{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T19:39:49Z","timestamp":1789501189241,"version":"build-2803163510"},"reference-count":79,"publisher":"American Medical Association (AMA)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n There is limited research investigating associations between extreme heat events (EHEs) and adverse outcomes for veterans and high-risk veteran subpopulations.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n To investigate the association between EHEs and mortality among California veterans with common cardiometabolic diseases and to examine how this risk differs by race and ethnicity, neighborhood health-related social risk factors, and history of homelessness.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This case-crossover study used administrative data from the Veterans Health Administration (VA) Corporate Data Warehouse to identify veterans with a California address from October 1, 2015, to September 30, 2021, and a diagnosis of a cardiometabolic condition of hypertension, diabetes, ischemic heart disease, congestive heart failure, chronic kidney disease, stroke, or peripheral arterial disease. Data were analyzed from October 2023 to December 2024.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Date- and address-specific EHEs as defined by daily maximum temperatures greater than the 90th, 95th, and 97.5th percentiles of 2006 to 2020 historical normal temperatures derived from National Center for Environmental Information meteorological data. Patient residential addresses were linked with the nearest weather station. The associations of same-day to 4-day EHEs with mortality were assessed.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The main outcome was individual all-cause mortality during warm months (April-October). A time-stratified case-crossover design with conditional logistic regression was used to investigate associations between EHEs and mortality. Planned exploratory subgroup analyses were performed by race and ethnicity, Area Deprivation Index (ADI) for patient address, and homeless status.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 13\u202f556 veterans (median age, 78 years [IQR, 71-87 years]; 13\u202f265 men [97.9%]) experienced mortality during the study period. Extreme heat events were significantly associated with mortality at all percentile thresholds (eg, at 95th percentile odds ratio [OR] range, 1.10 [95% CI, 1.04-1.17] to 1.14 [95% CI, 1.08-1.20];\n P<\/jats:italic>\n \u2009=\u2009.005). Effect estimates were greater for veterans in high vs lower ADI neighborhoods (eg, 3-day EHEs at 95th percentile: OR, 1.44 [95% CI, 1.15-1.80] vs OR, 1.12 [95% CI, 1.06-1.19]), and veterans who experienced homelessness compared with those who did not (eg, 3-day EHEs at 95th percentile: OR, 1.25 [95% CI, 1.09-1.45] vs OR, 1.12 [95% CI, 1.05-1.19]) across EHE definitions, although there was no statistically significant effect modification.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this study of California veterans with common cardiometabolic diseases, EHEs were significantly associated with mortality. These results suggest that the VA should develop EHE risk-mitigating interventions to protect veterans, particularly those at greatest risk, from heat-related mortality.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.45524","type":"journal-article","created":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T16:00:33Z","timestamp":1764086433000},"page":"e2545524","source":"Crossref","is-referenced-by-count":5,"title":["Extreme Heat, Social Factors, and Mortality Among California Veterans With Cardiometabolic Disease"],"prefix":"10.1001","volume":"8","author":[{"given":"Evan Michael","family":"Shannon","sequence":"first","affiliation":[{"name":"Veterans Affairs Health Systems Research Center for the Study of Healthcare Innovation, Implementation & Policy, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California"},{"name":"Division of General Internal Medicine and Health Services Research, UCLA David Geffen School of Medicine, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lillian","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine and Health Services Research, UCLA David Geffen School of Medicine, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita","family":"Yuan","sequence":"additional","affiliation":[{"name":"Veterans