Table 2.

Studies on climate-related adult health outcomes included in review

Climate impact	Health outcome	Racial/ethnic group	Geographic scope	Example findings of disparities
Temperature	Mortality [11–15]	All	PA, PR, TN, US	Significantly increased risk in stroke and cardiovascular disease mortality in Puerto Rico during the summers of 2012 and 2013, the hottest on record, associated with elevated temperature [14]
	Mental health [16–19]	All	CA, NY, TN	Greatest increase in mental health-related ED visit risk in California (2005–2013) among Hispanics compared to Whites for every 10°F increase in mean daily temperature [16]
	Cardiovascular [20, 21]	B, L, W	FL, MD, US	Significantly higher odds of myocardial infarction hospitalization associated with extreme heat events among non-Hispanic Blacks than non-Hispanic Whites in Maryland from 2000 to 2012 [21]
	Renal illness [22–24]	All	MA, NY, PA, US	Higher risk of hospitalization and mortality among non-Hispanic Blacks with end-stage renal disease than non-Hispanic Whites associated with heat in Boston, Philadelphia, and New York City [24]
	Occupational [25–28]	B, L, W	FL, IA, US, WA	84% of Latinx farmworkers in a Florida prospective cohort experienced at least one heat-related illness symptom and 40% experienced three or more. Females had higher odds than males [27]
	ED visits, HA [29–38]	All	AZ, CA, FL, MI, US, VA	Higher risk for ED visits among groups of color identified as “non-white” than Whites due to cold weather conditions in Roanoke and Charlottesville, Virginia, from 2010 to 2017 [31]
	Respiratory [39–42]	B, L, W	GA, NE, US	More than three times higher ED asthma diagnosis risk among Blacks than non-Blacks associated with 2012 heatwave in Douglas County, Nebraska [39]
Hurricane, flood	Mortality [43–45, 46••]	L	PR	Estimated mortality rate of 14.3 deaths per 1,000 people from Hurricane Maria—a total of 4,645 excess deaths, which translates to a 62% increase in mortality rate compared to the prior year [46••]
	Mental health [47–55]	A, B, L, W	LA, NJ, NY, PR, TX	Highest risk for poor mental health among Hispanics compared to Blacks and Whites among Hurricane Sandy survivors in New York and New Jersey [50]
	Cardiovascular [56, 57]	B, W	LA	Higher likelihood for Blacks with PTSD 1–2 years after Hurricane Katrina to have a cardiovascular disease event than those without PTSD. No significant association among Whites [56]
	Reproductive [58, 59]	B, L, W	LA, NY	Highest increase in ED visits related to pregnancy complications among Hispanics associated with power outages after Hurricane Sandy in New York followed by Blacks and Whites [59]
	Chronic [60, 61]	L	PR	Increased prevalence of chronic disease (e.g., hypertension, high cholesterol) following Maria [60]
	Infectious [62]	B, L, N, W	NC	Higher risk of acute gastrointestinal illness ED visits among American Indians and Blacks compared to non-Hispanic Whites associated with Hurricane Florence [62]
	ED visits, HA [63–67]	B, L, W	NY, PR	68.9% increase in Hurricane Maria-related ED visits in NYC, a primary destination for displaced Puerto Ricans, during and after the hurricane’s landfall, as compared to 8 weeks prior [63]
Wildfire	ED visits, HA [68••, 69, 70]	B, N, W	AK, US, Western US	Higher odds of asthma- and heart failure-related ED visits among Alaska Natives than non-Alaska Natives associated with wildfire PM2.5 exposure during 2015–2019 wildfire seasons in Alaska [69]
Other	Mortality [71, 72••, 73••]	All	US	Highest mortality rate from natural hazards (e.g., heat/cold, storm) among Native Americans, followed by Blacks, Whites, Latinos, and Asians/Pacific Islanders among those aged 0–84 [71]
	Respiratory [74•]	B, W	MD	Higher risk of asthma hospitalization among Blacks than Whites associated with late vs. normal and very early vs. normal onset of Spring in Maryland from 2001 to 2012 [74•]
	Infectious [75–77]	All	MA, US	Higher risk for influenza ED visits among Blacks than Whites and those categorized as “other” race associated with extreme precipitation in Massachusetts [76]

All Asian, Black, Latinx, Native American, Pacific islander, White. A Asian, B Black, L Latinx, N Native American, P Pacific Islander, W White. ED Emergency Department, HA hospital admissions. Other category includes drought, precipitation, phenological events, multiple climate exposures