A Delphi Consensus Study on International Best Practice to Promote Resilience,Sustainability,and Safeguard Prisons and Prison Communities Against the Consequences of Climate Change

Abstract

Background: Prison systems are routinely excluded from emergency management plans globally, nationally, and locally, increasing vulnerability to climate disasters and posing a risk to health. A global e-Delphi consensus study aimed to define the international best practice to promote resilience, sustainability, and safeguard prisons and prison communities against the consequences of climate change.

Research Design: A global e-Delphi consensus approach was used to define the critical components of an effective prison system response to climate change. A consensus was defined a priori as ≥70% participants scoring an outcome from 7 to 9 and <15% scoring it from 1 to 3. In 2024, 4200 International Corrections and Prisons Association members were invited to participate in two online surveys.

Results: Of 142 participants, 102 expressing interest completed Round 1 (79% response rate), scoring 40 statements by importance, where 39 exceeded the set threshold of the consensus. Statements were adjusted based on the feedback for Round 2. Of 142 participants, 81 completed Round 2 (72% response rate), scoring 50 statements, with 49 exceeding the set threshold of the consensus.

Conclusion and Implications for Practice: Participants agreed on the seven core components of an effective prison system response to climate change: climate principles; climate change and disaster preparedness, planning, and infrastructure protection; partnerships, capacity building, and resources; climate change and disaster response; health-related impacts of climate change; expanding sustainable development approaches; and evaluation, research, and innovation. Further action is required to encourage prison systems to incorporate these components into their policies, guidelines, and initiatives to optimize efforts to safeguard prisons and prison communities.

INTRODUCTION

Global prison trends

On any given day, 11.5 million people are incarcerated worldwide.¹ Women make up 6.9% of the global prison population, with a 60% increase over the past 20 years compared with 22% for men.² Approximately one-third of all people in prison are in pretrial detention, disproportionately affecting women due to poverty.³ Marginalized groups—Indigenous, religious, racial, and ethnic minorities—are consistently overrepresented.⁴ Prison overcrowding remains a critical challenge worldwide, with some facilities operating at >400% capacity under inhumane conditions.⁵ This exacerbates the already poor infrastructure, sanitation, staffing, health care, and emergency response systems.⁶ Climate change amplifies the impacts of pre-existing inequalities already present in custodial settings, further increasing the risks to prison systems and populations.⁷

Consequences of climate change worldwide

Human-caused climate change is increasing extreme weather events, resulting in widespread harm to ecosystems and communities, especially those who have contributed the least to global emissions.⁸ There is a notable rise in climate-related food-, water-, and vector-borne diseases and mental health issues linked to environmental degradation.⁹ These impacts intensify food and water insecurity, particularly in Africa, Asia, Latin America, the Arctic, and among Indigenous and low-income communities. Climate change undermines progress toward the United Nations (UN) 2030 Sustainable Development Goals (SDGs), especially SDG3, SDG6, and SDG13.¹⁰ Despite international treaties such as the Kyoto Protocol and Paris Agreement, places of detention remain largely excluded from climate adaptation efforts.¹¹

Response to climate change and natural hazards: A human rights-based approach

Climate change threatens multiple internationally protected human rights. The UN Climate Change Implementation Plan (2022) calls for rights-based action on climate, food, and water security.¹² The Nelson Mandela Rules set global standards for humane prison treatment.¹³ In July 2023, a UN meeting of >40 member states emphasized the need to address climate impacts on prisons.¹⁴ Yet, most countries lack binding policies addressing prison-specific climate risks.¹⁵ Adaptation remains reactive, leaving prisons exposed. The UN Office of the High Commissioner for Human Rights urges priority for vulnerable groups, including incarcerated individuals.¹⁶ This necessitates coordinated action from prison authorities and civil society to implement sustainable, proactive responses.¹⁷

Impact of climate change on prisons

Prisons in low- and middle-income countries face heightened risks from heatwaves, floods, and water scarcity. Incarcerated populations, who rely entirely on the State, face disproportionate threats to health and safety.^18,19,20 Due to stigma, they are often deprioritized during emergencies.²¹ Poor infrastructure and lack of investment in essential services exacerbate the spread of climate-sensitive diseases.²² Prisons in high-incarceration, high-risk areas should be prioritized for public health interventions.²³ Further impacts relate to varying climate-related exposures, for example, the increasing threat of extreme heat in the United States, in particular in the absence of air-conditioning.²⁴ Heat exposure varies by demographics and facility. Elevated risk in unexpected regions, such as the Pacific Northeast and Northwest, has been reported for correctional facilities housing higher proportions of non-White and Hispanic individuals disproportionately affected.²⁵ These studies highlight the importance of quantitative analyses to contextualize prison vulnerability to climate-related exposures.

Despite growing awareness, prisons remain excluded from national climate strategies.²⁶ Funding gaps, weak political commitment, and societal marginalization limit emergency preparedness.²⁷ Findings from a scoping review on disaster risk reduction and emergency management in prisons highlight the deeply embedded perceptions and deprioritization of people in custody, “We don’t really want to look after prisoners, even though we could, as we only have a certain amount of staff.”²⁸

In 2025, UN Interregional Crime and Justice Research Institute and Penal Reform International released Green Prisons: A Guide to Creating Environmentally Sustainable Prisons, outlining the following five core strategies: policy commitment, sustainable infrastructure and energy, waste management, green rehabilitation programs, and water/food systems.²⁹ Our study builds on this by conducting a global e-Delphi consensus to define best practices for sustainable prison management amid climate risks. The goal is to foster international dialog, inform domestic responses, and promote proactive planning, risk reduction, and knowledge-sharing across correctional, health, and climate sectors.

METHODOLOGY

This study adopted the e-Delphi method, an approach that gathers input from international multidisciplinary substantive technical experts through several rounds of surveys. It is a structured consensus building process that incorporates a diverse range of perspectives across disciplines and geographic areas. This method works well for topics where empirical evidence is either limited or emerging, making it well-suited to this study’s objective to elicit expert opinions on best practices for promoting sustainability and mitigating climate change and natural hazard effects in custodial settings.³⁰

Design of the global e-Delphi

A global e-Delphi consensus study was conducted using an iterative online survey approach to gather expert opinions on best practices for promoting sustainability and mitigating climate change and natural hazard effects in custodial settings.³¹ It is well-recognized that recruitment for Delphi studies can be challenging due to participant time commitment in completing each round of the Delphi study.³² The size of Delphi panels can range widely.³³ The International Corrections and Prisons Association’s (ICPA) network of 4200 professionals received an invitation to submit an electronic expression of interest (EOI) via Qualtrics. Respondents signed a commitment to participate in two rounds. The diverse panel included prison officials, policy makers, health providers, academics, and people with lived experience, aligning with the Core Outcome Measures in Effectiveness Trials methodology.³⁴

Ethical approval for this study was granted in July 2024 by the University of Wollongong Human Research Ethics Committee (2024/114). Informed consent was obtained online, and participant data were securely stored and anonymized. Participation was voluntary, with the option to withdraw at any point.

Survey development and consensus criteria

The survey asked participants to rank 40 statements on a 9-point Likert scale (1 = low priority; 9 = high priority). The statements were developed based on evidence gathered from a rapid scoping review of peer-reviewed articles and grey literature. Rapid reviews are a form of information synthesis that aim to produce information in a timely manner by simplifying or omitting components of a systematic review.³⁵ Findings from the rapid review were used to inform key concepts, recurring themes, and gaps in research, policy, and practice.

The 40 statements were grouped under seven dimensions: climate principles; planning and infrastructure; partnerships and resources; disaster response; health impacts; sustainable development; and innovation. Additional suggestions could be submitted via free-text fields.

A consensus was predefined as ≥70% of participants rating a statement 7–9 and <15% rating it 1–3—consistent with established Delphi thresholds.³⁶ Data were analyzed using IBM SPSS Statistics (version 27). To limit attrition and bias, this study used two rounds,³⁷ a standard Delphi practice despite >70% of studies not relying on the consensus as a stopping rule ³⁸

Panel participation and rounds

Of 142 confirmed EOIs, 102 participants completed Round 1. They rated the 40 statements, with 39 meeting the consensus threshold. Based on feedback from 26 participants, 10 new statements (7 original, 3 split from previous statements) were added for Round 2, resulting in 50 total statements (as shown in Fig. 1).

FIG. 1.

Flow diagram. ^aNew statements added in Round 2: 1, 5, 12, 14, 24, 38, 49; ^bRound 1 statements divided into two for Round 2: 13, 23, 39; ^cClarified statements in Round 2: 1–9, 11–13, 15–20, 22–29, 31–32, 34–35, 38–40. n = 8 statements remained unchanged between Rounds 1 and 2: 10, 14, 21, 30, 33, 36–37.

In Round 2, the 102 Round 1 participants received individualized results and were asked to reconsider their ratings. After 14 days and three reminders, 81 participants completed the round. Ultimately, 49 of the 50 statements reached the predefined consensus threshold (as shown in Table 1).

