PROJECT SUMMARY (OVERALL) The University of Southern California (USC) CLIMAte-Related Exposures, Adaptation, and Health Equity (CLIMA) Center's mission is to build a community of transdisciplinary scientists and robust research infrastructure to advance its theme of community-engaged, solution-oriented climate change (CC), adaptation, and health research. The goal is to inform climate action policies for health equity that strengthen local adaptive capacity, reduce vulnerability, and increase resilience across the life course. A Methods Development Research Core (MDRC) will develop innovative, highly spatiotemporally resolved models of exposure to urban heat islands, wildfire smoke, and increasingly frequent, concurrently, or consecutively occurring compound climate events and investigate their overlap with neighborhood adaptation strategies (e.g., air conditioning use, tree canopy shade, greening interventions) and vulnerabilities (power outages) to identify priorities for increasing CC resilience. These exposure and adaptation measures will be linked to large and diverse electronic medical record (EMR) Data Lakes from USC-affiliated hospital systems, with novel geo-enrichment with neighborhood social and environmental determinants of health in Research Project 1 (RP1), and with lifetime residential histories of young adults with detailed cardiovascular health assessment starting from childhood in Research Project 2 (RP2). RP1 will assess heat extremes and wildfire influenced particulate matter air pollution impact on acute heart failure hospitalization and rehospitalization risk in adults, while informing new directions in biostatistical methods. RP2 will assess the lifetime heat stress and wildfire smoke exposures impact on cardiovascular health measures (blood pressure, pulse rate) and allostatic load as a measure of biological resilience, and as a cardiovascular risk indicator earlier in life. The two RP's will investigate how these effects differ by social vulnerability and adaptation factors (e.g., air conditioning use, power outages, power grid resilience, urban heat islands, tree canopies etc.). The Community Engagement Core (CEC) will facilitate solution-oriented translational research and multi-directional communication with policymakers and the public. It will engage environmental justice communities using an intergenerational approach, including community participatory action research and education to engage youth in the co-design, monitoring, and ground-truthing of adaptation strategies. The CLIMA Center will create strong transdisciplinary research teams, capacity, and culture urgently needed to assess the complex, cascading impacts of CC hazards and exposures on health equity and adaptive capacity over the life course, starting with cardiovascular health and disease as a sentinel public health burden. Given California's diverse communities and array of climate adaptation, mitigation, and health equity policies, it provides an oppo...