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If you’re lucky enough to escape unscathed from contact with a Texas police officer, but unlucky enough to have broken an unjust law such as drug possession, the danger is not over.

550 people have died while in custody of Texas law enforcement so far in 2015, mostly under the Texas Department of Criminal Justice. Local departments and sheriff’s offices do their part too. Some places, such as Dallas, see “custodial deaths” at all levels of incarceration—city, county and state.

Causes of custodial death can include illness (heart disease, cancer, etc.), suicide, drug or alcohol intoxication, accident or homicide. However, it is likely that there are more homicides than reported, only at the hands of cops.

The case of Sandra Bland illustrates how suspicious some of these deaths can be. Bland was charged with “assault on a public servant,” but dashcam video showed no such thing. The arresting officer, enraged at Bland’s flexing of her rights, threatened her repeatedly before making the arrest. Bland was later found dead in her cell, allegedly hanging herself with a plastic bag.

In July, 32-year-old Jesse Jacobs checked himself into Galveston County Jail to serve a 30-day sentence. He was denied medication after suffering seizures and died after becoming unresponsive three days later. The department insists he died of natural causes, yet they were aware that he needed the medication from a phone call put in by Jacobs’ mother.

Four people in eight days died while in the custody of the Houston Police Department, two before they even reached a jail cell. One died by allegedly hanging himself 12 hours after being booked for drug possession, even though he passed their mental health evaluation.

Unnatural causes of death while in custody have increased in the U.S. since 2007, while illness-related deaths have declined. Suicide is consistently the leading cause of death, but intoxication, accidents, and homicides have all increased. California joins Texas to produce nearly a quarter of all jail inmate deaths.

Many of these “intoxication” or “natural cause” deaths are likely due to the police denying medical services or medication to those who are obviously in need, as in the case of Jacobs. These deaths could be construed as a form of homicide.

Once in custody of law enforcement, it is easy for an “accident” to happen on the way to or in jail that leaves a person “unresponsive” and eventually dead, with the incident chalked off as a natural cause. Some cops are known to take out their racism or other phobia on those they apprehend.

Sandra Bland was an outspoken civil rights activist, and the arresting officer had a history of “humiliating and mistreating” black people. Jesse Jacobs was among a string of high-profile cases of gay men dying in police custody.

With 550 people dying while in custody so far this year, Texas is on its way to preserving another notorious reputation, alongside its ravenous appetite for state-sanctioned execution.

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