Table 1.

Round 1 and Round 2 Statements

Round 1	Round 2
Dimension 1: Climate change and natural hazards—principles
1: “Climate change” strategic plans, policies, guidelines, and standards should be inclusive of people in prison.	1: Prisons need to be viewed as integral parts of the community, not isolated entities, within the official strategic response to climate change and natural hazards (new).
2: “Climate change” strategic plans, policies, guidelines, and standards should contribute and align with the goals and targets outlined in the Sustainable Development Goals (SDGs), ensuring that no one is left behind.	2: Climate change strategic plans should embrace an equitable vision of progress that prioritizes the well-being of all, including the people in prison, ensuring that their welfare is integral to policies, guidelines, standards, and regulations. (S1)
3: “Climate change”-responsive prison policies should be underpinned by international standards, best practice evidence, and incorporate human-rights-based development frameworks to detect, understand, prevent, and respond to the impact of “climate change.”	3: Climate-responsive prison policies should be tailored to regional or country-level differences and have a duty to align with international human rights standards and the SDGs. (S2, S3)
4: “Climate change”-responsive prison policies should be fully supported by laws and political endorsement, regional, and local adaptation.	4: Climate-responsive prison policies should incorporate context-specific climate response plans and be fully supported by political endorsement, legislation, and regional and local adaptation. (S4)
5: Efforts to keep pretrial detention and imprisonment to a measure of last resort should be prioritized to reduce overcrowding to minimize the effects of “climate change.”	5: Correctional leaders can drive climate response inclusion and progress independently of political support through courage and the willingness to create a space for change within correctional jurisdictions. (new)
	6: Efforts to keep pretrial detention and imprisonment to a measure of last resort should be prioritized to reduce overcrowding to minimize the adverse effects of climate change. (S5)
Dimension 2: Climate change and disaster preparedness, planning, and infrastructure protection
6: A transparent process for monitoring and planning for “climate change” should be developed in the form of regular infrastructural and procedural risk assessments.	7: Protecting infrastructure and essential services from climate-related damages safeguards prisons, as climate change can exacerbate existing systematic deficiencies in prison (e.g., overcrowding, poor infrastructure, ventilation, hygiene and sanitation, communicable disease outbreaks, hunger crises, interrupted electricity, and supply of medication, medical equipment, and sanitation resources). (S9)
7: Infrastructural and procedural risk assessments should include hazards and exposure (events that could occur and exposure to them), vulnerability (the susceptibility of communities to those hazards), and lack of coping capacity (lack of resources available that can alleviate the impact).	8: A transparent process for climate change planning needs to include regular infrastructural and procedural risk and needs assessments, including independent inspections, with expert input. (S6)
8: Governments must identify and map high-risk prisons located in high-hazard-exposure areas to aid preparedness, crisis response, and recovery considering all forms of natural disasters (e.g., floods, droughts, typhoons, landslides, heatwaves, earthquakes, and volcanoes).	9: Risk and needs assessments should involve people in prison, communities, and a team of specialists in assessing hazards and exposure (events likely to occur and communities’ exposure to them), vulnerability (the susceptibility of communities to those hazards), and lack of coping capacity (resources needed to alleviate the impact). (S7)
9: Protecting infrastructure and essential services from climate-related damages is important, as “climate change” can exacerbate the existing systematic deficiencies in prison (e.g., overcrowding, poor infrastructure, ventilation, hygiene and sanitation, communicable disease outbreaks, hunger crises, interrupted electricity, and supply of medication, medical equipment, and sanitation resources).	10: Governments must identify and map prisons located in high-hazard-exposure areas to aid preparedness and planning considering all forms of natural disasters (e.g., floods, droughts, typhoons, landslides, heatwaves, earthquakes, and volcanoes). (S8)
10: States should apply innovative, climate-sensitive architectural design when building new or refurbishing old prisons to reduce carbon emissions and operational costs (e.g., implementing energy-efficient building designs and technologies) and be adapted to withstand the impact of extreme weather events.	11: Risk assessments on locations for new prisons should align with revised standards that promote long-term sustainability and preparedness, balancing costs and benefits effectively.
11: Contingency plans to mitigate for climate-related risks to supply of water, sanitation, and hygiene (WASH) during extreme weather emergencies are critical.	12: Assessment findings must drive effective mitigation efforts to prevent loss of life, reduce harm for those living and working in prisons, and protect public safety. (new)
12: WASH risk assessment, repair, and implementation of solutions should consider stockpiles of hygiene sanitation supplies, location/design of flood/cyclone-proof water and sanitation points, water storage tanks, and water testing/purification kits to withstand extreme weather events.	13: States should apply innovative, climate-sensitive architectural design when building new or refurbishing old prisons to reduce carbon emissions and operational costs (e.g., implementing energy-efficient building designs and technologies) and be adapted to withstand the impact of extreme weather events. (S10)
13: Practical responses to protect health infrastructure and essential services should include safe storage of clinical records and involve devising robust supply chains to safeguard medicine supply, including HIV drugs and medical resources (e.g., equipment/supplies, menstrual hygiene resources).	14: Data and technology science, such as geo-mapping and real-time wildfire reporting applications, should be leveraged to enhance situational awareness and support government and prison system planning, response, and recovery during environmental disasters. (new)
	15: Contingency plans to mitigate for climate-related risks to supply of WASH during extreme weather emergencies are critical. (S11)
	16: WASH risk and needs assessments, repair, and implementation should be tailored to the country’s level of preparedness and include flood- or cyclone-proof water and sanitation points, water storage tanks, water testing and purification kits, and stockpiles of hygiene and sanitation supplies. (S12)
	17: Practical responses to protect health infrastructure and essential services should include the safe storage of clinical records, leveraging digitalization with robust disaster recovery protocols, to secure critical information during emergencies. (S13)
	18: Efforts to protect health infrastructure and essential services must focus on establishing robust supply chains to safeguard the availability of essential medicines, including HIV drugs, medical equipment, and menstrual hygiene resources. (S13)
Dimension 3: Partnerships, capacity building, and resources
14: Active participation from all members of the prison community, including officials, staff, people in prison, their families, and their advocates, is essential throughout all stages of addressing “climate change”—from climate-responsive prison policy development to program implementation.	19: Active participation from all members of the prison community, including officials, staff, people in prison, their families, and their advocates, is essential throughout all stages of addressing climate change—from climate-responsive prison policy development to program implementation. (S14)
15: An inclusive approach based on building partnerships across various sectors, including public health authorities, government, business, nongovernment agencies, community members, and academia, is essential to effectively promote sustainability and mitigate “climate change” effects in prisons.	20: Building collaborative, cross-sector partnerships are important for leveraging diverse expertise, resources, and support to promote sustainability and address the multifaceted impacts of climate change in prisons (e.g., prison administrators, broader public health authorities, businesses, governments, nongovernment agencies, international organisations, cultural institutions, education, academia, and community). (S15)
16: Building partnerships with other public sectors, such as start-ups and universities, to test “climate change” innovations that can support prison systems and facilities (e.g., prison rooftop micro energy plants) should be considered.	21: Building partnerships with other public sectors should be considered, such as start-ups and universities, to test climate change innovations, such as prison rooftop micro energy plants, to support prison systems and facilities. (S16)
17: Specialized training programs should be provided to all those living and working in prisons to respond effectively to all climate-related challenges and natural disasters.	22: Specialized climate action education and training should be provided to all those living and working in prisons to build capacity and address climate challenges, fostering unity and collective responsibility, emphasizing that “we are all in this together to mitigate impact.” (S17)
18: Adequate resources, including financial resources, equipment, and human resources, should be allocated to prison systems to respond to “climate change” considering the health needs and human rights of people deprived of their liberty and respecting the principles of equity and equivalence of care.	23: Adequate resources—financial, equipment, human resources, and technical directives—should be allocated to prison systems to respond to climate change and natural disasters. (S18)
24: Resource allocation must align with laws, uphold human rights, ensure equitable care, address short- and long-term needs, and be supported by a cross-political consensus for continuity beyond electoral cycles. (new)
Dimension 4: Climate change and disaster response
19: Contextually appropriate early warning systems for implementation when needed should be linked to community services that provide information on disaster or disease outbreak risks, extreme weather, or disrupted supply chains.	25: Efforts to improve cross-sector coordination are required to include detention settings in community contingency plans to ensure the safety of all those living and working in prisons during climate-related emergencies. (S20)
20: Efforts to improve intersectoral coordination are required to include detention settings in community contingency plans to ensure the safety of all those living and working in prisons during “climate-related emergencies.”	26: Contextually appropriate early warning systems should be linked to community services to provide timely information and assistance during disasters, disease outbreaks, extreme weather, or disrupted supply chains. (S19)
21: Regular stress testing of climate-responsive prison plans should ensure validity and functionality, with explicit directives on evacuation procedures and practice drills.	27: To ensure operational functionality during disasters, prison systems should develop customized and unique disaster-specific contingency plans (standard operating procedures/guidelines), transparently and clearly articulating all potential steps required to respond, and recover from disasters. (S22)
