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


"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

"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

Media Appearances

Meet the Press

Dateline with Lester Holt

Ready to hear more from the authors? Subscribe to the "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
  • 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)