Inequities in heat-related emergency department visits in California from 2005 – 2017
4 affiliations
- 1Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California Davis, Davis, California, United States of America
- 2Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
- 3California Department of Public Health, Office of Health Equity, Richmond, California, United States of America
- 4Independent Researcher, California Department of Public Health, San Francisco, California, United States of America
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.
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BibTeX
@article{donnelly2026inequities,
title = {{Inequities in heat-related emergency department visits in California from 2005 – 2017}},
author = {Marisa Donnelly and Brooke Lappe and Meredith Milet and Jason Vargo},
journal = {PLOS Climate},
year = {2026},
month = oct,
doi = {10.1371/journal.pclm.0000586},
url = {https://journals.plos.org/climate/article?id=10.1371/journal.pclm.0000586},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Inequities in heat-related emergency department visits in California from 2005 – 2017
AU - Marisa Donnelly
AU - Brooke Lappe
AU - Meredith Milet
AU - Jason Vargo
PY - 2026
DA - 2026/10/06
JO - PLOS Climate
DO - 10.1371/journal.pclm.0000586
UR - https://journals.plos.org/climate/article?id=10.1371/journal.pclm.0000586
AB - 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.
SN - 2767-3200
ER -