22: To ensure operational functionality during disasters, prison systems should develop customized, transparent, and disaster-specific contingency plans (procedures/guidelines), clearly articulating all the potential steps required to prevent, mitigate, respond, and recover from disasters.	28: Disaster contingency plans should address the needs of everyone in prison, including staff and families, and outline event-specific requirements such as food, water, medications, shelter, evacuation, staffing, support, and services. (S23)
23: Disaster-specific contingency plans should include the requirements in each event (e.g., food, water, medications, shelter), reflect the needs of the prison population, staffing levels, location, available support, and ancillary services and be reviewed and audited regularly.	29: Regular stress testing of climate-responsive prison plans should ensure validity and functionality, with explicit directives on evacuation procedures and practice drills. (S21)
24: Regular and transparent communication and information dissemination channels should be in place between people in prison and their families before, during, and after extreme weather events via virtual visits and communication platforms.	30: Disaster-specific contingency plans should be externally reviewed and audited regularly. (S23)
31: A communication strategy should be developed to ensure regular and transparent updates between people in prison and their families via virtual platforms where possible, particularly before, during, and after extreme weather events, to maintain emotional well-being and reduce anxiety. (S24)
Dimension 5: Health-related impacts of “climate change”
25: The diverse and specific needs of priority populations living in prison should be identified and supported within inclusive climate-responsive plans. Populations may include, yet are not limited to, juveniles, pregnant women and infants, people living with disabilities or chronic disease, older people, women, people who identify as LGBTQIA+, First Nations people, individuals who are bedridden/terminal, and those on heat-sensitive medication that increases their susceptibility to temperature-related illnesses and heat stroke (e.g., psychotropics, diuretics, beta-blockers).	32: The diverse and specific needs of priority populations living in prison should be identified and supported within inclusive climate-responsive plans. Populations may include, yet are not limited to, juveniles, pregnant women and infants, people living with disabilities or chronic disease, older people, women, people who identify as neurodiverse, LGBTQIA+ or ethnic and Indigenous minorities, individuals who are bedridden/terminal, and those on heat-sensitive medication that increases their susceptibility to temperature-related illnesses and heat stroke. (S25)
26: Health care services should be resilient, robust, and prepared for rapid adaptation in disaster situations, including rapid response planning for disease outbreaks.	33: Health care services should be maintained in order to be resilient, robust, and prepared for rapid adaptation in disaster situations, including rapid response planning before, during, and after disease outbreaks. (S26)
27: Critical actions for disease outbreak planning should include all aspects of “readiness and preparedness,” “active outbreak,” and “crisis,” with special considerations made for cholera and antimicrobial resistance (AMR).	34: Critical actions for disease outbreak planning should include all aspects of “readiness and preparedness,” “active outbreak,” and “crisis.” (S27)
28: The delivery of immunization services should be prioritized, as “climate change” exposes prison populations to new pathogens (e.g., vector-borne disease [malaria, yellow fever and dengue], water-borne diseases [cholera], and meningitis) to align with the WHO Immunization Agenda 2030.	35: The delivery of immunization services should be prioritized and aligned with the WHO Immunization Agenda 2030, as climate change exposes prison populations to new pathogens (e.g., vector-borne disease [malaria, yellow fever and dengue], water-borne diseases [cholera], and meningitis). (S28)
29: Climate control standards, policies, and guidelines for each prison system should include the monitoring, surveillance, and documentation of acceptable temperature (and humidity) ranges using heat and cold index categories (e.g., danger, extreme caution, caution, no caution).	36: Climate control standards, policies, guidelines, and regulations for each prison system must be adaptable to regional conditions and should include the monitoring, surveillance, and documentation of acceptable temperature (and humidity) ranges using heat and cold index categories (e.g., danger, extreme caution, caution, no caution). (S29)
30: Standards, policies, and guidelines on ventilation conditions and air filtration should be included in prison emergency preparedness and response plans to mitigate the effects of extreme heat and fires and prevent the transmission of skin and communicable respiratory diseases (e.g., tuberculosis).	37: Standards, policies, guidelines, and regulations on ventilation conditions and air filtration should be included in prison emergency preparedness and response plans to mitigate the effects of extreme heat and fires and prevent the transmission of skin and communicable respiratory diseases (e.g., tuberculosis). (S30)
31: Ventilation assessments should be conducted on an ongoing basis, in summer and winter, and increase in the event of a climate crisis to identify high-risk prisons and monitor the impact of mitigation measures designed to improve ventilation.	38: The utilization of technology, such as smart sensors, should be considered to maintain optimal humidity and ventilation levels, ensuring compliance with health standards. (new)
32: Prison health care services should be supported to develop tailored, preventative health care plans to minimize the impact of extreme weather events (e.g., co-developing asthma care plans with patients for use during dust storms/fires).	39: Ongoing ventilation assessments should be conducted year-round, with increased frequency during climate crises, to identify high-risk prisons and evaluate the impact of mitigation measures designed to improve ventilation, with a commitment to act on the findings. (S31)
33: Recognizing and responding to eco-anxiety, a chronic fear of environmental doom, among all those living and working in prison is important to mitigate the psychological and mental health distress of “climate change” through assessment, preventative education, and care to promote resilience and well-being beyond immediate consequences of “climate change.”	40: Prison health care services should be supported and allocated resources to develop tailored, preventative health care plans aligned with community standards to minimize the impact of extreme weather events (e.g., co-developing asthma care plans with patients for dust storms or fires). (S32)
	41: Recognizing and responding to eco-anxiety, a chronic fear of environmental doom, among all those living and working in prison is important to mitigate the psychological and mental health distress of climate change through assessment, preventative education, and care to promote resilience and well-being beyond immediate consequences. (S33)
Dimension 6: Expanding sustainable development approaches
34: Sustainable practices should be promoted by prison systems to mitigate environmental impacts such as renewable energy sources for power generation, clean water supply, cooling and heating mechanisms, and other energy requirements.	42: Prison systems, similar to all public institutions, should lead by example in promoting sustainable practices aligned with the SDGs, including the use of renewable energy for power, clean water supply, efficient cooling and heating, and sustainable cooking facilities. (S34)
35: To lower carbon emissions, responsive prison systems should ensure that all members of the prison community are educated on, and adhere to, appropriate clinical/general waste disposal, including the separation of compostable and recyclable waste.	43: To lower carbon emissions, prison systems should provide education opportunities for the prison community on waste disposal practices, including composting and recycling, aligned with external standards. (S35)
36: Sustainable agricultural practices within prison farms can improve resilience to environmental stressors, promote sustainable food production, and provide vocational training opportunities for people in prison.	44: Sustainable agricultural practices within prison farms can improve resilience to environmental stressors, promote sustainable food production, and provide vocational training opportunities for people in prison. (S36)
Dimension 7: Evaluation, research, and innovation
37: Prison staff should be involved in the planning of recovery and accountability processes, including lessons learned and conducting post-disaster risk assessments.	45: Prison staff should be involved in the planning of recovery and accountability processes, including lessons learned and conducting post-disaster risk and needs assessments. (S37)
38: Prison systems should be supported to create indicators as well as performance and control tools to assess the progress of “climate change” initiatives, improve decision making, facilitate efficient allocation of resources, and enhance accountability.	46: Prison systems and governments should develop indicators and performance tools to monitor climate action initiatives, improve decision making, optimize resource allocation, and ensure accountability in achieving sustainability goals. (S38)
39: Regular and transparent exchanges should occur between prison systems and governments at the global, national, and local levels to share strategies and best practice examples on how to identify risks, mitigate, and recover from the consequences of “climate change” and natural disasters.	47: Efforts to share best practices across jurisdictions must be prioritized through regular, transparent exchanges between prison systems and governments, enabling the adaptation of effective strategies to identify risks, mitigate impacts, and recover from climate change and natural disasters. (S39)
40: To foster collaboration and engagement, donors, academic institutions, and research funders should consult stakeholders, including individuals with lived experience of detention, to identify global research priorities on health and “climate change” in detention settings, driving targeted research initiatives for impactful change.	48: Lessons from successful disaster mitigation, as well as shortcomings that hindered responses and recovery, should inform the development of responsive and adaptive policies. (S39)
	49: Further research is essential to understand the impact of climate change on the mental health and well-being, behaviors, and experiences of those living and working in prisons. This research should inform the development of responsive prison policies, targeted interventions, and support strategies within prison settings. (new)
50: Donors, academic institutions, and research funders should collaborate with stakeholders, including those with lived experience of detention, to set global research priorities on health and climate change in detention settings, driving impactful and targeted initiatives. (S40)

S1 refers to the corresponding statement of Round 1, where the order may have changed between the rounds. S2 and S3 refer to where statements from Round 1 were combined for clarity. (new) refers to a new statement devised from Round 1 feedback.

