Climate Control for Extreme Temperatures in Corrections (2024) | National Commission on Correctional Health Care

Climate Control for Extreme Temperatures in Corrections (2024)

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Position Statement

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Extreme indoor and outdoor temperatures adversely affect the health of people residing and working in carceral settings. Every carceral facility should implement standards to minimize extreme temperature exposure indoors and outdoors and adopt steps for prevention and mitigation.

Discussion

Climate scientists forecast rising ambient temperatures and days with extreme heat in addition to greater variation in weather, including cold spells.

In major cities across the United States, heat waves are occurring more frequently than they have in the past, increasing from an average of two per year during the 1960s to six per year during the 2010s and 2020s.1 Notably, the average heat wave season across 50 cities included in an Environmental Protection Agency study is roughly 46 days longer now than it was in the 1960s.1 By middle of this century, the annual numbers of days with heat indices exceeding 100 °F and 105 °F are projected to double and triple, respectively, compared to a 1971–2000 baseline.2

There is robust evidence that high temperatures in carceral facilities are associated with morbidity and mortality.3,4 Certain areas of the facility may be more prone to extreme high temperatures, such as kitchen or laundry areas, if there is insufficient cooling and ventilation in those areas. Extreme cold also poses risk from inadequate and/or uneven indoor heating and unmitigated outdoor exposures for incarcerated people and carceral employees.5

High temperatures impose physiological stress on the human body, putting older people, those with mental disorders, those who take medications that affect body temperature regulation, and those who have certain comorbidities at risk for hospitalization or death.6-9 High temperatures also impair sleep quality and exacerbate sleep apnea,10 and are associated with occupational safety.11-13 Air conditioning and appropriate heating in carceral facilities is protective.14 For those who work outside, access to water/hydration and sun protection is also protective.

There is some, albeit mixed, evidence of the impact of heat on judicial, police, and other decision-making.15-20 Numerous studies, including systematic reviews and meta-analyses, show high temperatures are associated with worse mental health, aggressive behavior, and, importantly, higher rates of suicide and violence.21-33 Adverse heat-related effects on mental health and violence have been shown in corrections34,35 and appear causal.36 Temperature control policies are lacking in many state prisons37 and, to date, court cases have been the main recourse.4 A recent national survey of jail leaders found high levels of support for adequate air conditioning in jails.38 A review of 100 legal cases related to carceral temperature exposures found 61 cases related to cold exposure, 32 related to heat exposure, and seven related to both.5

In summary, there is compelling evidence that exposure to extreme temperatures has adverse physical, mental, and behavioral effects, including increasing mortality. These exposures in carceral environments, whether indoors or outdoors, undermine the principle of proportionality in terms of retribution and the principle of rehabilitation based on worsening mental effects and violence. Given the absence of policies and transparency surrounding this issue, NCCHC exhorts all carceral facilities to implement standards to minimize extreme temperature exposures and adopt prevention and mitigation steps by incorporating these considerations as a component of the facility’s safety plan and housing plan.

August 2024 – Adopted by the National Commission on Correctional Health Care Governance Board

