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Objectives. To examine the relationships among environmental characteristics, temperature, and health outcomes during heat advisories at the geographic scale of street segments.

Methods. We combined multiple data sets from Boston, Massachusetts, including remotely sensed measures of temperature and associated environmental characteristics (e.g., canopy cover), 911 dispatches for medical emergencies, daily weather conditions, and demographic and physical context from the American Community Survey and City of Boston Property Assessments. We used multilevel models to analyze the distribution of land surface temperature and elevated vulnerability during heat advisories across streets and neighborhoods.

Results. A substantial proportion of variation in land surface temperature existed between streets within census tracts (38%), explained by canopy, impervious surface, and albedo. Streets with higher land surface temperature had a greater likelihood of medical emergencies during heat advisories relative to the frequency of medical emergencies during non–heat advisory periods. There was no independent effect of the average land surface temperature of the census tract.

Conclusions. The relationships among environmental characteristics, temperature, and health outcomes operate at the spatial scale of the street segment, calling for more geographically precise analysis and intervention.

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