Affairs Health Systems Research Center for the Study of Healthcare Innovation, Implementation & Policy, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aarthi","family":"Chary","sequence":"additional","affiliation":[{"name":"Department of Medicine, Stanford University School of Medicine, Stanford, California"},{"name":"Veterans Affairs Palo Alto Healthcare System, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonya","family":"Gabrielian","sequence":"additional","affiliation":[{"name":"Veterans Affairs Health Systems Research Center for the Study of Healthcare Innovation, Implementation & Policy, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California"},{"name":"Department of Psychiatry, UCLA David Geffen School of Medicine, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David P.","family":"Eisenman","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine and Health Services Research, UCLA David Geffen School of Medicine, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna L.","family":"Washington","sequence":"additional","affiliation":[{"name":"Veterans Affairs Health Systems Research Center for the Study of Healthcare Innovation, Implementation & Policy, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California"},{"name":"Division of General Internal Medicine and Health Services Research, UCLA David Geffen School of Medicine, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2025,11,25]]},"reference":[{"key":"zoi251232r2","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1186\/1476-069X-8-40","article-title":"High ambient temperature and mortality: a review of epidemiologic studies from 2001 to 2008.","volume":"8","author":"Basu","year":"2009","journal-title":"Environ Health"},{"issue":"1","key":"zoi251232r3","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1097\/EDE.0b013e31815c1da7","article-title":"Characterizing temperature and mortality in nine California counties.","volume":"19","author":"Basu","year":"2008","journal-title":"Epidemiology"},{"key":"zoi251232r4","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1186\/1476-069X-9-37","article-title":"The impact of heat waves on mortality in 9 European cities: results from the EuroHEAT project.","volume":"9","author":"D\u2019Ippoliti","year":"2010","journal-title":"Environ Health"},{"issue":"7","key":"zoi251232r5","doi-asserted-by":"publisher","first-page":"672","DOI":"10.1289\/ehp.1408178","article-title":"A case-only study of vulnerability to heat wave-related mortality in New York City (2000-2011).","volume":"123","author":"Madrigano","year":"2015","journal-title":"Environ Health Perspect"},{"key":"zoi251232r6","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.3574","article-title":"Ambient temperature and cardiovascular mortality: a systematic review and meta-analysis.","volume":"5","author":"Moghadamnia","year":"2017","journal-title":"PeerJ"},{"issue":"8","key":"zoi251232r7","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.8904","article-title":"Association of extreme heat events with hospital admission or mortality among patients with end-stage renal disease.","volume":"2","author":"Remigio","year":"2019","journal-title":"JAMA Netw Open"},{"issue":"3","key":"zoi251232r10","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1161\/CIRCULATIONAHA.122.060746","article-title":"Association of extreme heat and cardiovascular mortality in the United States: a county-level longitudinal analysis from 2008 to 2017.","volume":"146","author":"Khatana","year":"2022","journal-title":"Circulation"},{"issue":"12","key":"zoi251232r11","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0243665","article-title":"Heatwaves, medications, and heat-related hospitalization in older Medicare beneficiaries with chronic conditions.","volume":"15","author":"Layton","year":"2020","journal-title":"PLoS One"},{"key":"zoi251232r12","article-title":"Multiple chronic conditions among veterans and nonveterans: United States, 2015\u20132018.","year":"2021","journal-title":"Natl Health Stat Rep"},{"issue":"5","key":"zoi251232r13","doi-asserted-by":"publisher","first-page":"1489","DOI":"10.1038\/s41591-024-02880-4","article-title":"Risk factors associated with heatwave mortality in Chinese adults over 65 years.","volume":"30","author":"Xi","year":"2024","journal-title":"Nat