Source: Created by authors.

This study is the first to consult stakeholders from internationally diverse backgrounds to consider best practices for sustainable prison management in the context of climate change and natural hazards.

Procedures

Specific decisions were made during data cleaning and analysis to ensure consistency. Age was rounded to the nearest whole year, and where participants provided a range, the mid-point was used. Age was reported as the mean and standard deviation. For years of practice, responses indicating values greater than a certain threshold (e.g., “>10”) were truncated to the minimum stated value. When both years and months were reported (e.g., “10 years 9 months”), values were rounded up to the nearest year. Country names were standardized; “United States of America” and “United States” were recorded as “U.S.,” while “United Kingdom” was changed to “U.K.” References to specific regions or facilities such as “Somalia Puntland state” and “Garowe city prison” were simplified to “Somalia.” Participants listing multiple countries or indicating international work were grouped under the label “global.”

RESULTS

Profile of participants

In Rounds 1 and 2, the majority of participants were male (62% and 50%, respectively). The mean age in Round 1 was 48 years and 50 years in Round 2. The most commonly represented regions were East and Asia Pacific, Europe and Central Asia, Sub-Saharan Africa, and North America, with the least representation in Latin America, the Middle East, and North Africa and South Asia. A proportion remained unspecified (7% in Round 1; 4% in Round 2). The most represented countries in Round 1 were Australia, the United States, and Namibia; yet, in Round 2, they were Australia and Namibia. High-income countries were the most represented (34% in Round 1; 36% in Round 2), followed by lower-income countries (24% in Round 1; 23% in Round 2) and lower-middle and upper-middle countries. Participants ranged from a diverse background of different roles in the prisons and corrections field, particularly advocacy and civil society, education and vocational training, and researchers, with the highest proportion working as policy makers (28% in Round 1 and 40% in Round 2). Participants with lived experience of imprisonment were among the smallest groups represented (8% in Round 1 and 7% in Round 2) (as shown in Table 2).

Table 2.

Patient Demographics

	Round 1 N = (102)n (%)	Round 2 N = (80)n (%)
Gender
Male	63 (61.8)	50 (61.7)
Female	38 (37.3)	29 (35.8)
Other	1 (1)	1 (1.2)
Age (mean age and standard deviation)	48.7 (SD 10.5)	49.7 (SD 10.3)
Region of activity
East Asia and Pacific	37 (36.3)	35 (43.2)
Europe and Central Asia	29 (28.4)	22 (27.2)
Latin America and the Caribbean	6 (5.9)	6 (7.4)
Middle East and North Africa	7 (6.9)	6 (7.4)
North America	15 (14.7)	11 (13.6)
South Asia	11 (10.8)	10 (12.3)
Sub-Saharan Africa	25 (24.5)	19 (23.5)
Not specified	7 (6.9)	3 (3.7)
Country of activity
Afghanistan	1 (1.0)	1 (1.2)
Aotearoa New Zealand	2 (2.0)	2 (2.5)
Australia	21 (20.6)	20 (24.7)
Bangladesh	1 (1.0)	1 (1.2)
Burkina Faso	2 (2.0)	2 (2.5)
Cameroon	1 (1.0)	1 (1.2)
Canada	3 (2.9)	2 (2.5)
Chile	1 (1.0)	1 (1.2)
Curacao	1 (1.0)	1 (1.2)
Finland	1 (1.0)	1 (1.2)
Germany	1 (1.0)	1 (1.2)
Ghana	3 (2.9)	1 (1.2)
Global	13 (12.7)	12 (14.8)
Hong Kong (China)	1 (1.0)	1 (1.2)
India	1 (1.0)	1 (1.2)
Jordan	1 (1.0)	1 (1.2)
Kenya	2 (2.0)	2 (2.5)
Malaysia	1 (1.0)	1 (1.2)
Moldova	1 (1.0)	0
Mozambique	1 (1.0)	1 (1.2)
Namibia	8 (7.8)	5 (6.2)
Netherlands	1 (1.0)	1 (1.2)
Nigeria	3 (2.9)	2 (2.5)
Norway	2 (2.0)	2 (2.5)
Pakistan	1 (1.0)	1 (1.2)
Papua New Guinea	1 (1.0)	1 (1.2)
Philippines	2 (2.0)	2 (2.5)
Portugal	1 (1.0)	0
Romania	2 (2.0)	2 (2.5)
Singapore	2 (2.0)	1 (1.2)
Somalia	1 (1.0)	1 (1.2)
South Africa	1 (1.0)	1 (1.2)
Türkiye	2 (2.0)	0
Uganda	2 (2.0)	1 (1.2)
U.K.	4 (3.9)	2 (2.5)
Ukraine	1 (1.0)	1 (1.2)
United States	7 (6.9)	4 (4.9)
Zambia	1 (1.0)	0
Zimbabwe	1 (1.0)	0
Country income
Middle (lower-middle) income country	23 (22.5)	15 (18.5)
Middle (upper-middle) income country	12 (11.8)	11 (13.6)
High-income country	35 (34.3)	29 (35.8)
Lower-income country	24 (23.5)	18 (22.2)
Not specified	8 (7.8)	7 (8.6)
Role in the prisons and corrections field
Advocacy and civil society	18 (17.6)	13 (16)
Clinical	6 (5.9)	5 (6.2)
Education and vocational training	21 (20.6)	15 (18.5)
Prison health and social care	16 (15.7)	14 (17.3)
Person with lived experience of detention	8 (7.8)	6 (7.4)
Policy maker	28 (27.5)	25 (30.9)
Prison security staff	22 (1.6)	15 (18.5)
Case worker	7 (6.9)	6 (7.4)
Researcher	22 (21.6)	18 (22.2)
Community services for former prisoners (housing, family, financial, etc.)	8 (7.8)	6 (7.4)
Work in an international organization	13 (12.7)	11 (13.6)
Law enforcement	8 (7.8)	5 (6.2)
Not specified	15 (14.7)	12 (14.8)

Source: Created by authors.

Delphi Round 1 results

One hundred and two participants completed Round 1, representing 72% of those who initially expressed interest (n = 142). Moreover, 39 of the 40 statements (97.5%) met the preset consensus threshold, with an average agreement level of 84%. All statements in Dimensions 1, 2, 3, 4, 6, and 7 reached the consensus (as shown in Table 3).

Table 3.

