Deaths in Missouri state prisons reached a new high in 2024. The Missouri Department of Corrections reported 139 deaths that year — the highest total recorded in at least the prior five years, and the fourth consecutive year in which deaths in Missouri prisons averaged 10 or more per month. The deaths span disease, overdose, violence, and suicide, and represent a pattern of mortality that advocacy organizations, journalists, and legislators have called a public health and accountability crisis.
The Four-Year Trend
Missouri DOC reported 137 deaths in each of 2022 and 2023. The 2024 figure of 139 is two more — a marginal statistical increase at the top of an already elevated plateau. What is notable is not the year-over-year change but the sustained elevation: four years of averaging more than 10 deaths per month inside state prisons is not a fluctuation, it is a sustained pattern that demands explanation.
For context, Missouri's state prison population of approximately 23,000 to 25,000 means the crude mortality rate inside state prisons is well above what would be expected in a comparable general population of similar age and demographic composition, even accounting for the known health disparities of incarcerated populations.
Where the Deaths Are Concentrated
The geography of Missouri prison deaths in 2024 is striking:
- Eastern Reception, Diagnostic and Correctional Center (ERDCC) — Bonne Terre: 23 deaths, the highest of any single facility. ERDCC is a reception center that processes newly sentenced inmates from the St. Louis region and also functions as a regular prison. Its high death count relative to its population is an outlier that invites scrutiny.
- South Central Correctional Center (SCCC) — Licking: 19 deaths in 2024, making it the second-highest in the state. SCCC has been the subject of particular scrutiny because drug overdose — primarily fentanyl — was the leading cause of death at the facility from 2018 through 2024, with overdoses accounting for roughly a third of deaths in 2024.
- Jefferson City Correctional Center — Jefferson City: 16 deaths in 2024, third highest in the state.
Causes of Death
Of the 139 deaths in 2024, four were executions (Missouri is one of the more active death-penalty states). The other 135 deaths were distributed among:
- Disease — the largest category overall, reflecting both the aging prison population and the accumulated health deficits of people entering custody with untreated conditions.
- Drug overdose — particularly fentanyl, concentrated at South Central but present across the system.
- Violence — homicides committed by other inmates.
- Suicide — a significant and often underreported cause of prison mortality nationally.
Data Transparency: A New System
One improvement in Missouri in 2024 was the implementation of a new death tracking system. According to KCUR and reporting by the Missouri Independent, the DOC updated its data collection method to automatically pull each death from its offender management system into a single document updated weekly — giving the department (and eventually the public and legislature) a real-time picture of mortality across facilities for the first time.
Before this change, Missouri had no reliable mechanism for tracking how many people died in state prisons in real time. Deaths were documented at the facility level but were not automatically aggregated or reported — meaning that the DOC's own leadership was operating without current mortality data. This is a transparency baseline that most states already met; Missouri's 2024 implementation brought it up to standard, at least administratively.
What Families Should Know
If your loved one is in a Missouri state prison, the 2024 data is relevant context:
- If they are at Eastern Reception, South Central, or Jefferson City Correctional, those are the three facilities with the highest 2024 death counts.
- If they have a serious chronic condition, the disease mortality category is the largest driver of deaths — ensuring they are connected to the medical unit and receiving treatment for any diagnosed conditions is essential.
- If they have a history of substance use, the overdose risk at South Central and systemwide is real — ask about medication-assisted treatment (MAT) availability.
Missouri DOC headquarters: 2729 Plaza Drive, PO Box 236, Jefferson City, MO 65102. Phone: (573) 751-2389. Website: doc.mo.gov.