Med"},{"issue":"4","key":"zoi251232r14","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1159\/000398787","article-title":"The effects of climate change on cardiac health.","volume":"131","author":"De Blois","year":"2015","journal-title":"Cardiology"},{"issue":"11","key":"zoi251232r16","doi-asserted-by":"publisher","first-page":"1576","DOI":"10.1093\/aje\/kwae084","article-title":"Daily heat and mortality among people experiencing homelessness in 2 urban US counties, 2015-2022.","volume":"193","author":"Lin","year":"2024","journal-title":"Am J Epidemiol"},{"issue":"1","key":"zoi251232r17","doi-asserted-by":"publisher","first-page":"98","DOI":"10.2105\/AJPH.2021.306557","article-title":"Heat waves and emergency department visits among the homeless, San Diego, 2012-2019.","volume":"112","author":"Schwarz","year":"2022","journal-title":"Am J Public Health"},{"issue":"8","key":"zoi251232r18","doi-asserted-by":"publisher","first-page":"1034","DOI":"10.1001\/jamainternmed.2025.1407","article-title":"Heat-related illness among US patients experiencing homelessness.","volume":"185","author":"Weckstein","year":"2025","journal-title":"JAMA Intern Med"},{"issue":"4","key":"zoi251232r20","doi-asserted-by":"publisher","first-page":"580","DOI":"10.3390\/ijerph15040580","article-title":"Mortality and morbidity during extreme heat events and prevalence of outdoor work: an analysis of community-level data from Los Angeles County, California.","volume":"15","author":"Riley","year":"2018","journal-title":"Int J Environ Res Public Health"},{"issue":"2","key":"zoi251232r21","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1177\/17579139231224690","article-title":"Heatwaves and homelessness.","volume":"144","author":"Leggat","year":"2024","journal-title":"Perspect Public Health"},{"key":"zoi251232r22","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijdrr.2023.103904","author":"Gabbe","year":"2023","journal-title":"Int J Disaster Risk Reduction"},{"issue":"6","key":"zoi251232r23","doi-asserted-by":"publisher","first-page":"632","DOI":"10.1093\/aje\/kwn170","article-title":"A multicounty analysis identifying the populations vulnerable to mortality associated with high ambient temperature in California.","volume":"168","author":"Basu","year":"2008","journal-title":"Am J Epidemiol"},{"issue":"12","key":"zoi251232r24","doi-asserted-by":"publisher","first-page":"7329","DOI":"10.1007\/s10661-011-2502-z","article-title":"A spatio-temporal index for heat vulnerability assessment.","volume":"184","author":"Kershaw","year":"2012","journal-title":"Environ Monit Assess"},{"issue":"4","key":"zoi251232r25","doi-asserted-by":"publisher","first-page":"840","DOI":"10.1111\/ina.12367","article-title":"Predictors of summertime heat index levels in New York City apartments.","volume":"27","author":"Quinn","year":"2017","journal-title":"Indoor Air"},{"issue":"11","key":"zoi251232r26","doi-asserted-by":"publisher","first-page":"1730","DOI":"10.1289\/ehp.0900683","article-title":"Mapping community determinants of heat vulnerability.","volume":"117","author":"Reid","year":"2009","journal-title":"Environ Health Perspect"},{"issue":"2","key":"zoi251232r27","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1016\/j.healthplace.2010.12.005","article-title":"Intra-urban societal vulnerability to extreme heat: the role of heat exposure and the built environment, socioeconomics, and neighborhood stability.","volume":"17","author":"Uejio","year":"2011","journal-title":"Health Place"},{"issue":"6","key":"zoi251232r28","doi-asserted-by":"publisher","first-page":"809","DOI":"10.1097\/01.ede.0000434432.06765.91","article-title":"Susceptibility to mortality in weather extremes: effect modification by personal and small-area characteristics.","volume":"24","author":"Zanobetti","year":"2013","journal-title":"Epidemiology"},{"issue":"1","key":"zoi251232r29","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1289\/ehp.11594","article-title":"The 2006 California heat wave: impacts on hospitalizations and emergency department visits.","volume":"117","author":"Knowlton","year":"2009","journal-title":"Environ Health Perspect"},{"issue":"12","key":"zoi251232r30","doi-asserted-by":"publisher","first-page":"1074","DOI":"10.1093\/aje\/kwg096","article-title":"Modifiers of the temperature and mortality association in seven US