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A study published in Nature Communications found that extremely hot and cold days were associated with higher rates of deaths, infirmary admissions and transfers to outside medical facilities among people in Pennsylvania state prisons over 20 years. The researchers also found that women had greater increases in some medical-care measures after very hot days than men; the study does not establish that temperatures alone caused those outcomes.
A study of Pennsylvania state prisons found that extreme heat and cold were associated with higher rates of deaths, infirmary admissions and transfers to outside medical facilities over a 20-year period. Published in Nature Communications, the research also reported that women had greater increases than men in some medical-care measures after extremely hot days, drawing attention to risks in an aging prison system where cooling is limited at some facilities.
The study, led by epidemiologist Jaquelyn L. Jahn and colleagues, analyzed mortality and health-service use among people held in Pennsylvania state prisons. The researchers reported that both very hot and very cold temperatures were associated with increased rates of the measured outcomes. The findings add data to longstanding concerns raised by incarcerated people, advocates and local media about temperature extremes inside prisons.
The report describes outdoor temperatures across Pennsylvania reaching 103 degrees Fahrenheit and falling to minus 9 degrees during the year before publication. People in custody cannot freely seek air conditioning or a public warming center. The source says several prisons have air conditioning only in certain buildings or units, including some nursing-care areas, rather than throughout the facility.
One finding the researchers described as unexpected was that women had greater increases in infirmary visits and transfers to external medical facilities on and after extremely hot days than men. The report links this possible vulnerability to the health needs of incarcerated women, including menopause-related hot flashes and night sweats, while noting that earlier research in the general population has not consistently found greater heat risk for women.
Heat Adds Pressure to Prison Health Care
The findings matter because extreme temperatures can add medical demand to a system the report describes as already under strain. Pennsylvania holds nearly 40,000 people in state prisons, and the source says most facilities were built in the 1990s or earlier. Some have partial or very limited air conditioning, leaving people dependent on facility conditions during heat waves and cold spells.
The report also describes an aging population with substantial health needs. The average age at admission rose from 31 in 2000 to 38 in 2023, while medication costs for adults over 50 averaged $3,357 per person annually, 53% more than for younger incarcerated adults. Staffing shortages can further restrict access to appointments and other services. In that setting, temperature-related increases in deaths or medical care could complicate an already demanding health-care workload.
The results do not establish that extreme temperatures caused each death or medical visit. They do identify an association that researchers say should inform planning, particularly for older adults and women whose health needs may be affected by heat.
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Older Facilities, Growing Health Needs
Pennsylvania has the sixth-largest state prison population in the country, according to the source. Facilities named as having partial or limited air conditioning include Cambridge Springs, Dallas, Laurel Highlands, Muncy, Waymart and Huntingdon. The source identifies Huntingdon as the state’s oldest continuously operating correctional facility.
Prison health-care access is shaped not only by buildings and weather, but also by staffing and policy. The report says some facilities have had medical staff vacancy rates near 40%. It also notes that people in Pennsylvania prisons may be charged a $5 copay for a visit classified by the Department of Corrections as non-emergency, while prison wages range from 23 to 50 cents an hour.
The researchers place their findings alongside earlier research indicating that people incarcerated in the Northeast have experienced some of the largest increases in heat-related mortality risk since 2001. Their study focuses on Pennsylvania and examines both hot and cold extremes, rather than treating temperature exposure as a concern limited to summer heat.
“Extreme heat and extreme cold increase the demands on an already strained system of prison operations and health care delivery.”
— The study authors
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Limits of the Temperature Findings
The study reports associations, not proof that extreme temperatures directly caused individual deaths or medical visits. The source material does not provide the study’s detailed effect sizes, temperature thresholds, or full methods, so the magnitude of risk and how it varied among facilities cannot be assessed from the report excerpt alone.
It is also unclear what specific changes, if any, Pennsylvania officials have adopted in response to the findings, whether facilities have plans for upgrading cooling or heating systems, or how quickly those upgrades could be made. The report’s finding about women concerns increases in health-care use after hot days; it does not establish the biological or institutional causes of that difference.
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Planning for Future Temperature Extremes
The researchers argue that climate resilience planning should include improvements to prison conditions and health-care systems, as well as policy efforts to reduce the number of people incarcerated, particularly older adults. The source does not describe a specific state response or timetable for action.
Further scrutiny will depend on whether prison officials assess temperature conditions facility by facility, publish plans for heat and cold emergencies, and address access to medical care during extreme weather. For now, the study provides evidence for the relationship between temperature extremes and health-service outcomes in Pennsylvania prisons, while leaving the scale and timing of any operational changes unresolved.
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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 people in Pennsylvania state prisons over 20 years.
Did the study prove that extreme temperatures caused deaths?
No. The reported results show an association between temperature extremes and outcomes. The source does not say the study established that temperatures directly caused individual deaths or medical visits.
What did researchers find about women in custody?
Women had greater increases than men in infirmary visits and transfers to outside medical facilities on and after extremely hot days. The report says the reason for the difference remains uncertain.
Why are Pennsylvania prisons considered vulnerable?
The source says most state facilities were built in the 1990s or earlier and that some have air conditioning in only part of the facility or very limited cooling. It also describes an aging prison population and health-care staffing shortages.
Has Pennsylvania announced changes in response?
The source material does not identify a state response, specific facility upgrades or an implementation schedule. The researchers call for climate resilience planning, but the next steps from officials are unclear.
Source: rss
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