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A study published in Nature Communications found that extreme heat and cold were associated with higher death rates, infirmary admissions and outside medical transfers among people in Pennsylvania state prisons over 20 years. Women had larger increases in infirmary visits and transfers on and after extremely hot days than men, according to the researchers. The findings come as many facilities have limited air conditioning and the prison population is aging.
A study published in Nature Communications found that extremely hot and cold temperatures were associated with higher rates of deaths, infirmary admissions and transfers to outside medical facilities among people held in Pennsylvania state prisons over the past 20 years. The researchers also found that women had larger increases in infirmary visits and external medical transfers on and after extremely hot days than men, findings that raise concerns as many facilities have limited air conditioning and the prison population grows older.
The study, led by epidemiologist Jaquelyn L. Jahn and colleagues, analyzed mortality and health-service use in Pennsylvania state prisons after extreme ambient temperatures. The researchers reported associations with both extreme heat and extreme cold; the findings do not, on their own, establish that temperature caused an individual death or medical visit. The paper appears in the journal Nature Communications.
One finding the authors described as unexpected was that women experienced greater increases in infirmary visits and transfers to outside medical facilities on and after extremely hot days than men. The report says earlier studies in the general population have not consistently found women to be more vulnerable to heat-related health risks. The researchers suggest that conditions affecting incarcerated women, including menopause symptoms and limited access to cooling, hydration or hormone therapy, may help explain the pattern, but the supplied report does not establish a specific mechanism.
The report says outdoor temperatures in Pennsylvania reached 103 degrees Fahrenheit and fell to -9 F during the year before the report. People in custody cannot freely seek air conditioning or use public warming centers. Several state facilities—including Cambridge Springs, Dallas, Laurel Highlands, Muncy, Waymart and Huntingdon—have partial or very limited air conditioning, meaning some buildings or units have cooling while others do not. These conditions are described in the report alongside accounts of harsh indoor temperatures, including testimony from a woman incarcerated at MCI Muncy who said she wore several layers during winter.
Heat Risks for Women and Older Prisoners
The findings matter because temperature extremes add pressure to a prison health system that the report describes as already strained. Pennsylvania has nearly 40,000 people in state prisons, and it has the sixth-largest state prison population in the country, according to the source report. Many incarcerated people have chronic conditions, and older adults often need more medical attention than younger people.
The report says the average age at admission to Pennsylvania prisons rose from 31 in 2000 to 38 in 2023. It also puts annual medication costs for incarcerated adults over 50 at an average of $3,357 per person—53% more than for younger incarcerated adults. Extreme heat or cold can increase demand for medical attention at the same time staffing shortages limit the system’s capacity to provide it.
Women’s larger increases in some health-service measures warrant attention in planning and further research, particularly because the report says incarcerated people may experience accelerated aging and earlier chronic disease. The study does not show that all women face the same risk, or that the reported associations apply equally to every facility. It does indicate that prison climate planning and access to care may need to account for differences in age, health and facility conditions.
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Older Facilities, Strained Care
The report says most Pennsylvania state prisons were built in the 1990s or earlier, before current patterns of extreme weather. Some facilities have cooling only in selected buildings or units, such as nursing-care areas. The source describes winter heating problems as well as hot indoor conditions during heat waves, making the exposure a concern in both seasons rather than heat alone.
Health care access is also affected by staffing and movement restrictions. The report cites chronic shortages of corrections officers, nurses and physicians, with medical-staff vacancy rates nearing 40% at some facilities. When corrections staffing is short, movement within facilities can be restricted, limiting access to appointments and programming. Pennsylvania also charges a $5 copay for visits the Department of Corrections classifies as non-emergency; the report notes prison wages of 23 to 50 cents an hour, putting the charge in that financial context.
The report argues that temperature exposure intersects with these existing challenges. It also notes constitutional protections against deliberate indifference to prisoners’ medical needs. The study’s findings add evidence about health-service use and deaths during temperature extremes, but they do not by themselves determine whether any particular prison’s conditions violate the law.
“Extremely hot and cold temperatures were associated with higher rates of deaths, infirmary admissions and transfers to external medical facilities.”
— Jaquelyn L. Jahn and co-authors, in the study as summarized by Medical Xpress
Limits of the Findings
The supplied report does not provide the study’s full numerical estimates, the exact temperature thresholds used to define extreme heat and cold, or facility-by-facility results. It also does not specify how the analysis accounted for other factors that might affect deaths or medical-service use. The reported associations should not be read as proof that extreme temperatures caused each outcome.
It remains unclear what specific changes, if any, Pennsylvania officials plan to make in response, how many people are housed in units without air conditioning, and whether cooling or heating upgrades are funded or scheduled. The report also does not establish why women showed larger increases in some health-service measures after extreme heat. Further detail from the full paper and state officials would help clarify those questions.
Planning for Future Temperature Extremes
The researchers argue that climate resilience planning will require better prison conditions, stronger prison health care systems and policy efforts to reduce the number of people incarcerated, particularly older adults. The supplied report does not identify a state response deadline or a scheduled infrastructure plan, so no specific upgrade timeline is confirmed.
The next developments to watch are whether Pennsylvania corrections officials review temperature protections and medical access in facilities with limited cooling, and whether they publish plans for heat and cold emergencies. Additional reporting on the study’s methods and results, along with state data on building conditions, staffing and health outcomes, could show where risks are concentrated and what steps are being considered.
Key Questions
What did the Pennsylvania prison study find?
It found that extreme heat and cold were associated with higher rates of deaths, infirmary admissions and transfers to outside medical facilities among people in Pennsylvania state prisons over a 20-year period.
Did women show a different pattern during extreme heat?
Yes. The researchers reported larger increases among women than men in infirmary visits and external medical transfers on and after extremely hot days. The study summary does not establish why this difference occurred.
Do Pennsylvania prisons all have air conditioning?
No such systemwide coverage is described in the report. It says several facilities have partial or very limited air conditioning, with cooling in some buildings or units but not others.
Does the study prove that temperature caused the deaths or medical visits?
No. The reported results describe associations between extreme temperatures and outcomes. They do not establish that temperature caused each individual death, infirmary admission or transfer.
What changes are planned in response?
The report calls for climate resilience planning but does not confirm a specific state plan, funding decision or timeline. Whether Pennsylvania officials will announce facility upgrades or other measures remains unclear.
Source: rss