cities.","volume":"157","author":"O\u2019Neill","year":"2003","journal-title":"Am J Epidemiol"},{"key":"zoi251232r31","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1186\/1476-072X-11-38","article-title":"Mapping heatwave health risk at the community level for public health action.","volume":"11","author":"Buscail","year":"2012","journal-title":"Int J Health Geogr"},{"issue":"3","key":"zoi251232r32","doi-asserted-by":"publisher","first-page":"941","DOI":"10.3390\/ijerph18030941","article-title":"Dimensions of thermal inequity: neighborhood social demographics and urban heat in the Southwestern U.S.","volume":"18","author":"Dialesandro","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"zoi251232r33","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1016\/j.envint.2017.09.011","article-title":"The Heat Exposure Integrated Deprivation Index (HEIDI): a data-driven approach to quantifying neighborhood risk during extreme hot weather.","volume":"109","author":"Krstic","year":"2017","journal-title":"Environ Int"},{"issue":"1","key":"zoi251232r34","doi-asserted-by":"publisher","DOI":"10.3390\/cli8010012","article-title":"The effects of historical housing policies on resident exposure to intra-urban heat: a study of 108 US urban areas.","volume":"8","author":"Hoffman","year":"2020","journal-title":"Climate (Basel)"},{"issue":"2","key":"zoi251232r35","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1093\/jurban\/78.2.214","article-title":"Jails, prisons, and the health of urban populations: a review of the impact of the correctional system on community health.","volume":"78","author":"Freudenberg","year":"2001","journal-title":"J Urban Health"},{"issue":"1","key":"zoi251232r36","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1097\/01.ede.0000147114.25957.71","article-title":"Who is sensitive to extremes of temperature?: a case-only analysis.","volume":"16","author":"Schwartz","year":"2005","journal-title":"Epidemiology"},{"issue":"1","key":"zoi251232r37","doi-asserted-by":"publisher","first-page":"I117","DOI":"10.1097\/00005650-200201001-00013","article-title":"Veteran identity and race\/ethnicity: influences on VA outpatient care utilization.","volume":"40","author":"Harada","year":"2002","journal-title":"Med Care"},{"issue":"6","key":"zoi251232r38","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.14374","article-title":"The foundational science of learning health systems.","volume":"59","author":"Kilbourne","year":"2024","journal-title":"Health Serv Res"},{"issue":"1","key":"zoi251232r39","doi-asserted-by":"publisher","first-page":"2679","DOI":"10.1186\/s12889-025-24012-4","article-title":"Heat-related illnesses: a scoping review of health system strategies, emergency responses and interventions in heat-prone areas.","volume":"25","author":"Bassey","year":"2025","journal-title":"BMC Public Health"},{"issue":"6","key":"zoi251232r40","doi-asserted-by":"publisher","first-page":"995","DOI":"10.1097\/HJH.0000000000003424","article-title":"The prevalence and treatment of hypertension in Veterans Health Administration, assessing the impact of the updated clinical guidelines.","volume":"41","author":"Yamada","year":"2023","journal-title":"J Hypertens"},{"issue":"8","key":"zoi251232r43","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-147-8-200710160-00010-w1","article-title":"Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration.","volume":"147","author":"Vandenbroucke","year":"2007","journal-title":"Ann Intern Med"},{"issue":"4","key":"zoi251232r44","doi-asserted-by":"publisher","first-page":"416","DOI":"10.1007\/s11606-016-3905-x","article-title":"The association between neighborhood environment and mortality: results from a national study of veterans.","volume":"32","author":"Nelson","year":"2017","journal-title":"J Gen Intern Med"},{"issue":"7","key":"zoi251232r45","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1016\/j.jclinepi.2010.10.004","article-title":"A combined comorbidity score predicted mortality in elderly patients better than existing scores.","volume":"64","author":"Gagne","year":"2011","journal-title":"J Clin Epidemiol"},{"issue":"6","key":"zoi251232r46","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.8120","article-title":"Use of general primary care, specialized primary care, and other Veterans Affairs services among high-risk