A magazine for friends of the Warren Alpert Medical School of Brown University.

In Prisons, Heat Waves Kill


More people died in Texas prisons without air conditioning than in those with it, study finds.

The US has the world’s largest population of prisoners, and Texas holds more incarcerated people than any other state. As climate change continues to increase the severity, frequency, and duration of heat waves, the approximately 160,000 individuals in Texas prisons—as well as the people who work in these settings—come under intense physical duress in prisons without climate controls, according to a new study led by researchers at Brown University.

The study, published in JAMA Network Open, examined the relationship between heat exposure and mortality risks in Texas prisons, focusing on how these risks vary between prisons with air conditioning and those without it.

The researchers analyzed data gathered between 2001 and 2019 showing that 271 people died due to extreme heat exposure during that timeframe.

Even a 1 degree increase above 85 degrees Fahrenheit can elevate the daily risk of dying by 0.7 percent, the researchers found.

The research team—which also included scholars from Harvard University, Boston University, and the organization Texas Prison Community Advocates—combined data from the US Bureau of Justice Statistics on mortality in Texas prisons with temperature data from NASA and used a novel epidemiologic analysis to arrive at its findings. The team reported that approximately 13 percent of mortality during warm months may be attributable to extreme heat in Texas prison facilities without air conditioning.

It is important to note that while an average of 14 people died each year from heat-related causes in Texas prisons without air conditioning, not a single heat-related death occurred in climate-controlled prisons, says lead study author Julie Skarha PhD’22.

“The majority of Texas prisons do not have universal air conditioning,” Skarha says. “And in these settings, we found a 30-fold increase in heat-related mortality when compared to estimates of heat-related mortality in the general US population.”

Study co-author David Dosa, MD, MPH, an associate professor of medicine and of health services, policy, and practice at Brown, says heat is often a silent killer.

“We have seen similar situations in nursing homes, where heat isn’t reported on the death certificate,” says Dosa, a practicing geriatrician with dual appointments at the Providence VA Medical Center and Rhode Island Hospital. “It’s only after we run these analyses that we can determine how much of a role heat played in someone’s death.”

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