Recurrent climate related extreme events and patterns of race/ethnic mortality: opportunities to advance population health equity.

Introduction: Climate change increases the frequency and intensity of droughts, excessive heat, damaging storms and other extreme events. In the United States, economic and racial inequality, combined with widespread divestment in communities, exacerbate the health risks from climate change through recurrent and overlapping climate extremes. Yet, the population health consequences of recurrent climate risks are not well understood. Methods: Using existing environmental and climate data from several sources, we develop a novel measure of recurrent climate extreme events from 2010-2019. We merge this with population health data from the County Health Rankings and Roadmap project. Our analysis examines the association between recurrent climate extreme events and age-adjusted premature mortality across two subgroups, non-Hispanic Black and non-Hispanic White residents. Results: Controlling for established determinants of population health, climate extremes are associated with higher levels of premature mortality for non-Hispanic Black residents, but within the same counties, climate extremes are not consistently related to White premature mortality. Specifically, results showed a statistically significant 37% increase in premature mortality for multiple decadal climate events for non-Hispanic Black populations. Conclusions: Local communities experience and respond to climate-related events, but within the same locality, climate extremes can magnify health disparities. Policies that integrate climate change and health must be informed by local data that help identify and support populations within a community made differentially vulnerable to climate change.