veterans.","volume":"3","author":"Chang","year":"2020","journal-title":"JAMA Netw Open"},{"issue":"24","key":"zoi251232r47","doi-asserted-by":"publisher","first-page":"2659","DOI":"10.1001\/jama.2014.15715","article-title":"Cause-specific risk of hospital admission related to extreme heat in older adults.","volume":"312","author":"Bobb","year":"2014","journal-title":"JAMA"},{"issue":"12","key":"zoi251232r48","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0144202","article-title":"Frequency of extreme heat event as a surrogate exposure metric for examining the human health effects of climate change.","volume":"10","author":"Romeo Upperman","year":"2015","journal-title":"PLoS One"},{"issue":"8","key":"zoi251232r49","doi-asserted-by":"publisher","first-page":"673","DOI":"10.1136\/heartjnl-2017-311821","article-title":"Increased coronary heart disease and stroke hospitalisations from ambient temperatures in Ontario.","volume":"104","author":"Bai","year":"2018","journal-title":"Heart"},{"issue":"11","key":"zoi251232r50","doi-asserted-by":"publisher","first-page":"1187","DOI":"10.1289\/ehp.1206132","article-title":"Heat, heat waves, and hospital admissions among the elderly in the United States, 1992-2006.","volume":"122","author":"Gronlund","year":"2014","journal-title":"Environ Health Perspect"},{"issue":"12","key":"zoi251232r51","doi-asserted-by":"publisher","first-page":"2119","DOI":"10.3390\/ijerph16122119","article-title":"Impact of extremely hot days on emergency department visits for cardiovascular disease among older adults in New York state.","volume":"16","author":"Li","year":"2019","journal-title":"Int J Environ Res Public Health"},{"issue":"26","key":"zoi251232r53","doi-asserted-by":"publisher","first-page":"2456","DOI":"10.1056\/NEJMp1802313","article-title":"Making neighborhood-disadvantage metrics accessible\u2014the neighborhood atlas.","volume":"378","author":"Kind","year":"2018","journal-title":"N Engl J Med"},{"issue":"3","key":"zoi251232r55","doi-asserted-by":"publisher","first-page":"860","DOI":"10.1080\/13811118.2023.2244534","article-title":"Association between services to address adverse social determinants of health and suicide mortality among veterans with indicators of housing instability, unemployment, and justice involvement.","volume":"28","author":"Montgomery","year":"2024","journal-title":"Arch Suicide Res"},{"issue":"3","key":"zoi251232r56","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1097\/00001648-199605000-00003","article-title":"Confounding and exposure trends in case-crossover and case-time-control designs.","volume":"7","author":"Greenland","year":"1996","journal-title":"Epidemiology"},{"issue":"5","key":"zoi251232r57","doi-asserted-by":"publisher","first-page":"1645","DOI":"10.1093\/ije\/dyu081","article-title":"Exchangeability in the case-crossover design.","volume":"43","author":"Mittleman","year":"2014","journal-title":"Int J Epidemiol"},{"issue":"2","key":"zoi251232r58","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyae020","article-title":"Time-stratified case-crossover studies for aggregated data in environmental epidemiology: a tutorial.","volume":"53","author":"Tobias","year":"2024","journal-title":"Int J Epidemiol"},{"key":"zoi251232r60","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1186\/1471-2288-14-122","article-title":"Conditional Poisson models: a flexible alternative to conditional logistic case cross-over analysis.","volume":"14","author":"Armstrong","year":"2014","journal-title":"BMC Med Res Methodol"},{"issue":"1","key":"zoi251232r61","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1289\/EHP166","article-title":"Towards more comprehensive projections of urban heat-related mortality: estimates for New York City under multiple population, adaptation, and climate scenarios.","volume":"125","author":"Petkova","year":"2017","journal-title":"Environ Health Perspect"},{"issue":"4","key":"zoi251232r62","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1001\/jamapsychiatry.2021.4369","article-title":"Association between ambient heat and risk of emergency department visits for mental health among US adults, 2010 to 2019.","volume":"79","author":"Nori-Sarma","year":"2022","journal-title":"JAMA Psychiatry"},{"key":"zoi251232r63","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2021.147958","article-title":"The role of extreme temperature in