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

In an era of climate change-driven weather events, extreme heat has become the most lethal form of "natural disaster" in the United States. However, its negative consequences are unequally distributed. Incarceration exacerbates vulnerability to heat-related illnesses and deaths. This article reviews and synthesizes a range of literature related to carceral heat exposure to characterize the complex biological, social, infrastructural, financial, and legal mechanisms through which incarcerated people experience heat-related illnesses and deaths. These mechanisms include the location, design, and construction of carceral facilities; structural racism and poverty that lead to the overrepresentation of specific populations within the carceral system; comorbid conditions amongst incarcerated people; the use of medication as a form of control; barriers to medical care; institutional neglect; and the weaponization of heat as a tactic of retaliation. This article also reviews the patchwork regulatory apparatus related to carceral heat exposure, legal efforts to improve protections for incarcerated people, and obstacles to implementing those protections. In reviewing the literature, we find that there is no singular factor that explains how and why incarcerated people are especially vulnerable to the deleterious effects of heat. We offer instead an integrative model for understanding how multiple mechanisms are consolidated by the carceral system, magnifying the vulnerability of incarcerated people to the effects of heat. As social scientists have demonstrated in other contexts, no one dies from a heat wave alone; instead, they experience illness and death as a result of social and infrastructural arrangements that render them vulnerable to the effects of heat. Our aim is to elucidate the specific arrangements through which the carceral system makes people vulnerable to heat. We argue that exposure to debilitating heat and its attendant consequences represent more than a failure of the carceral system - rather, they reveal its fundamentally harmful design.