References

  1. Environmental Protection Agency. (2024). Climate change indicators: Heat waves. Available at https://www.epa.gov/climate-indicators/climate-change-indicators-heat-waves
  2. Dahl, K., Licker, R., Abatzoglou, J. T., & Declet-Barreto, J. (2019). Increased frequency of and population exposure to extreme heat index days in the United States during the 21st century. Environmental Research Communications, 1(7), 075002. https://doi.org/10.1088/2515-7620/ab27cf
  3. Skarha, J., Spangler, K., Dosa, D., Rich, J. D., Savitz, D. A., & Zanobetti, A. (2023). Heat-related mortality in U.S. state and private prisons: A case-crossover analysis. PloS One, 18(3), e0281389. https://doi.org/10.1371/journal.pone.0281389
  4. Palacios, J. E., & Vaughn, M. S. (2023). Inmates with heat-sensitive health conditions: Surveying prisoner litigation in the age of climate change. Criminal Justice Review, https://doi.org/10.1177/07340168231166748
  5. Skarha, J., Peterson, M., Rich, J. D., & Dosa, D. (2020). An overlooked crisis: Extreme temperature exposures in incarceration settings. American Journal of Public Health, 110(S1), S41-s42. https://doi.org/10.2105/ajph.2019.305453
  6. Williams, S., Nitschke, M., Weinstein, P., Pisaniello, D. L., Parton, K. A., & Bi, P. (2012). The impact of summer temperatures and heatwaves on mortality and morbidity in Perth, Australia 1994-2008. Environment International, 40, 33-38. https://doi.org/10.1016/j.envint.2011.11.011
  7. Bunker, A., Wildenhain, J., Vandenbergh, A., Henschke, N., Rocklöv, J., Hajat, S., & Sauerborn, R. (2016). Effects of air temperature on climate-sensitive mortality and morbidity outcomes in the elderly; a systematic review and meta-analysis of epidemiological evidence. EBioMedicine, 6, 258-268. https://doi.org/1016/j.ebiom.2016.02.034
  8. Burke, M., González, F., Baylis, P., Heft-Neal, S., Baysan, C., Basu, S., & Hsiang, S. (2018). Higher temperatures increase suicide rates in the United States and Mexico. Nature Climate Change, 8, 723-729. https://doi.org/10.1038/s41558-018-0222-x
  9. Liu, J., Varghese, B. M., Hansen, A., Borg, M., Zhang, Y., Driscoll, T., Morgan, G., Dear, K., Gourley, M., Capon, A., & Bi, P. (2021). Hot weather as a risk factor for kidney disease outcomes: A systematic review and meta-analysis of epidemiological evidence. Science of the Total Environment, 801, https://doi.org/10.1016/j.scitotenv.2021.149806
  10. Rifkin, D. I., Long, M. W., & Perry, M. J. (2018). Climate change and sleep: A systematic review of the literature and conceptual framework. Sleep Medicine Reviews, 42, 3-9. https://doi.org/10.1016/j.smrv.2018.07.007
  11. Park, R. J., Pankratz, N., & Behrer, A. P. (2021). Temperature, workplace safety, and labor market inequality (Working paper series). Washington Center for Equitable Growth. https://equitablegrowth.org/working-papers/temperature-workplace-safety-and-labor-market-inequality
  12. Lai, W., Qiu, Y., Tang, Q., Xi, C., & Zhang, P. (2023). The effects of temperature on labor productivity. Annual Review of Resource Economics, 15, 213–232. https://doi.org/10.1146/annurev-resource-101222-125630
  13. Filomena, M., & Picchio, M. (2023). Unsafe temperatures, unsafe jobs: The impact of weather conditions on work-related injuries. Journal of Economic Behavior & Organization, 224, 851–875. https://doi.org/10.1016/j.jebo.2024.06.016
  14. Skarha, J., Dominick, A., Spangler, K., Dosa, D., Rich, J. D., Savitz, D. A., & Zanobetti, A. (2022). Provision of air conditioning and heat-related mortality in Texas prisons. JAMA Network Open, 5(11), e2239849. https://doi.org/10.1001/jamanetworkopen.2022.39849
  15. Heyes, A., & Saberian, S. (2019). Temperature and decisions: Evidence from 207,000 court cases. American Economic Journal: Applied Economics, 11(2), 238-265. https://doi.org/1257/app.20170223
  16. Craigie, T.-A., Taraz, V., & Zapryanova, M. (2023). Temperature and convictions: Evidence from India. Environment and Development Economics, 28(6), 1-21. https://doi.org/10.1017/S1355770X23000050
  17. Krause, J. S., Brandt, G., Schmidt, U., & Schunk, D. (2023). Don’t sweat it: Ambient temperature does not affect social behavior and perception. Journal of Economic Psychology, 99, https://doi.org/10.1016/j.joep.2023.102657
  18. Fesselmeyer, E. (2021). The impact of temperature on labor quality: Umpire accuracy in Major League Baseball. Southern Economic Journal, 88(2), 545–567. https://doi.org/10.1002/soej.12524