cause-specific acute cardiovascular mortality in Switzerland: a case-crossover study.","volume":"790","author":"Saucy","year":"2021","journal-title":"Sci Total Environ"},{"key":"zoi251232r64","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1016\/j.healthplace.2016.08.007","article-title":"Heat death associations with the built environment, social vulnerability and their interactions with rising temperature.","volume":"41","author":"Eisenman","year":"2016","journal-title":"Health Place"},{"issue":"6","key":"zoi251232r65","doi-asserted-by":"publisher","first-page":"755","DOI":"10.1097\/01.ede.0000134875.15919.0f","article-title":"Hospital admissions for heart disease: the effects of temperature and humidity.","volume":"15","author":"Schwartz","year":"2004","journal-title":"Epidemiology"},{"key":"zoi251232r66","first-page":"541","article-title":"Spatial aggregation and the ecological fallacy.","volume":"2010","year":"2010","journal-title":"Chapman Hall CRC Handb Mod Stat Methods"},{"key":"zoi251232r67","doi-asserted-by":"publisher","first-page":"1106","DOI":"10.1016\/j.envpol.2018.06.045","article-title":"Effects of ambient temperature on myocardial infarction: a systematic review and meta-analysis.","volume":"241","author":"Sun","year":"2018","journal-title":"Environ Pollut"},{"key":"zoi251232r68","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.202312-1089OC","article-title":"Comorbidities, tobacco exposure, and geography: added risk factors of heat and cold wave related mortality among U.S. veterans with chronic obstructive pulmonary disease.","author":"Rau","year":"2025","journal-title":"Ann Am Thorac Soc"},{"issue":"2","key":"zoi251232r69","doi-asserted-by":"publisher","first-page":"27004","DOI":"10.1289\/EHP13176","article-title":"Heat and cold wave\u2013related mortality risk among United States veterans with chronic obstructive pulmonary disease: a case-crossover study.","volume":"132","author":"Rau","year":"2024","journal-title":"Environ Health Perspect"},{"issue":"12","key":"zoi251232r70","doi-asserted-by":"publisher","first-page":"2231","DOI":"10.2105\/AJPH.2004.043570","article-title":"Racial\/ethnic variations in veterans\u2019 ambulatory care use.","volume":"95","author":"Washington","year":"2005","journal-title":"Am J Public Health"},{"issue":"10","key":"zoi251232r71","doi-asserted-by":"publisher","first-page":"1785","DOI":"10.1007\/s11606-018-4566-8","article-title":"Evidence review\u2014social determinants of health for veterans.","volume":"33","author":"Duan-Porter","year":"2018","journal-title":"J Gen Intern Med"},{"issue":"8","key":"zoi251232r73","doi-asserted-by":"publisher","first-page":"1067","DOI":"10.1175\/BAMS-85-8-1067","article-title":"Heat watch\/warning systems save lives: estimated costs and benefits for Philadelphia 1995\u201398.","volume":"85","author":"Ebi","year":"2004","journal-title":"Bull Am Meteorol Soc"},{"issue":"7","key":"zoi251232r74","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-012125","article-title":"Evaluation of a heat warning system in Adelaide, South Australia, using case-series analysis.","volume":"6","author":"Nitschke","year":"2016","journal-title":"BMJ Open"},{"issue":"12","key":"zoi251232r75","doi-asserted-by":"publisher","first-page":"2245","DOI":"10.3390\/ijerph16122245","article-title":"The use of a quasi-experimental study on the mortality effect of a heat wave warning system in Korea.","volume":"16","author":"Heo","year":"2019","journal-title":"Int J Environ Res Public Health"},{"issue":"11","key":"zoi251232r76","doi-asserted-by":"publisher","first-page":"1694","DOI":"10.1289\/EHP203","article-title":"A difference-in-differences approach to assess the effect of a heat action plan on heat-related mortality, and differences in effectiveness according to sex, age, and socioeconomic status (Montreal, Quebec).","volume":"124","author":"Benmarhnia","year":"2016","journal-title":"Environ Health Perspect"},{"issue":"5","key":"zoi251232r77","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1007\/s00484-009-0232-5","article-title":"Hot weather warning might help to reduce elderly mortality in Hong Kong.","volume":"53","author":"Chau","year":"2009","journal-title":"Int J Biometeorol"},{"issue":"8","key":"zoi251232r78","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2024.105045","article-title":"Building a national standard for