U.S. heat exposure and mental health hospitalization: Exploring disparities by race, ethnicity and insurance status

Authors

• AK Small
• KJ Jones
• L Marineau
• E Liedtke
• M Sona
• SN Zenk

Abstract

Extreme heat exposure continues to show clear negative effects on mental health outcomes. Yet while heat related physical health disparities have been well documented no similar body of research exists for mental health disparities. Although some studies have identified racial and ethnicity differences, results are conflicting across studies and have made it challenging to identify at-risk groups. Additionally, insurance status and its connection to socioeconomic status has received very little attention in this area. The current study investigates group differences by race, ethnicity, and insurance status in the relationships between mental health connected hospitalizations and multiple aspects of heat exposure. Inpatient hospitalization data were obtained from the Healthcare Costs and Utilization Project for U.S. states Arizona, New York, North Carolina, Georgia, and Mississippi (2016-2019). Records was an ICD-10-CM code for mental/behavioral disorders in the primary diagnosis were identified and separately by race, ethnicity (Hispanic/Latinx and non-Hispanic/Latinx) and insurance status (privately insurance, publicly insured, or unissued). Gridded heat exposure measures were aggregated to the ZIP code level for monthly means of daily extremes (maximum/minimum temperatures) and daily temperature range (amplitude). Separate group quasi-Poisson regressions at the ZIP code/month level tested relationships between heat exposure metrics and hospitalization counts controlling for month, year, and state. Appropriate coordinating ZIP code level population offsets were obtained from the American Community Survey. Results are forthcoming and will highlight disparities across multiple groups to identify communities and individuals at highest risk for heat exposure related mental health outcomes to better guide mitigation and prevention efforts.

Scientific Focus Area: Health Disparities

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