  19. Behrer, A. P., & Bolotnyy, V. (2024). Heat and law enforcement. PNAS Nexus, 3(5), pgad425. https://doi.org/1093/pnasnexus/pgad425
  20. Spamann, H. (2020). No, judges are not influenced by outdoor temperature (or other weather): Comment (Harvard Law School John M Olin Center Discussion Paper No. 1036). http://www.law.harvard.edu/programs/olin_center/papers/pdf/Spamann_1036.pdf
  21. Dixon, P. G., McDonald, A. N., Scheitlin, K. N., Stapleton, J. E., Allen, J. S., Carter, M. W., Holley, M. R., Inman, D. D., & Roberts, J. B. (2007). Effects of temperature variation on suicide in five US counties, 1991–2001. International Journal of Biometeorology, 51, 395-403. https://doi.org/10.1007/s00484-006-0081-4
  22. Cianconi, P., Betrò, S., & Janiri, L. (2020). The impact of climate change on mental health: A systematic descriptive review. Frontiers in Psychiatry, 11, https://doi.org/10.3389/fpsyt.2020.00074
  23. Mullins, J. T., & White C. (2019). Temperature and mental health: Evidence from the spectrum of mental health outcomes. Journal of Health Economics, 68, https://doi.org/10.1016/j.jhealeco.2019.102240
  24. Liu, J., Varghese, B. M., Hansen, A., & Xiang, J. (2021). Is there an association between hot weather and poor mental health outcomes? A systematic review and meta-analysis. Environment International, 153(6), 106533. https://doi.org/10.1016/j.envint.2021.106533
  25. Heilmann, K., Kahn, M. E., & Tang, C. K. (2021). The urban crime and heat gradient in high and low poverty areas. Journal of Public Economics, 197, https://doi.org/10.1016/j.jpubeco.2021.104408
  26. Florido Ngu, F., Kelman, I., Chambers, J., & Ayeb-Karlsson, S. (2021). Correlating heatwaves and relative humidity with suicide (fatal intentional self-harm). Scientific Reports, 11(1), 22175. https://doi.org/10.1038/s41598-021-03089-y
  27. Noelke, C., McGovern, M., Corsi, D. J., Jimenez, M. P., Stern, A., Wing, I. S., & Berkman, L. (2016). Increasing ambient temperature reduces emotional well-being. Environmental Research, 151, 124-129. https://doi.org/10.1016/j.envres.2016.06.045
  28. Colmer, J., & Doleac J. L. (2022). Access to guns in the heat of the moment: More restrictive gun laws mitigate the effect of temperature on violence (CESifo working paper no. 10525). https://dx.doi.org/10.2139/ssrn.4499480
  29. Narayan, A. (2022). The impact of extreme heat on workplace harassment and discrimination. PNAS, 119(39), e2204076119. https://doi.org/10.1073/pnas.2204076119
  30. Otrachshenko, V., Popova, O., & Tavares, J. (2021). Extreme temperature and extreme violence: Evidence from Russia. Economic Inquiry, 59(1), 243-262. https://doi.org/10.1111/ecin.12936
  31. Chen, Y., Sun, R., Chen, X., & Qin, X. (2023). Does extreme temperature exposure take a toll on mental health? Evidence from the China Health and Retirement Longitudinal Study. Environment and Development Economics, 28(5), 486–510. https://doi.org/10.1017/S1355770X23000037
  32. Awaworyi Churchill, S., Smyth, R., & Trinh, T.-A. (2023). Crime, weather and climate change in Australia. Economic Record, 99(324), 84-107. https://doi.org/10.1111/1475-4932.12720
  33. Janzen, B. (2022). Temperature and mental health: Evidence from helpline calls. arXiv: https://doi.org/10.48550/arXiv.2207.04992
  34. Cloud, D. H., Williams, B. A., Haardörfer, R., Brinkley-Rubinstein, L., & Cooper, H. L. F. (2023). Extreme heat and suicide watch incidents among incarcerated men. JAMA Network Open, 6(8), e2328380. https://doi.org/10.1001/jamanetworkopen.2023.28380
  35. Skarha, J., Peterson, M., Rich, J. D., & Dosa, D. (2020). An overlooked crisis: Extreme temperature exposures in incarceration settings. American Journal of Public Health, 110, S41-S42. https://doi.org/10.2105/AJPH.2019.305453
  36. Mukherjee, A., & Sanders, N. J. (2021). The causal effect of heat on violence: Social implications of unmitigated heat among the incarcerated (Working paper 28987). National Bureau of Economic Research. https://doi.org/10.3386/w28987
  37. Segule, M., Lin, J., Allen, J., & Jimenez, M. (2022). Heat policies and AC availability in US prison systems. ISEE Conference Abstracts. https://doi.org/10.1289/isee.2022.P-0279
  38. Applegate, B. K., Daou, J., & Ouellette, H. M. (2024). The future of American jails: A national survey of jail leaders’ ideals. The Prison Journal, 104(1), 3–23. https://doi.org/10.1177/00328855231212421

