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A study published in Nature Communications found that extreme heat and cold were associated with higher rates of deaths, infirmary admissions and transfers to outside medical facilities in Pennsylvania state prisons over 20 years. Women had greater increases in infirmary visits and outside medical transfers on and after extremely hot days than men, the researchers reported. The findings add to concerns about aging facilities, limited air conditioning and strained prison health services.
A 20-year study of Pennsylvania state prisons found that extremely hot and cold temperatures were associated with higher rates of deaths, infirmary admissions and transfers to outside medical facilities among incarcerated people. Published in Nature Communications, the research also found that women had greater increases than men in infirmary visits and outside medical transfers on and after extremely hot days, raising concerns about the capacity of aging facilities to protect people during temperature extremes.
The study, led by epidemiologist Jaquelyn L. Jahn and colleagues, examined mortality and use of health services in Pennsylvania prisons following extreme ambient temperatures. The researchers said the findings put data behind concerns voiced for years by incarcerated people, advocates and local media about dangerous heat and cold inside facilities. The study reports associations; the source material does not establish that temperature alone caused the deaths or medical visits.
Pennsylvania has nearly 40,000 people in state prisons, the sixth-largest state prison population in the country, according to the report. Most facilities were built in the 1990s or earlier, and some have only partial or limited air conditioning, with cooling available in certain buildings or units but not others. The source cites extreme temperatures of 103 degrees Fahrenheit and minus 9 degrees recorded across the state last year.
The researchers’ unexpected finding about women concerns increases in infirmary visits and transfers to external medical facilities around extremely hot days. The report says previous research in the general population has not consistently found greater heat vulnerability among women. It suggests menopause-related symptoms, including hot flashes and night sweats, may add risks when cooling, hydration or hormone therapy is limited, but the study summary does not establish those symptoms as the cause of the observed difference.
Heat Risks Meet Limited Prison Care
The findings matter because incarcerated people cannot freely leave a cell or facility to seek air conditioning, warmth or public shelter during extreme weather. In prisons with limited cooling or unreliable heating, exposure may coincide with restricted movement and limited access to health care. That can be especially consequential for older people and those with chronic conditions.
The report describes an already strained care system. The average age at admission to Pennsylvania prisons rose from 31 in 2000 to 38 in 2023, and the average annual medication cost for incarcerated adults over 50 was $3,357 per person, 53% above the figure for younger adults. Some facilities have had medical-staff vacancy rates near 40%, according to the source. Extreme temperatures may add demand when staffing and access to appointments are already constrained.
The research does not prescribe a specific policy or quantify the cost of facility upgrades. Its authors argue that climate resilience will require attention to prison conditions and health-care capacity, as well as policy efforts to reduce incarceration, particularly among older adults.
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Aging Buildings, Older Population
Reports of uncomfortable or dangerous temperatures in Pennsylvania prisons predate this study. The source describes summer conditions as sauna-like and winter cold when heating systems malfunction. Amy McBride, an incarcerated woman in her early 60s at MCI Muncy, told the Prison Journalism Project that in winter she sometimes wore two to three layers of pants and four to six layers of shirts, along with a jacket and coat.
Facilities named in the report as having partial or very limited air conditioning include Cambridge Springs, Dallas, Laurel Highlands, Muncy, Waymart and Huntingdon. The report also points to national research suggesting that incarcerated people in the Northeast have experienced some of the greatest increases in heat-related mortality risk since 2001; that is prior research, not a result specific to this Pennsylvania study.
Health risks may be compounded by conditions of confinement. The source says incarcerated people are more likely than the general population to have chronic illnesses and that staff shortages can restrict movement, reducing access to appointments, therapy and other programming. Pennsylvania charges a $5 copay for certain non-emergency medical visits, while prison wages range from 23 to 50 cents an hour, according to the report.
“Extreme heat and extreme cold increase the demands on an already strained system of prison operations and health care delivery.”
— Jaquelyn L. Jahn and colleagues, study authors
Limits of the Findings
The reported results show associations between extreme temperatures and health outcomes; the supplied material does not provide effect sizes, detailed methods or evidence that temperature directly caused any individual death or medical visit. It also does not identify which specific facilities or temperature thresholds accounted for the reported patterns.
The reason women experienced greater increases in some measures after very hot days remains uncertain. Menopause and related symptoms are offered as possible considerations, not a confirmed explanation. The source does not say whether prison officials have announced a response, which facilities will receive upgrades, or when any climate-resilience measures might be implemented.
Planning for Future Temperature Extremes
The researchers argue that preparation for a warmer climate should include improvements to prison conditions and health-care systems, alongside policy efforts to reduce the number of people incarcerated, especially older adults. The supplied report does not describe a state plan, timetable or funding commitment tied to the study.
Further details on facility-level exposure, the scale of the observed changes and the study’s methods would help officials and readers judge where interventions may be most needed. For now, the study adds evidence to a longstanding debate about whether aging prison buildings and constrained medical services can protect people during severe heat and cold.
Key Questions
What did the Pennsylvania prison study find?
It found that extremely hot and cold temperatures were associated with higher rates of deaths, infirmary admissions and transfers to outside medical facilities among incarcerated people over a 20-year period.
What did the study report about incarcerated women?
Women had greater increases than men in infirmary visits and transfers to external medical facilities on and after extremely hot days. The reason for that difference is not established in the source material.
Do Pennsylvania prisons all have air conditioning?
No. The report says some facilities have partial or very limited air conditioning, with cooling in some buildings or units but not others. It does not provide a system-wide inventory of equipment.
Does the study prove extreme temperatures caused the reported deaths?
No. The report describes associations between temperature extremes and health outcomes. It does not establish that temperature alone caused particular deaths or medical-care events.
Has Pennsylvania announced upgrades in response?
The supplied report does not mention a state response, funding plan or construction timetable. The researchers call for climate-resilience planning, but specific next steps remain unclear.
Source: rss
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