outreach and assistance to at-risk patients during large-scale disasters.","volume":"25","author":"Wyte-Lake","year":"2024","journal-title":"J Am Med Dir Assoc"},{"issue":"12","key":"zoi251232r79","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0279973","article-title":"Developing an operational definition of housing instability and homelessness in Veterans Health Administration\u2019s medical records.","volume":"17","author":"Tsai","year":"2022","journal-title":"PLoS One"},{"key":"zoi251232r1","unstructured":"P\u00f6rtner H-O, Roberts DC, Tignor M, et al, eds. Climate Change 2022: Impacts, Adaptation, and Vulnerability. Contribution of Working Group II to the Sixth Assessment Report of the Intergovernmental Panel on Climate Change. Cambridge University Press. Accessed May 23, 2025. https:\/\/www.ipcc.ch\/report\/ar6\/wg2\/downloads\/report\/IPCC_AR6_WGII_FullReport.pdf"},{"key":"zoi251232r8","unstructured":"Adams-Fuller? T. Extreme heat is deadlier than hurricanes, floods and tornadoes combined. Scientific American. July 1, 2023. Accessed April 1, 2025. https:\/\/www.scientificamerican.com\/article\/extreme-heat-is-deadlier-than-hurricanes-floods-and-tornadoes-combined\/"},{"key":"zoi251232r9","unstructured":"Popovich? N, Choi-Schagrin? W. Hidden toll of the northwest heat wave: hundreds of extra deaths. New York Times. August 11, 2021. Accessed December 17, 2021. https:\/\/www.nytimes.com\/interactive\/2021\/08\/11\/climate\/deaths-pacific-northwest-heat-wave.html"},{"key":"zoi251232r15","unstructured":"Halaharvi? H, Schramm? PJ, Vaidyanathan? A. Heat Exposure and Cardiovascular Health: A Summary for Health Departments. Climate and Health Program, Centers for Disease Control and Prevention. Updated July 2020. Accessed December 17, 2021. https:\/\/www.medbox.org\/pdf\/624359ffe456ad675b734ba4"},{"key":"zoi251232r19","unstructured":"de Sousa? T, Henry? M, Khadduri? J. The 2024 Annual Homelessness Assessment Report (AHAR) to Congress: part 1: point-in-time estimates on homelessness. Office of Community Planning and Development, U.S. Department of Housing and Urban Development. December 2024. Accessed April 1, 2025. https:\/\/www.huduser.gov\/portal\/sites\/default\/files\/pdf\/2024-AHAR-Part-1.pdf"},{"key":"zoi251232r41","unstructured":"Effects of climate change on health. Centers for Disease Control and Prevention. Updated February 29, 2024. Accessed October 14, 2025. https:\/\/www.cdc.gov\/climate-health\/php\/effects\/index.html"},{"key":"zoi251232r42","unstructured":"Point-in-time count and housing inventory count. US Department of Housing and Urban Development. Accessed January 30, 2025. https:\/\/www.hudexchange.info\/programs\/hdx\/pit-hic\/#pit-count-and-hic-data-and-reports"},{"key":"zoi251232r52","unstructured":"University of Wisconsin School of Medicine and Public Health. Area Deprivation Index. Accessed February 25, 2022. https:\/\/www.neighborhoodatlas.medicine.wisc.edu\/"},{"key":"zoi251232r54","unstructured":"Kushel? MD, Moore? T. Toward a new understanding: the California statewide study of people experiencing homelessness. UCSF Benioff Homelessness and Housing Initiative. June 2023. Accessed September 12, 2024. https:\/\/homelessness.ucsf.edu\/sites\/default\/files\/2023-06\/CASPEH_Report_62023.pdf"},{"key":"zoi251232r59","unstructured":"Stillitano? C. Understanding California\u2019s climate zones. University of San Diego. May 6, 2025. Accessed September 10, 2025. https:\/\/digital.sandiego.edu\/cgi\/viewcontent.cgi?article=1043&context=npi-sdclimate"},{"key":"zoi251232r72","unstructured":"Abbinett? J, Schramm? PJ, Widerynski? S, . Heat response plans: summary of evidence and strategies for collaboration and implementation. Climate and Health Program, Centers for Disease Control and Prevention. Accessed February 27, 2025. https:\/\/stacks.cdc.gov\/view\/cdc\/93705"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2841820\/shannon_2025_oi_251232_1763504209.36125.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T16:00:38Z","timestamp":1764086438000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2841820"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,25]]},"references-count":79,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11,3]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2025.45524","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,25]]}}}