Carceral heat exposure as harmful design: An integrative model for understanding the health impacts of heat on incarcerated people in the United States

Brunn, Karina; Toledo, Olivia; Tran, Chelsea Chau; Vasudevan, Ashwin; Venkat, Bharat Jayram

doi:10.1016/j.socscimed.2025.117679

Abstract The risks associated with extreme heat are increasing as heat waves become more frequent and severe across larger areas. As people begin to experience heat waves more often and in more places, how will individuals respond? Measuring experience with heat simply as exposure to extreme temperatures may not fully capture how people subjectively experience those temperatures or their varied impacts on human health. These impacts may also influence an individual’s response to heat and motivate risk-reduction behaviors. If subjectively experiencing negative health effects from extreme heat promotes protective actions, these effects could be used alongside temperature exposure to more accurately measure extreme heat experience and inform risk prevention and communication strategies according to local community needs. Using a multilevel regression model, this study analyzes georeferenced national survey data to assess whether Americans’ exposure to extreme heat and experience with its health effects are associated with self-reported protective behaviors. Subjective experience with heat-related health symptoms strongly predicted all reported protective behaviors while measured heat exposure had a much weaker influence. Risk perception was strongly associated with some behaviors. This study focuses particularly on the practice of checking on family, friends, and neighbors during a heat wave, which can be carried out by many people. For this behavior, age, race/ethnicity, gender, and income, along with subjective experience and risk perception, were important predictors. Results suggest that the subjective experience of extreme heat influences health-related behavioral responses and should therefore be considered when designing or improving local heat protection plans.

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