Definitions

Adolescents: people under the age of 18

Young adults: people ages 18-25

Discussion

A focus on rehabilitation of adolescents remains at the core of all health care and correctional programming in the juvenile legal system. Adequate sleep is critical to adolescent health and rehabilitation. Moreover, reports of sleep disturbance and requests for “sleep meds” are recurrent among many detained youth. The American Academy of Sleep Medicine recommends 8 to 10 hours of sleep per night for teenagers and 7 to 9 hours for young adults.3,4 However, as many as 73% of adolescents in the community get fewer hours of sleep,5 and approximately 24% suffer from insomnia.6

Adolescent insomnia may be related to medical comorbidities (including sleep apnea, particularly among youth with obesity and those who snore loudly) as well as the following risk factors often found in youth who are detained:

  • Psychological conditions (e.g., ADHD with medication treatment [stimulants], PTSD, anxiety disorders, depressive and other mood disorders)
  • Poor sleep hygiene (e.g., inconsistent sleep schedules; afternoon caffeine consumption; use of blue light electronic devices such as tablets, television, computers; and high-impact activities before “lights out”)
  • Acute stress/family disorganization7
  • Substance use, especially marijuana, alcohol, and psychostimulants

In addition, many youth enter the juvenile legal system already taking psychotropic or over-the-counter medication that either specifically targets insomnia or somehow impacts sleep architecture.

Additional risk factors for poor sleep specifically associated with the detention environment may impact sleep even in youth without premorbid medical or psychiatric conditions or prior history of sleep disturbance, including the following:

  • Adjustment issues (e.g., sights, sounds, smells, fears of being physically or sexually assaulted, fear of being bullied or extorted)
  • Environmental factors (e.g., doors slamming, yelling, loudspeaker announcements, staff talking by handheld devices/intercoms, comfort of bed and bedding, room temperature, room lights)
  • Sleep–wake cycle and forced phase shift at time of detention

Numerous sequelae of impaired sleep have been identified, including the following:

  • Psychological: Patients with impaired sleep have been found to be 4 times more likely to develop new major depression over the next 3 to 5 years, 2 times more likely to develop anxiety, and 7 times more likely to develop substance use disorders.8 Insomnia is also associated with suicide risk.9
  • Medical: Patients with impaired sleep have higher rates of hypertension, heart disease, and diabetes mellitus, 10 and obesity.11
  • Social: Incarcerated adults with impaired sleep have demonstrated lesser ability to partake in or benefit from prison-based programs compared to incarcerated adults without sleep impairment.12
  • Academic: Poor sleep interferes with executive functioning tasks including attention, information processing, and self-regulatory processes such as impulse control. School performance appears worse in those with impaired sleep.13

Overall, although sleep management has not been well-studied in the youth detention setting, the available evidence indicates that a multifaceted approach that incorporates psychoeducation, cognitive behavioral therapy, and, when indicated, medication has been shown most effective both for adolescents both in the community and in detention.

References

1     Levenson, J., London, S., Ekas, D., Woods, M., Vojtash, M., Mulvey, E., & Miller, E. (2022). Sleep among adolescents in juvenile detention. Sleep, 45(1), A218. https://doi.org/10.1093/sleep/zsac079.488

2     Sheppard, N., & Hogan, L. (2022). Prevalence of insomnia and poor sleep quality in the prison population: A systematic review. Journal of Sleep Research, 31(6), e13677. https://doi.org/10.1111/jsr.13677

3     Paruthi, S., Brooks, L. J., D’Ambrosio, C., Hall, W. A., Kotagal, S., Lloyd, R. M., Malow, B. A., Maski, K., Nichols, C., Quan, S. F., Rosen, C. L., Troester, M. M., & Wise M. S. (2016). Recommended amount of sleep for pediatric populations: A consensus statement of the American Academy of Sleep Medicine. Journal of Clinical Sleep Medicine, 12(6), 785–786. https://doi.org/10.5664/jcsm.5866

