Abstract
Extreme heat contributes to adverse health outcomes and public cooling centers are often used as both a heat-health mitigation and management strategy to protect public health during extreme heat events. While the presence of a cooling center should theoretically improve heat-health outcomes in the surrounding community, there are no quantitative studies evaluating this relationship. Using heat-related emergency department and urgent care center visits from the 2014–2020 summer seasons, this study evaluates the relationship between heat-related illness (HRI) and cooling centers in Virginia. In total, more than 10,000 incidences of HRI occurred over the period across 68% of Virginia ZIP codes as reported. Communities with a cooling center had higher rates of HRI than those without, and this difference was most significant in urban areas. This result was coincident with a significant increase in non-white residents in these ZCTA. Our results draw attention to the need for additional research on the topic of cooling center access, efficacy, and operations. Strategically locating cooling centers near or within vulnerable communities is one just consideration, and more work is needed to uncover if, when, who, and how communities are utilizing, or in many cases not utilizing or unable to utilize, cooling centers.