PA) is the founder and director of the Center for Human Rights Science at Carnegie Mellon University, where he is a professor of science, technology, and society in the Department of History. He is the author of Who Owns the Dead? The Science and Politics of Death at Ground Zero and Genetic Witness: Science, Law, and Controversy in the Making of DNA Profiling.

Jay Aronson

Media Appearances

Meet the Press

Dateline with Lester Holt


"There’s no real way to know how many people die in custody each year. In their book, Death in Custody, Roger and Jay chronicle the efforts of activists and journalists to uncover the true scope of this problem, to try to figure out how many people actually are dying in custody. And they argue for a straightforward solution. I learned a lot from this book. It blew my mind."

DeRay McKesson, Pod Save the People

Dr. Mitchell and Professor Aronson's meticulous examination of our criminal legal system is a shocking exposure of just how little our society knows or cares to know about people dying in custody. In their careful accounting of various attempts to understand and prevent deaths in custody, one thing becomes clear: the reforms on the margins that federal, state, and local governments engage in are simply not enough to stop the human suffering that occurs every day in this country.

Hunter Parnell, Public Defenseless Podcast

Death in Custody is a radical shift in how to analyze violence, misconduct, and dysfunction in the criminal justice system in the modern era. Aronson and Mitchell offer recommendations for attempting to sort out this crisis, but this book would be important even if it didn't. Death in Custody makes the case that white supremacy, economic inequality, and exploitation are among the causes of this festering problem.

Brian Gilmore, The Progressive

"America's prisons have become death houses for so many people who have tragically lost their lives as a result of neglect, abuse, and mismanagement. This critically important work shines a powerful light on a public health emergency created by our nation's addiction to incarceration and extreme punishment. An urgent, compelling, and necessary call to action we should all embrace."

Bryan Stevenson, Founder and Executive Director, Equal Justice Initiative

Death in Custody provides readers with the brutal history on which the U.S. criminal legal system was built. These unnecessary deaths will continue to occur until there is a uniform way of making our judicial system transparent and accountable.

Antoine Davis, ZEKE magazine

In Death in Custody, Roger A. Mitchell Jr. and Jay D. Aronson argue that deaths in law enforcement custody amount to a public health emergency. Their work ties in high-profile examples and shows how journalists have long done the work of tracking in-custody deaths. Mitchell and Aronson argue that collecting accurate data is the first step toward addressing this crisis.

Chris Blackwell, The Appeal

"Dr. Roger Mitchell has an extensive history conducting in-custody death investigations. I cannot think of anyone more qualified, committed, or passionate in exposing these often-invisible deaths that leave so many grieving families with unanswered questions. Death in Custody by Dr. Mitchell and Dr. Jay Aronson is an exhaustive and critical examination that is long overdue."

Keith L. Alexander, Pulitzer Prize–winning crime and courts reporter, The Washington Post

"This timely, important, and well-researched book shines a much-needed light on the epidemic of preventable―and hidden―deaths in our nation's prisons and jails. It's impossible to read it without demanding that policy makers address the lack of data, the lack of oversight, and the lack of humanity in these dark places."

Michele Deitch, Prison and Jail Innovation Lab, The University of Texas at Austin

Ready to hear more from the authors? Subscribe to the "Official Ignorance" podcast.

Official Ignorance Podcast


  • National Medical Association Annual Meeting (New Orleans, LA) Session on “Care Behind Bars – Setting an NMA Agenda for Correctional Medicine” August 1, 2023
  • Book Launch (Washington, DC ) at 14th and V Busboys and Poets Thursday Sept 7, 2023 7-9pm Registration Link
  • Congressional Black Caucus Authors Forum (Washington, DC) Sept 2023
  • University of Pittsburgh School of Law (Pittsburgh, PA) Thursday Sept 28, 2023 Barco Building, Room #107 12:30-2pm
  • Community Book Launch (Pittsburgh, PA ) at Trace Brewery Thursday Sept 28, 2023 6:30-8:30pm Registration Link
  • Duquesne University Wecht Institute Forensic Fridays Event on Death in Custody and Excited Delirium (Pittsburgh, PA and online), featuring Dr. Joye Carter (forensic pathologist) and Joanna Naples-Mitchell (Physicians for Human Rights) Friday Sept 29, 2023 8:30am-12pm ET (CLE and CME available; more info and registration link coming soon!)
  • Carnegie Mellon University Dept. of History and CAUSE Book Forum (Pittsburgh, PA) Friday Sept 29, 4-6pm
  • Riverstone Books (Pittsburgh, PA) Jay Aronson in conversation with Tanisha Long. October 19, 2023
  • Howard University Homecoming (Washington, DC) Roger Mitchell Book Signing. October 19, 2023
  • Santa Clara University (Santa Clara, CA) 12:15-1:30pm PT, Learning Commons University Library—St. Clare Room and Zoom. November 9, 2023 - Registration Link
  • NACOLE Prison and Jail Oversight Virtual Workshop on Recording and Investigating Deaths in Custody (featuring Madalyn Wasilczuk from University of South Carolina School of Law and the Incarceration Transparency-SC) Tuesday December 5, 2023 12:45-2:15pm ET (registration info coming soon)
  • Philadelphia Book Launch, in conjunction with the Pennsylvania Prison Society. January 25, 2024
  • CSU Santa Barbara Lecture Series on Race and Policing 1-2pm PT/4-5pm ET. February 7, 2024