Likert Scale Scores for Round 1

		Round 1
Statements	n	Score 1–3N (%)	Score 4–6N (%)	Score 7–9N (%)
Dimension 1: Climate change and natural hazards—principles
1: “Climate change” strategic plans, policies, guidelines, and standards should be inclusive of people in prison.	102	1 (1)	19 (18.4)	83 (80.6)
2: “Climate change” strategic plans, policies, guidelines, and standards should contribute and align with the goals and targets outlined in the SDGs ensuring that no one is left behind.	102	1 (1)	20 (19.4)	82 (79.6)
3: “Climate change”-responsive prison policies should be underpinned by international standards, best practice evidence, and incorporate human-rights-based development frameworks to detect, understand, prevent, and respond to the impact of “climate change.”	102	1 (1)	15 (14.6)	87 (84.5)
4: “Climate change”-responsive prison policies should be fully supported by laws and political endorsement, regional, and local adaptation.	102	0	20 (19.4)	83 (80.6)
5: Efforts to keep pretrial detention and imprisonment to a measure of last resort should be prioritized to reduce overcrowding to minimize the effects of “climate change.”	102	6 (5.8)	20 (19.4)	77 (74.8)
Dimension 2: Climate change and disaster preparedness, planning, and infrastructure protection
6: A transparent process for monitoring and planning for “climate change” should be developed in the form of regular infrastructural and procedural risk assessments.	102	1 (1)	21 (20.4)	81 (78.6)
7: Infrastructural and procedural risk assessments should include hazards and exposure (events that could occur and exposure to them), vulnerability (the susceptibility of communities to those hazards), and lack of coping capacity (lack of resources available that can alleviate the impact).	102	3 (2.9)	10 (9.7)	90 (87.4)
8: Governments must identify and map high-risk prisons located in high-hazard-exposure areas to aid preparedness, crisis response, and recovery considering all forms of natural disasters (e.g., floods, droughts, typhoons, landslides, heatwaves, earthquakes, and volcanoes).	102	0	5 (4.9)	98 (95.1)
9: Protecting infrastructure and essential services from climate-related damages is important as “climate change” can exacerbate the existing systematic deficiencies in prison (e.g., overcrowding, poor infrastructure, ventilation, hygiene and sanitation, communicable disease outbreaks, hunger crises, interrupted electricity, supply of medication, medical equipment, and sanitation resources).	102	0	8 (7.8)	95 (92.2)
10: States should apply innovative, climate-sensitive architectural design when building new, or refurbishing old prisons to reduce carbon emissions and operational costs (e.g., implementing energy-efficient building designs and technologies) and be adapted to withstand the impact of extreme weather events.	102	0	9 (8.7)	94 (91.3)
11: Contingency plans to mitigate for climate-related risks to supply of WASH during extreme weather emergencies are critical.	102	1 (1)	7 (6.8)	95 (92.2)
12: WASH risk assessment, repair, and implementation of solutions should consider stockpiles of hygiene sanitation supplies, location/design of flood/cyclone-proof water and sanitation points, water storage tanks, and water testing/purification kits to withstand extreme weather events.	102	1 (1)	13 (12.6)	89 (86.4)
13: Practical responses to protect health infrastructure and essential services should include safe storage of clinical records and involve devising robust supply chains to safeguard medicine supply, including HIV drugs and medical resources (e.g., equipment/supplies, menstrual hygiene resources).	102	2 (1.9)	10 (9.7)	91 (88.3)
Dimension 3: Partnerships, capacity building, and resources
14: Active participation from all members of the prison community, including officials, staff, people in prison, their families, and their advocates, is essential throughout all stages of addressing “climate change”—from climate-responsive prison policy development to program implementation.	102	4 (3.9)	16 (15.5)	83 (80.6)
15: An inclusive approach based on building partnerships across various sectors, including public health authorities, government, business, nongovernment agencies, community members, and academia, is essential to effectively promote sustainability and mitigate “climate change” effects in prisons.	102	2 (1.9)	12 (11.7)	89 (86.4)
16: Building partnerships with other public sectors, such as start-ups and universities, to test “climate change” innovations that can support prison systems and facilities (e.g., prison rooftop micro energy plants) should be considered.	102	2 (1.9)	20 (19.4)	81 (78.6)
17: Specialized training programs should be provided to all those living and working in prisons to respond effectively to all climate-related challenges and natural disasters.	102	2 (1.9)	15 (14.6)	86 (83.5)
18: Adequate resources, including financial resources, equipment, and human resources, should be allocated to prison systems to respond to “climate change” considering the health needs and human rights of people deprived of their liberty and respecting the principles of equity and equivalence of care.	102	2 (1.9)	7 (6.8)	94 (91.3)
Dimension 4: Climate change and disaster response
19: Contextually appropriate early warning systems, for implementation when needed should be linked to community services that provide information on disaster or disease outbreak risks, extreme weather, or disrupted supply chains.	102	2 (1.9)	12 (11.7)	89 (86.4)
20: Efforts to improve intersectoral coordination are required to include detention settings in community contingency plans to ensure the safety of all those living and working in prisons during “climate-related emergencies.”	102	2 (1.9)	11 (10.7)	90 (87.4)
21: Regular stress testing of climate-responsive prison plans should ensure validity and functionality with explicit directives on evacuation procedures and practice drills.	102	2 (1.9)	18 (17.5)	83 (80.6)
22: To ensure operational functionality during disasters, prison systems should develop customized, transparent, disaster-specific contingency plans (procedures/guidelines), clearly articulating all potential steps required to prevent, mitigate, respond, and recover from disasters.	102	0	8 (7.8)	95 (92.2)
23: Disaster-specific contingency plans should include requirements in each event (e.g., food, water, medications, shelter), reflect the needs of the prison population, staffing levels, location, available support, and ancillary services and be reviewed and audited regularly.	102	1 (1)	10 (9.7)	92 (89.3)
24: Regular and transparent communication and information dissemination channels should be in place between people in prison and their families before, during, and after extreme weather events via virtual visits and communication platforms.	102	2 (1.9)	20 (19.4)	81 (78.6)
Dimension 5: Health-related impacts of “climate change”
25: The diverse and specific needs of priority populations living in prison should be identified and supported within inclusive climate-responsive plans. Populations may include, yet are not limited to, juveniles, pregnant women and infants, people living with disabilities or chronic disease, older people, women, people who identify as LGBTQIA+, First Nations people, individuals who are bedridden/terminal, and those on heat-sensitive medication that increases their susceptibility to temperature-related illnesses and heat stroke (e.g., psychotropics, diuretics, beta-blockers).	102	4 (3.9)	14 (13.6)	85 (82.5)
26: Health care services should be resilient, robust, and prepared for rapid adaptation in disaster situations, including rapid response planning for disease outbreaks.	102	1 (1)	9 (8.7)	93 (90.3)
27: Critical actions for disease outbreak planning should include all aspects of “readiness and preparedness,” “active outbreak,” and “crisis,” with special considerations made for cholera and antimicrobial resistance (AMR).	102	1 (1)	12 (11.7)	90 (87.4)
28: The delivery of immunization services should be prioritized, as “climate change” exposes prison populations to new pathogens (e.g., vector-borne disease [malaria, yellow fever and dengue], water-borne diseases [cholera], and meningitis) to align with the WHO Immunization Agenda 2030.	102	3 (2.9)	16 (15.5)	84 (81.6)
29: Climate control standards, policies, and guidelines for each prison system should include the monitoring, surveillance, and documentation of acceptable temperature (and humidity) ranges using heat and cold index categories (e.g., danger, extreme caution, caution, no caution).	102	2 (1.9)	21 (20.4)	80 (77.7)
30: Standards, policies, and guidelines on ventilation conditions and air filtration should be included in prison emergency preparedness and response plans to mitigate the effects of extreme heat and fires and prevent the transmission of skin and communicable respiratory diseases (e.g., tuberculosis).	102	1 (1)	19 (18.4)	83 (80.6)
31: Ventilation assessments should be conducted on an ongoing basis, in summer and winter, and increase in the event of a climate crisis, to identify high-risk prisons and monitor the impact of mitigation measures designed to improve ventilation.	102	1 (1)	20 (19.4)	82 (79.6)
32: Prison health care services should be supported to develop tailored, preventative health care plans to minimize the impact of extreme weather events (e.g., co-developing asthma care plans with patients for use during dust storms/fires).	102	3 (2.9)	12 (11.7)	88 (85.4)
33: Recognizing and responding to eco-anxiety, a chronic fear of environmental doom, among all those living and working in prison is important to mitigate the psychological and mental health distress of “climate change” through assessment, preventative education, and care to promote resilience and well-being beyond immediate consequences of “climate change.”	102	9 (8.7)	37 (35.9)	57 (55.3)
Dimension 6: Expanding sustainable development approaches
34: Sustainable practices should be promoted by prison systems to mitigate environmental impacts such as renewable energy sources for power generation, clean water supply, cooling and heating mechanisms, and other energy requirements.	102	0	17 (16.5)	86 (83.5)
35: To lower carbon emissions, responsive prison systems should ensure that all members of the prison community are educated on, and adhere to, appropriate clinical/general waste disposal, including the separation of compostable and recyclable waste.	102	1	21 (20.4)	81 (78.6)
36: Sustainable agricultural practices within prison farms can improve resilience to environmental stressors, promote sustainable food production, and provide vocational training opportunities for people in prison.	102	2 (1.9)	13 (12.6)	88 (85.4)
Dimension 7: Evaluation, research, and innovation
37: Prison staff should be involved in the planning of recovery and accountability processes, including lessons learned and conducting post-disaster risk assessments.	102	1 (1)	13 (12.6)	89 (86.4)
38: Prison systems should be supported to create indicators as well as performance and control tools to assess the progress of “climate change” initiatives, improve decision making, facilitate efficient allocation of resources, and enhance accountability.	102	2 (1.9)	20 (19.4)	81 (78.6)
39: Regular and transparent exchanges should occur between prison systems and governments at the global, national, and local levels to share strategies and best practice examples on how to identify risks, mitigate, and recover from the consequences of “climate change” and natural disasters.	102	1 (1)	16 (15.5)	86 (83.5)
40: To foster collaboration and engagement, donors, academic institutions, and research funders should consult stakeholders, including individuals with lived experience of detention, to identify global research priorities on health and “climate change” in detention settings, driving targeted research initiatives for impactful change.	102	2 (1.9)	19 (18.4)	82 (79.6)

Dimension 1: Climate change and natural hazards—principles

Four statements exceeded the 80% consensus, emphasizing international standards, human rights frameworks (87%), political and legal endorsement (83%), inclusion of incarcerated individuals (83%), and SDG alignment (82%). The remaining statements scored >70%.

Dimension 2: Disaster preparedness, planning, and infrastructure

Six statements scored >90%, two just <90% (i.e., 88% and 89%), and one at 82%, reflecting strong support for infrastructure resilience, planning, and preparedness.

Dimension 3: Partnerships, capacity building, and resources

All statements exceeded the 80% consensus, with two >90%, highlighting the need for collaboration, capacity development, and equitable resource allocation.

Dimension 4: Disaster response

Three statements scored ≥90%, with three others close behind (89%, 83%, 81%), supporting effective contingency planning and intersectoral coordination.

