Place-based structural inequalities can have critical implications for the health of vulnerable populations. Historical urban policies, such as redlining, have contributed to current inequalities in exposure to intra-urban heat. However, it is unknown whether these spatial inequalities are associated with disparities in heat-related health outcomes. The aim of this study is to determine the relationships between historical redlining, intra-urban heat conditions, and heat-related emergency department visits using data from 11 Texas cities. At the zip code level, the proportion of historical redlining was determined, and heat exposure was measured using daytime and nighttime land surface temperature (LST). Heat-related inpatient and outpatient rates were calculated based on emergency department visit data that included ten categories of heat-related diseases between 2016 and 2019. Regression or spatial error/lag models revealed significant associations between higher proportions of redlined areas in the neighborhood and higher LST (Coef. = 0.0122, 95% CI = 0.0039–0.0205). After adjusting for indicators of social vulnerability, neighborhoods with higher proportions of redlining showed significantly elevated heat-related outpatient visit rate (Coef. = 0.0036, 95% CI = 0.0007–0.0066) and inpatient admission rate (Coef. = 0.0018, 95% CI = 0.0001–0.0035). These results highlight the role of historical discriminatory policies on the disparities of heat-related illness and suggest a need for equity-based urban heat planning and management strategies.

基于地点的结构性不平等可能对弱势群体的健康产生重大影响。历史上的城市政策，例如红线，导致了当前城市内高温暴露的不平等。然而，尚不清楚这些空间不平等是否与热相关健康结果的差异有关。本研究的目的是利用德克萨斯州 11 个城市的数据来确定历史红线、城市内高温状况以及与高温相关的急诊部门就诊之间的关系。在邮政编码级别，确定了历史红线的比例，并使用白天和夜间地表温度（LST）测量了热暴露。与高温相关的住院和门诊率是根据 2016 年至 2019 年间包括十类与高温相关疾病的急诊科就诊数据计算得出的。回归或空间误差/滞后模型揭示了附近较高比例的红线区域与较高比例的红线区域之间存在显着关联。 LST（系数 = 0.0122，95% CI = 0.0039–0.0205）。在调整社会脆弱性指标后，红线比例较高的社区表现出与高温相关的门诊就诊率（Coef. = 0.0036，95% CI = 0.0007–0.0066）和住院率（Coef. = 0.0018，95% CI = 0.0007-0.0066）和住院率显着升高。 = 0.0001–0.0035)。这些结果凸显了历史上歧视性政策对与高温相关疾病的差异的作用，并表明需要基于公平的城市高温规划和管理策略。