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Cold-related Mortality in US State and Private Prisons: A Case-Crossover Analysis
Julianne Skarha1, Keith Spangler2, David Dosa3,4
1From the Department of Epidemiology, School of Public Health, Brown University, Providence, RI.
Epidemiology (Cambridge, Mass.)
|December 31, 2024
Summary
Cold prison temperatures increase mortality risk, especially for suicides. Older Southern or Western facilities and medical units showed higher risks, highlighting the impact of the prison environment on incarcerated health.
Area of Science:
- Environmental Health
- Public Health
- Epidemiology
Background:
- Cold temperatures are linked to higher cardiovascular and respiratory disease mortality.
- Prisons have poor temperature regulation, increasing vulnerability for incarcerated populations.
Purpose of the Study:
- To investigate the association between cold temperatures and mortality in US prisons.
- To examine the impact of cold exposure on total mortality, cardiovascular disease, respiratory disease, and suicide deaths.
Main Methods:
- Analysis of US prison mortality data from 2001 to 2019.
- Case-crossover study design to assess the association between cold temperature decreases and mortality risk.
- Evaluation of effect modification by personal, facility, and regional characteristics.
Main Results:
- A 10°F temperature decrease was linked to a 5.1% increase in total mortality.
- Extreme cold days showed an 11% increase in total mortality and a 55% increase in suicides.
- Increased mortality risk was highest in older prisons (pre-1980), in Southern/Western regions, and dedicated medical facilities.
Conclusions:
- Cold temperatures significantly increase mortality risk in prisons, with a notable rise in suicides.
- The physical environment of correctional facilities critically impacts the health outcomes of incarcerated individuals.
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