Dimension 5: Health-related impacts of climate change

Two statements surpassed the 90% consensus, while most others exceeded 80%. One statement on eco-anxiety scored only 55%, falling below the threshold. This may suggest that mental health concerns are not yet viewed as priority in this context.

Dimension 6: Sustainable development approaches

All three statements reached the >80% consensus, indicating broad support for sustainability and environmental stewardship in prison systems.

Dimension 7: Evaluation, research, and innovation

Four statements exceeded the 80% consensus, supporting the involvement of prison staff in planning and post-disaster review, the creation of monitoring tools, international knowledge-sharing, and global research collaboration.

Qualitative feedback

Participants provided 188 comments (avg. five per statement), with 26 participants contributing. A technical error in Statement 9 prevented free-text input. The feedback informed the refinement and development of 10 new statements (7 original, 3 split from previous statements) across Dimensions 1, 2, 3, 5, and 7.

Delphi Round 2 results

Eighty-one participants completed Round 2, yielding a 79% retention rate from Round 1 (n = 102). Of the 50 statements assessed, 49 (98%) reached the preset consensus threshold, averaging 90% agreement. All statements in Dimensions 1, 2, 3, 4, 6, and 7 met the consensus. Only one—Statement 41 (previously amended Statement 33 in Round 1) within Dimension 5—did not, receiving 64.2% agreement. Despite improved support from Round 1 (55.3%), views were polarized: 64% rated it the highest priority, and 4% rated it the lowest. This limited its inclusion in the final conclusions (as shown in Table 4).

Table 4.

Likert Scale Scores for Round 2

Round 2
Statements	n	Score 1–3N (%)	Score 4–6N (%)	Score 7–9N (%)
Dimension 1: Climate change and natural hazards—principles
1: Prisons need to be viewed as integral parts of the community, not isolated entities, within the official strategic response to climate change and natural hazards (new)	81	1 (1.2)	4 (4.9)	76 (93.8)
2: Climate change strategic plans should embrace an equitable vision of progress that prioritizes the well-being of all, including the people in prison, ensuring that their welfare is integral to policies, guidelines, standards and regulations. (S1)	81	1 (1.2)	3 (3.7)	77 (95.1)
3: Climate-responsive prison policies should be tailored to regional or country-level differences and have a duty to align with international human rights standards and the SDGs. (S2, S3)	81	1 (1.2)	6 (7.4)	74 (91.4)
4: Climate-responsive prison policies should incorporate context-specific climate response plans and be fully supported by political endorsement, legislation, and regional and local adaptation. (S4)	81	1 (1.2)	5 (6.2)	75 (92.6)
5: Correctional leaders can drive climate response inclusion and progress independently of political support through courage and the willingness to create a space for change within correctional jurisdictions. (new)	81	2 (2.5)	18 (22.2)	61 (75.3)
6: Efforts to keep pretrial detention and imprisonment to a measure of last resort should be prioritized to reduce overcrowding to minimize the adverse effects of climate change. (S5)	81	2 (2.5)	10 (12.3)	69 (85.2)
Dimension 2: Climate change and disaster preparedness, planning, and infrastructure protection
7: Protecting infrastructure and essential services from climate-related damages safeguards prisons, as climate change can exacerbate existing systematic deficiencies in prison (e.g., overcrowding, poor infrastructure, ventilation, hygiene and sanitation, communicable disease outbreaks, hunger crises, interrupted electricity, supply of medication, medical equipment, and sanitation resources).	81	0	5 (6.2)	76 (93.8)
8: A transparent process for climate change planning needs to include regular infrastructural and procedural risk and needs assessments, including independent inspections, with expert input.	81	1 (1.2)	7 (8.6)	73 (90.1)
9: Risk and needs assessments should involve people in prison, communities, and a team of specialists in assessing hazards and exposure (events likely to occur and communities’ exposure to them), vulnerability (the susceptibility of communities to those hazards), and lack of coping capacity (resources needed to alleviate the impact).	81	0	8 (9.9)	73 (90.1)
10: Governments must identify and map prisons located in high-hazard-exposure areas to aid preparedness and planning considering all forms of natural disasters (e.g., floods, droughts, typhoons, landslides, heatwaves, earthquakes, and volcanoes).	81	0	6 (7.4)	75 (92.6)
11: Risk assessments on locations for new prisons should align with revised standards that promote long-term sustainability and preparedness, balancing costs and benefits effectively.	81	0	5 (6.2)	76 (93.8)
12: Assessment findings must drive effective mitigation efforts to prevent loss of life, reduce harm for those living and working in prisons, and protect public safety.	81	0	2 (2.5)	79 (97.5)
13: States should apply innovative, climate-sensitive architectural design when building new or refurbishing old prisons to reduce carbon emissions and operational costs (e.g., implementing energy-efficient building designs and technologies) and be adapted to withstand the impact of extreme weather events.	81	0	7 (8.6)	74 (91.4)
14: Data and technology science, such as geo-mapping and real-time wildfire reporting applications, should be leveraged to enhance situational awareness and support government and prison system planning, response, and recovery during environmental disasters.	81	0	7 (8.6)	74 (91.4)
15: Contingency plans to mitigate for climate-related risks to supply of WASH during extreme weather emergencies are critical. (S11)	81	0	3 (3.7)	78 (96.3)
16: WASH risk and needs assessments, repair, and implementation should be tailored to the country’s level of preparedness and include flood- or cyclone-proof water and sanitation points, water storage tanks, water testing and purification kits, and stockpiles of hygiene and sanitation supplies. (S12)	81	0	6 (7.4)	75 (92.6)
17: Practical responses to protect health infrastructure and essential services should include the safe storage of clinical records, leveraging digitalization with robust disaster recovery protocols, to secure critical information during emergencies. (S13)	81	1 (1.2)	6 (7.4)	74 (91.4)
18: Efforts to protect health infrastructure and essential services must focus on establishing robust supply chains to safeguard the availability of essential medicines, including HIV drugs, medical equipment, and menstrual hygiene resources. (S13)	81	0	6 (7.4)	75 (92.6)
Dimension 3: Partnerships, capacity building, and resources
19: Active participation from all members of the prison community, including officials, staff, people in prison, their families, and their advocates, is essential throughout all stages of addressing climate change—from climate-responsive prison policy development to program implementation. (S14)	81	4 (4.9)	9 (11.1)	68 (84)
20: Building collaborative, cross-sector partnerships are important for leveraging diverse expertise, resources, and support to promote sustainability and address the multifaceted impacts of climate change in prisons (e.g., prison administrators, broader public health authorities, businesses, governments, nongovernment agencies, international organisations, cultural institutions, education, academia, and community). (S15)	81	0	5 (6.2)	76 (93.8)
21: Building partnerships with other public sectors should be considered, such as start-ups and universities, to test climate change innovations, such as prison rooftop micro energy plants, to support prison systems and facilities. (S16)	81	0	12 (14.8)	69 (85.2)
22: Specialized climate action education and training should be provided to all those living and working in prisons to build capacity and address climate challenges, fostering unity and collective responsibility, emphasizing that “we are all in this together to mitigate impact.” (S17)	81	0	11 (13.6)	70 (86.4)
23: Adequate resources—financial, equipment, human resources, and technical directives—should be allocated to prison systems to respond to climate change and natural disasters. (S18)	81	0	5 (6.2)	76 (93.8)
24: Resource allocation must align with laws, uphold human rights, ensure equitable care, address short- and long-term needs, and be supported by a cross-political consensus for continuity beyond electoral cycles. (new)	81	1 (1.2)	5 (6.2)	75 (92.6)
Dimension 4: Climate change and disaster response
25: Efforts to improve cross-sector coordination are required to include detention settings in community contingency plans to ensure the safety of all those living and working in prisons during climate-related emergencies. (S20)	81	0	9 (11.1)	72 (88.9)
26: Contextually appropriate early warning systems should be linked to community services to provide timely information and assistance during disasters, disease outbreaks, extreme weather, or disrupted supply chains. (S19)	81	0	5 (6.2)	76 (93.8)
27: To ensure operational functionality during disasters, prison systems should develop customized and unique disaster-specific contingency plans (standard operating procedures/guidelines), transparently and clearly articulating all potential steps required to respond, and recover from disasters. (S22)	81	0	4 (4.9)	77 (95.1)
28: Disaster contingency plans should address the needs of everyone in prison, including staff and families, and outline event-specific requirements such as food, water, medications, shelter, evacuation, staffing, support, and services). (S23)	81	0	6 (7.4)	75 (92.6)
29: Regular stress testing of climate-responsive prison plans should ensure validity and functionality with explicit directives on evacuation procedures and practice drills. (S21)	81	0	9 (11.1)	72 (88.9)
30: Disaster-specific contingency plans should be externally reviewed and audited regularly. (S23)		0	7 (8.6)	74 (91.4)
31: A communication strategy should be developed to ensure regular and transparent updates between people in prison and their families via virtual platforms where possible, particularly before, during, and after extreme weather events, to maintain emotional well-being and reduce anxiety. (S24)		1 (1.2)	7 (8.6)	73 (90.1)
Dimension 5: Health-related impacts of “climate change”
32: The diverse and specific needs of priority populations living in prison should be identified and supported within inclusive climate-responsive plans. Populations may include, yet are not limited to juveniles, pregnant women and infants, people living with disabilities or chronic disease, older people, women, people who identify as neurodiverse, LGBTQIA+ or ethnic and Indigenous minorities, individuals who are bedridden/terminal, and those on heat-sensitive medication that increases their susceptibility to temperature-related illnesses and heat stroke. (S25)		3 (3.7)	11 (13.6)	67 (82.7)
33: Health care services should be maintained in order to be resilient, robust, and prepared for rapid adaptation in disaster situations, including rapid response planning before, during, and after disease outbreaks. (S26)		0	6 (7.4)	75 (92.6)
34: Critical actions for disease outbreak planning should include all aspects of “readiness and preparedness,” “active outbreak,” and “crisis.” (S27)		0	4 (4.9)	77 (95.1)
35: The delivery of immunization services should be prioritized and aligned with the WHO Immunization Agenda 2030, as climate change exposes prison populations to new pathogens (e.g., vector-borne disease [malaria, yellow fever and dengue], water-borne diseases [cholera], and meningitis). (S28)		1 (1.2)	7 (8.6)	73 (90.1)
36: Climate control standards, policies, guidelines, and regulations for each prison system must be adaptable to regional conditions and should include the monitoring, surveillance, and documentation of acceptable temperature (and humidity) ranges using heat and cold index categories (e.g., danger, extreme caution, caution, no caution). (S29)		1 (1.2)	6 (7.4)	74 (91.4)
37: Standards, policies, guidelines, and regulations on ventilation conditions and air filtration should be included in prison emergency preparedness and response plans to mitigate the effects of extreme heat and fires and prevent the transmission of skin and communicable respiratory diseases (e.g., tuberculosis). (S30)		1 (1.2)	5 (6.2)	75 (92.6)
38: The utilization of technology, such as smart sensors, should be considered to maintain optimal humidity and ventilation levels, ensuring compliance with health standards. (new)		1 (1.2)	10 (12.3)	70 (86.4)
39: Ongoing ventilation assessments should be conducted year-round, with increased frequency during climate crises, to identify high-risk prisons and evaluate the impact of mitigation measures designed to improve ventilation, with a commitment to act on the findings. (S31)		1 (1.2)	9 (11.1)	71 (87.7)
40: Prison health care services should be supported and allocated resources to develop tailored, preventative health care plans aligned with community standards, to minimize the impact of extreme weather events (e.g., co-developing asthma care plans with patients for dust storms or fires). (S32)		2 (2.5)	3 (3.37)	76 (93.8)
41: Recognizing and responding to eco-anxiety, a chronic fear of environmental doom, among all those living and working in prison is important to mitigate the psychological and mental health distress of climate change through assessment, preventative education, and care to promote resilience and well-being beyond immediate consequences. (S33)		4 (4.9)	25 (30.9)	52 (64.2)
Dimension 6: Expanding sustainable development approaches
42: Prison systems, similar to all public institutions, should lead by example in promoting sustainable practices aligned with the SDGs, including the use of renewable energy for power, clean water supply, efficient cooling and heating, and sustainable cooking facilities. (S34)		2 (2.5)	4 (4.9)	75 (92.6)
43: To lower carbon emissions, prison systems should provide education opportunities for the prison community on waste disposal practices, including composting and recycling, aligned with external standards. (S35)		0	13 (16)	68 (84)
44: Sustainable agricultural practices within prison farms can improve resilience to environmental stressors, promote sustainable food production, and provide vocational training opportunities for people in prison. (S36)		1 (1.2)	8 (9.9)	72 (88.9)
Dimension 7: Evaluation, research, and innovation
45: Prison staff should be involved in the planning of recovery and accountability processes, including lessons learned and conducting post-disaster risk and needs assessments. (S37)		1 (1.2)	4 (4.9)	76 (93.8)
46: Prison systems and governments should develop indicators and performance tools to monitor climate action initiatives, improve decision making, optimize resource allocation, and ensure accountability in achieving sustainability goals. (S38)		2 (2.5)	12 (14.8)	67 (82.7)
47: Efforts to share best practices across jurisdictions must be prioritized through regular, transparent exchanges between prison systems and governments, enabling the adaptation of effective strategies to identify risks, mitigate impacts, and recover from climate change and natural disasters. (S39)		0	6 (7.4)	75 (92.6)
48: Lessons from successful disaster mitigation, as well as shortcomings that hindered responses and recovery, should inform the development of responsive and adaptive policies. (S39)		0	2 (2.5)	79 (97.5)
49: Further research is essential to understand the impact of climate change on the mental health and well-being, behaviors, and experiences of those living and working in prisons. This research should inform the development of responsive prison policies, targeted interventions, and support strategies within prison settings. (new)		2 (2.5)	10 (12.3)	69 (85.2)
50: Donors, academic institutions, and research funders should collaborate with stakeholders, including those with lived experience of detention, to set global research priorities on health and climate change in detention settings, driving impactful and targeted initiatives. (S40)		2 (2.5)	6 (7.4)	73 (90.1)

