{
  "abstract": "Rising temperatures and extreme heat pose a substantial threat to human health through increases in heat-related morbidity and mortality. Moreover, social determinants of health can exacerbate the impact of heat on susceptible populations. This study investigates the inequities in heat-related emergency department (ED) visits in California from 2005-2017, focusing on how social determinants of health, represented by the California Healthy Places Index (HPI), may influence the associations between temperature and ED visits. A Distributed Lag Nonlinear Model (DLNM) was employed to assess the association between daily temperatures and ED visits for heat-related physical illness, mental health, and all-cause visits. The California HPI was used to stratify the data and evaluate disparities in heat-related ED visits across different socioeconomic conditions. There were 129,935,301 ED visits in California from 2005-2017. We find that 5.1% of heat-related physical illness visits, 5.4% of heat-related mental health visits, and <1% of all-cause ED visits in California were attributable to heat. Communities with lower HPI scores (indicating less healthy conditions) accounted for a higher proportion of ED visits than expected based on their population size, and higher burdens of heat-related morbidity, with four times greater risk of heat-attributable ED visits for physical illness, and two times greater risk for mental health and all-cause visits. This study underscores the disproportionate impact of extreme heat on communities with less healthy conditions and highlights the importance of social determinants of health in shaping heat-related morbidity. Heat-attributable emergency department visits represent a sizable portion of overall morbidity for heat-related outcomes and mental outcomes. Communities with the least healthy conditions have disproportionately higher heat-related morbidity.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California Davis, Davis, California, United States of America",
    "Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America",
    "California Department of Public Health, Office of Health Equity, Richmond, California, United States of America",
    "Independent Researcher, California Department of Public Health, San Francisco, California, United States of America"
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Marisa Donnelly"
    },
    {
      "affs": [
        1
      ],
      "name": "Brooke Lappe"
    },
    {
      "affs": [
        2
      ],
      "name": "Meredith Milet"
    },
    {
      "affs": [
        3
      ],
      "name": "Jason Vargo"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6qvjh05b04jy2.bib",
  "cited_by": 0,
  "doi": "10.1371/journal.pclm.0000586",
  "fulltext_url": "https://journals.plos.org/climate/article?id=10.1371/journal.pclm.0000586",
  "id": "6qvjh05b04jy2",
  "issns": [
    "2767-3200"
  ],
  "landing_url": "https://journals.plos.org/climate/article?id=10.1371/journal.pclm.0000586",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2307|Climate Change and Health Impacts"
    ],
    [
      "plos",
      "/Medicine and health sciences/Critical care and emergency medicine"
    ],
    [
      "plos",
      "/Medicine and health sciences/Epidemiology/Medical risk factors"
    ],
    [
      "plos",
      "/Medicine and health sciences/Health care/Health statistics/Morbidity"
    ],
    [
      "plos",
      "/Medicine and health sciences/Health care/Socioeconomic aspects of health"
    ],
    [
      "plos",
      "/Medicine and health sciences/Mental health and psychiatry"
    ],
    [
      "plos",
      "/Medicine and health sciences/Public and occupational health"
    ],
    [
      "plos",
      "/Medicine and health sciences/Public and occupational health/Behavioral and social aspects of health"
    ],
    [
      "plos",
      "/Medicine and health sciences/Public and occupational health/Socioeconomic aspects of health"
    ],
    [
      "plos",
      "/People and places/Geographical locations/North America/United States/California"
    ]
  ],
  "openalex": "W7220738562",
  "pdf_url": "https://journals.plos.org/climate/article/file?id=10.1371/journal.pclm.0000586&type=printable",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-06",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/6qvjh05b04jy2.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:30Z",
      "native_id": "10.1371/journal.pclm.0000586",
      "source": "plos",
      "url": "https://journals.plos.org/climate/article?id=10.1371/journal.pclm.0000586"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "plos:epidemiology",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Inequities in heat-related emergency department visits in California from 2005 – 2017",
  "title_text": "Inequities in heat-related emergency department visits in California from 2005 – 2017",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:30Z",
  "url": "https://research.draconitic.com/paper/6qvjh05b04jy2",
  "venue": "PLOS Climate",
  "versions": []
}