Heatwave frequency and disability status: Thermal inequities in the U.S. South.

Background: Although extreme heat has been found to be disproportionately distributed with respect to socially disadvantaged and marginalized groups, persons with disabilities have received limited attention in previous research on heat exposure disparities.

Objective: This gap is addressed by analyzing the relationship between local heatwave frequency and the percentages of people with a disability and specific disability types in the U.S. South-a region characterized by extremely high summer temperatures and greater disability prevalence.

Methods: Census tract level values of heatwave annualized frequency from the U.S. Federal Emergency Management Agency's National Risk Index are linked to relevant disability variables from the latest American Community Survey five-year estimates. Statistical analyses are based on bivariate correlations and multivariable generalized estimating equations that consider spatial clustering of tracts based on climate zone and county.

Results: The overall percentage of civilian noninstitutionalized persons with a disability and more than one disability are significantly greater (p < 0.001) in census tracts with higher heatwave frequency, after controlling for clustering, race/ethnicity, socioeconomic status, older age, population density, and metropolitan status. Heatwave frequency is also positively and significantly associated (p < 0.01) with the percentages of people with hearing, vision, cognitive, ambulatory, self-care, and independent living difficulties.

Conclusions: These heat-related distributive injustices in the U.S. South demonstrate an urgent need to: (1) include disability status in future research on social disparities in heatwave exposure; (2) conduct more detailed investigations in other regions, states, and nations; and (3) develop disability-inclusive policies and interventions that provide equitable protection during extreme weather events.