Source: Created by authors.

Dimension 1: Climate change and natural hazards—principles

All six statements met the consensus, with four >90%. The key themes included recognizing prisons as part of communities, context-specific policies rooted in human rights and SDGs, and leadership-led responses independent of political support. The highest-rated statement (95%) emphasized an equitable vision of well-being. A new, highly rated statement (93.8%) called for prisons to be viewed as integral parts of the community, not isolated entities, within the official strategic response to climate change.

Dimension 2: Disaster preparedness, planning, and infrastructure

All 12 statements exceeded the 90% consensus, reflecting strong agreement on infrastructure resilience, supply chains, architectural design, and water, sanitation, and hygiene. A new top-rated statement (97.5%) highlighted the role of assessments in driving mitigation. Other high-scoring areas included contingency planning (96.3%) and routine infrastructural reviews.

Dimension 3: Partnerships, capacity building, and resources

All six statements met the consensus. Three scored >90% (92%–93%), and three >80% (84%–86%), emphasizing the need for collaborative partnerships, adequate funding, and equitable resource allocation aligned with rights-based approaches.

Dimension 4: Disaster response

All seven statements met the consensus, five of which exceeded 90%. The highest-rated statement (95.1%) supported tailored, disaster-specific contingency plans. Slightly lower-scoring statements (88.9%) related to intersectoral coordination and regular stress testing.

Dimension 5: Health-related impacts of climate change

Nine out of ten statements met the consensus. The outlier, addressing eco-anxiety in prisons, remained below the threshold at 64.2%. Six statements surpassed 90%, with the highest (95.1%) emphasizing disease outbreak preparedness. Others highlighted continuity of care, immunization, regional adaptation of standards, and climate-sensitive health monitoring.

Dimension 6: Sustainable development approaches

All three statements reached >80% consensus. One (92.6%) strongly supported sustainable practices aligned with SDGs, including renewable energy for water, climate control, and cooking.

Dimension 7: Evaluation, research, and innovation

All six statements exceeded 80% consensus: four surpassed 90%, including the top-rated statements (97.5%) on developing adaptive policies informed by successful mitigation. Other high priorities included staff involvement in recovery, cross-jurisdictional learning, and research into climate-health impacts.

Qualitative feedback

Sixteen participants contributed 85 comments via open-text boxes, averaging two comments per statement, enriching interpretation and contextual insights.

DISCUSSION

This is the first global e-Delphi consensus study that identifies and defines core climate action components on the international best practice to promote resilience, sustainability, and safeguard prisons and prison communities against the consequences of climate change. Building the resilience of prisons to respond to crises is considered both a moral obligation and necessity.³⁹

Our results indicate that the ICPA experts participating in the e-Delphi method hold a strong consensus on what key components/outcomes and best practices should be implemented to achieve an effective response to climate change and natural hazards spanning strategies before, during, and after climate events (as shown in Fig. 2). Notably, throughout both rounds in the e-Delphi method, no substantive shift in the consensus was observed, as it related to the core Climate Change and Natural Hazard principles. The core principles centered on prisons as integral parts of the community and not isolated entities; an equitable vision including well-being, international human rights standards, and SDGs; broad political support; correctional leader-led responses independent of support; and imprisonment as a last resort. These are widely recognized in the literature as essential components of an effective response to climate change in closed settings, supporting a collaborative public health response, re-framing of prisons as part of society, promoting social and environmental justice, fostering political and institutional commitment, correctional leadership, and the urgent need for decarceration.⁴⁰ These principles align with broader climate action frameworks; yet, they require context-specific implementation strategies to navigate the unique challenges of closed settings, ensuring climate resilience beyond infrastructure to include systemic reform, equity, and sustainability.

