Abstract
To examine racial disparities in weather-related mortality in Virginia from 2005 to 2020. An ecological descriptive study using daily mortality data from the Virginia Department of Health and weather data from the National Climatic Data Center. Generalized additive models and distributed lag nonlinear models were used to estimate the relative risk of mortality as the primary endpoint associated with temperature extremes over a 21-day lag period, stratified by race. Black residents of the state had a higher risk of dying at both high and low temperatures compared to white residents; however, the risk was more profound with low temperatures. On the coldest days, the mortality risk for the Black population was more than three times that of the white population. Notably, the impact of cold on the Black population extended through lag day 15, while for white people, the impact only lasted through lag day 5. Heat-related mortality risk for Black individuals also exceeded that for white individuals, but only when the minimum temperature exceeded 20°C. Racial disparities exist in weather-related mortality in Virginia, with the Black population experiencing a disproportionately higher risk of death as well as poorer health outcomes, especially during extreme cold weather events. Policymakers should consider developing and evaluating policies that protect vulnerable communities when they are subject to weather extremes.