SUMMARY – RESEARCH PROJECT This project will characterize intra-urban inequities in the effects of extreme heat on mortality and examine individual-level and neighborhood factors associated with these inequities in five cities of the Americas, one of the most urbanized and unequal regions of the world. Understanding these inequities is critical for the development of urban policies and practices aimed at reducing the inequitable impacts of climate change in diverse urban populations. The combination of high levels of urbanization and associated heat island effect, an aging population, and extreme levels of inequality and economic and racial residential segregation makes urban populations in the region particularly susceptible to the effects of climate change. However intra-urban inequities associated with neighborhood and individual-level characteristics have not been systematically examined across multiple settings. A better understanding of how inequities in the impacts of heat on health vary across cities and countries is critical to adaptation policies and strategies and for targeting of resources. The overall goal of this project is to conduct policy-relevant climate change and health research across multiple countries in the Americas by studying inequities in the impact of extreme heat in five cities in four countries: Philadelphia (USA), São Paulo and Rio de Janeiro (Brazil), Guatemala City (Guatemala), and Panama City (Panama). We will investigate both neighborhood and individual-level factors and disentangle equity impacts of differential exposure to heat and differential effects of heat using a novel approach we will develop in collaboration with the Research and Capacity Building Core. We will leverage expertise on health disparities, biostatistics, urban planning, and policy translation at the Drexel Urban Health Collaborative (UHC) and our partners in this project (UC Berkeley, INCAP, and University of São Paulo). We will accomplish the following aims: 1) estimate intra-city heterogeneity in the temperature-mortality association; 2) investigate associations of neighborhood social, built, and natural environment factors with differential heat impacts on mortality; and 3) study the differential impact of heat on mortality by age, gender, race/ethnicity, and education. We will contribute to the data infrastructure created by the Administrative Core, advance methods development and training in partnership with the Research Capacity Building Core, and coordinate engagement of policymakers with the Community Engagement Core. Specifically, we will develop dissemination and engagement strategies using the results of our research projects that will influence policy in the cities of interest but also inform future dissemination and engagement efforts. In addition, through this project we will refine an approach to between- and within- city analysis from multiple countries, and conduct cross-country multi-city comparative analyses that can be l...