FIG. 2.

Effective climate action. Depicting the core climate action principles regarding prisons, spanning climate change and disaster preparedness, planning, and infrastructure protection; partnerships, capacity building, and resources; climate change and disaster responses; health-related impacts of climate change; expanding sustainable development approaches; and evaluation, research, and innovation.

There was a strong and consistent consensus in relation to the critical nature of collaborative approaches to disaster and climate impact preparedness, planning, and infrastructure protection and the importance of long-term sustainability. The meaningful involvement of lived experience in risk assessments in addition to communities and key experts is critical for effectiveness.⁴¹ Consideration of the physical design of prisons is fundamental to identifying the vulnerability for people living and working in prisons, as is the inclusion of prisons in public health intelligence such as remote sensing climate mapping tools to inform decision making may incur better climate action outcomes.⁴² Above all, it is suggested that the most sustainable prison is, in fact, the one that is never built.⁴³

A slight shift between the rounds toward the consensus was observed regarding partnerships and capacity building, particularly active participation from all members of the prison community from prison policy development to program implementation and other public sectors.⁴⁴ This aligns with the existing literature advocating that people in closed settings are routinely prevented from protecting themselves due to their reliance on institutional staff, structures, and practices that are mostly out of their control.⁴⁵ Further evidence suggests that the intrinsic capacities of people in closed settings may be underutilized, leading to exclusion from decision making or identifying and leading solutions during disasters.⁴⁶ While no substantive shift was noted between the rounds in relation to specialized education and training for all those living and working in prison, expert agreement was evident regarding an integrated approach including both agencies and people living and working in prisons, fostering unity and collective responsibility.⁴⁷ The existing evidence suggests that people in prison supported response efforts post an earthquake event, including food preparation for humanitarian works and volunteering, rebuilding homes, clearing debris, first-aid support, informal counseling to other people in prison, and fundraising.⁴⁸ However, consideration must be given to policies that include the force serving the public across the disaster life cycle, such as firefighting, ensuring the protection and well-being, appropriate compensation, and ongoing assessment of medical needs, as their involvement often places them at higher risk.^49,50

Our findings, from a global perspective, complement existing research related to domestic and regional disaster preparedness in custodial settings. For example, one study examining U.S. correctional facilities identified significant gaps in planning, resource allocation, and staff training, which limited institutional resilience during climate-related disasters.⁵¹ Participants in our sample of international multidisciplinary substantive technical experts supported the need for context-specific leadership and interagency collaboration opportunities and policy reform. This highlights the need for ongoing cross-jurisdictional research to identify best practices and lessons learned to inform contextually tailored interventions.

In relation to climate change and disaster response, the experts also agreed on the critical need to improve cross-sector coordination, with a notable shift toward the consensus between the rounds. This aligns with a body of literature that supports the critical need for enhanced emergency response planning, including practice drills.⁵² A clear communication strategy to ensure regular, transparent updates for people in closed settings and their families was perceived by the experts as very important, with a strong shift toward the consensus noted between the rounds. The existing literature supports clear communication as critical in reducing anxiety and psychological trauma during periods of heightened vulnerability.⁵³

This e-Delphi study underscores the need for inclusive health care services to be prepared and carefully consider various aspects from disease outbreaks to immunization services in addition to identifying and supporting the diverse and specific needs of priority populations. This shared perspective among the experts aligns with the literature emphasizing the amplification of health risks and conditions among priority populations during disasters and the increased risk of climate-related harms given the disproportionate burden of mental ill-health, substance use, disability, women and children, older persons, and ethnic and Indigenous minorities who require tailored, culturally sensitive care and support.⁵⁴ A marked increase toward the consensus in relation to the monitoring and surveillance of climate control was observed among the experts between the rounds, underscoring the critical importance of responding to extreme, fluctuating temperatures.⁵⁵ Of note, there was a consistent failure across both the rounds to achieve a consensus regarding the critical nature of recognizing and responding to eco-anxiety to mitigate the psychological and mental health distress of climate change.⁵⁶ This likely reflects the lower prioritization of the psychological well-being of prison populations, particularly in comparison with other climate-related concerns.

The experts also agreed on promoting sustainable practices aligned with the SDGs, with a key focus on renewable energy for power, heating and cooling systems, sustainable cooking facilities, and clean water access. A consensus was evident regarding the collective support for the importance of educational and vocational training opportunities for the prison community on agricultural practices, food production waste disposal practices and promote, consistent with previous research.⁵⁷

The experts widely endorsed evaluation, research, and innovation, with a shift toward a greater consensus visible between the rounds regarding broader involvement in recovery and accountability processes, the development of indicator and performance tools, and lessons learned.⁵⁸ While the importance of further research was acknowledged, a strong shift toward the consensus between the rounds was observed in relation to sharing best practices, suggestive of the value of global, cross-sector learning.⁵⁹

LIMITATIONS AND STRENGTHS

Strengths of this e-Delphi study center on the composition of our e-Delphi panel of experts drawn from a global network of prison experts (advocates, persons with lived experience, staff, policy makers, researchers) from different regions of the world and from countries with differing and development/income levels. A similar approach has been taken in other e-Delphi studies in the prison and correctional space⁶⁰ and is aligned with the recommended best practices in conducting an e-Delphi study and in order to minimize recruitment bias.⁶¹ There was also a relatively strong commitment to complete both rounds.

We identify several limitations; yet nonetheless, the e-Delphi method was still valuable for capturing a consensus of statements across disciplines and locations. A key limitation includes the low uptake from Latin America and the Caribbean, and the Middle East and North Africa. In addition, while the composition of the panel mostly included professionals with subject-matter expertise across both rounds, a significant limitation was recognized in that people with lived experience of incarceration were underrepresented despite being essential experts in this context. Given the limited participation of formerly or currently incarcerated individuals, this perspective was underrepresented in this study, reflecting broader systemic biases in whose knowledge is considered expertise. Furthermore, while our study cites the “empowerment of correctional leadership” as an essential component in advancing climate change responses, this contrasts with some existing studies that emphasize that leadership frequently acts as bottlenecks that constrain innovation and accountability, limiting the scope of measures that could protect those incarcerated. Due to the underrepresentation of those formerly incarcerated in our study, we acknowledge this point as a limitation and one that warrants centering future research on the voices and experiences of people with lived experience, who may frame correctional leadership differently.

Another limitation includes the potential introduction of bias via the inclusion of mostly positive statements. This may be perceived as limiting the expression of divergent or critical views; however, Delphi studies aim to generate a consensus around the best practice, in this case on the international best practice to promote resilience, sustainability, and safeguard prisons and prison communities against the consequences of climate change. Hence, why the statements are largely in the positive, as the aim was to establish standards rather than to conduct a survey to unpack challenges. Furthermore, it was beyond the scope of this study to weight expert perspectives by national incarceration rates or climate vulnerability given that Delphi studies do not weight, rather they generate a consensus at the global level. This may underrepresent perspectives from the countries most impacted. Lastly, the existing literature has argued that incarceration itself undermines climate-related resilience, where abolition emphasizes decarceration as a protective climate resilience strategy.⁶² Consistent with this perspective, the experts in our study endorsed that efforts to keep pretrial detention and imprisonment to a measure of last resort should be prioritized to reduce overcrowding to minimize the effects of climate change. While this perspective was not a key focus of our study and may be considered a limitation, future research should gather perspectives from abolitionists and people with lived experience of incarceration.

CONCLUSION

Addressing sustainability and resilience in prisons and other custodial settings is essential to ensuring equitable climate action. Policies, standard operation procedures, capacity building, and partnership efforts based on the dimensions highlighted in this e-Delphi study should be adapted into national contexts and include aspects of contextually appropriate emergency preparedness planning, structural integrity assessments, and hazard risk management through coordinated, interdisciplinary, and multidisciplinary actions to improve the global response to climate change in prisons. By leveraging the insights generated from this e-Delphi study and advancing knowledge in the field, policy makers, practitioners, and stakeholders may enact meaningful change and advance the sustainability agenda within such closed settings globally.

Footnotes

AUTHORS’ CONTRIBUTIONS

I.C. and M.C.V.H. were responsible for the conceptualization and design of the study, project coordination, data collection, data analysis, and review and editing prior to submission. R.B. was responsible for ethics, design of the study, project coordination, data collection, data analysis, writing of the original draft, and review and editing prior to submission. R.M. was responsible for design of the study, project coordination, data collection, data analysis, and review and editing prior to submission. M.B. was responsible for the design of the study, data collection, data analysis, and review and editing prior to submission. T.R. was responsible for the design of the study, data collection, and review and editing prior to submission. A.D. was responsible for the design of the study, data collection, and review and editing prior to submission. L.P. was responsible for the design of the study and review and editing prior to submission.

AUTHOR DISCLOSURE STATEMENT

No competing financial interests exist.

FUNDING INFORMATION

No funding was received for this article.