4     Watson, N. F., Badr, M. S., Belenky, G., Bliwise, D. L., Buxton, O. M., Buysse, D., Dinges, D. F., Gangwisch, J., Grandner, M. A., Kushida, C., Malhotra, R. K., Martin, J. L., Patel, S. R., Quan, S. F., & Tasali, E. (2015). Recommended amount of sleep for a healthy adult: A joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society. Journal of Clinical Sleep Medicine, 11(6), 591–592. https://doi.org/10.5664/jcsm.4758

5     Wheaton, A. G., Jones, S. E., Cooper, A. C., & Croft, J. B. (2018). Short sleep duration among middle school and high school students — United States, 2015. Morbidity and Mortality Weekly Report, 67(3), 85–90. http://dx.doi.org/10.15585/mmwr.mm6703a1

6       Hysing, M., Pallesen, S., Stormark, K., Lundervold, A., & Sivertsen B. (2013). Sleep patterns and insomnia among adolescents: A population-based study. Journal of Sleep Research, 22(5), 549–556. https://doi.org/10.1111/jsr.12055

7       Fellman, V., Heppell, P. J., & Rao, S. (2024). Afraid and awake: The interaction between trauma and sleep in children and adolescents. Psychiatric Clinics of North America, 47(1), 229–253. https://doi.org/10.1016/j.psc.2023.06.015

8     Morin, C. M., & Benca, R. (2012). Chronic insomnia. Lancet, 379(9821), 1129–1141. https://doi.org/10.1016/S0140-6736(11)60750-2

9     Wang, Z., Tang, Y., Wang, G., Deng, Y., Jiang, Y., Sun, W., Sun, X., Ip, P., Owens, J., Zhao, M., Xiao, Y., Jiang, F., & Wang, G. (2024). Insufficient sleep is associated with increasing trends in adolescent suicidal behaviors. Journal of Adolescent Health, 74(6), 1198–1207. https://doi.org/10.1016/j.jadohealth.2024.01.030

10   National Heart, Lung, and Blood Institute. (2022). What is insomnia? https://www.nhlbi.nih.gov/health/insomnia

11    Schneider, A.C., Zhang, D. & Xiao, Q. (2020). Adolescent sleep characteristics and body-mass index in the Family Life, Activity, Sun, Health, and Eating (FLASHE) Study. Scientific Reports, 10, 13277. https://doi.org/10.1038/s41598-020-70193-w

12   Harner, H. M., & Budescu, M. (2014). Sleep quality and risk for sleep apnea in incarcerated women. Nursing Research, 63(3), 158–169. https://doi.org/10.1097/NNR.0000000000000031

13    Perkinson-Gloor, N., Lemola, S., & Grob, A. (2013). Sleep duration, positive attitude toward life, and academic achievement: The role of daytime tiredness, behavioral persistence, and school start times. Journal of Adolescence, 36(2), 311–318. https://doi.org/10.1016/j.adolescence.2012.11.008

Resources

Adornetti, J. P., Woodard, K. N., Nogales, J. M., Carlucci, M., Crowley, S. J., & Wolfson, A. R., (2023). Sleep and circadian health in juvenile justice systems: A descriptive analysis. Sleep Health, 9(6), 876–881. https://doi.org/10.1016/j.sleh.2023.08.009

Asarnow, L. D., & Mirchandaney, R. (2024). Sleep and mood disorders among youth. Psychiatric Clinics of North America, 47(1), 255–272. https://doi.org/10.1016/j.psc.2023.06.016

Morris, N. P., Holliday, J. R., & Binder, R. L. (2021). Litigation over sleep deprivation in U.S. jails and prisons. Psychiatric Services, 72(10), 1237–1239. https://doi.org/10.1176/appi.ps.202100438

Penn, J. V., & Thomas, C. (2022). Practice parameter for the assessment and treatment of youth in juvenile detention and correctional facilities. Journal of the American Academy of Child & Adolescent Psychiatry, 44(10), 1085–1098. https://doi.org/10.1097/01.chi.0000175325.14481.21

Tamburello, A., Penn, J., Ford, E., Champion, M. K,, Glancy, G., Metzner, J., Ferguson, E., Tomita, T., & Ourada, J. (2022). Practice resource for prescribing in corrections. Journal of the American Academy of Psychiatry and the Law, 50(4). S1-S62.