The United States has approximately 5 percent of the world's population but incarcerates nearly 25 percent of the world's incarcerated population and produces nearly 25 percent of global carbon dioxide emissions to date. Climate change and hyperincarceration are causes and consequences of structural racism and economic deprivation, which disproportionately affect structurally disenfranchised citizens, including lower-income communities, communities of color, and people with disabilities. Empirical evidence exists regarding the adverse health effects of climate change and mass incarceration, which occur in cascading and overlapping categories and include preventable death, illness, and injury. Researchers underscore the medical vulnerability of incarcerated populations, who are increasingly susceptible to climate-driven exposure pathways and mental and physical health outcomes involving extreme temperatures, natural disasters, infectious diseases, and displacement. Intersectional structural drivers, such as anthropogenic climate change and hyperincarceration, undermine social and political determinants of health equity. Policymakers and health professionals can advance understanding and mitigate present and anticipated public health threats by increasing transparency, accountability, and human rights protections with an emphasis on decarceration and decarbonization.