#4-25E. Unequal Risk: Extreme Urban Heat and ED Visits in Older Adults (JAMA Netw Open, 2026)

Does extreme summer heat pose an equal risk to all older adults, or do social determinants of health create hidden vulnerabilities? Today, we examine a matched case-control study evaluating the association between extreme urban heat exposure and all-cause emergency department (ED) visits among adults aged 65 and older. By analyzing electronic health records from two New York City hospitals, researchers investigated how the daily maximum heat index affects acute care utilization. The study's most critical finding demonstrates that increased ED utilization occurred exclusively at the hospital serving a predominantly socioeconomically vulnerable, Medicaid-enrolled population, notably at temperatures below official municipal heat advisory thresholds. When critically appraising this paper, listeners must consider its limitations; the data stems from only two facilities within a single urban healthcare system using a single ground weather monitor, which limits broad generalizability. For practicing physicians, this study is highly relevant as it underscores that standard municipal heat advisories may inadequately protect our most at-risk patients. It highlights the urgent need to integrate social determinants of health into clinical risk assessments, allowing for tailored, preemptive heat-adaptation strategies and patient counseling to mitigate acute heat-related morbidity among disadvantaged older adults.

Citation: Siau E, Azan A. Extreme Urban Heat and Emergency Department Visits in Older Adults. JAMA Network Open. 2026. DOI: 10.1001/jamanetworkopen.2026.2645

Disclaimer: This audio summary is based on personal interpretation and does not guarantee the exact content of the original paper. Please refer to the original article for details.