Abstract
BACKGROUND: Socioeconomic deprivation and environmental heat exposure each increase cardiovascular risk, yet evidence is limited on how these stressors co-occur and jointly shape disease burden within cities. Mapping their overlap can inform equity-oriented planning and needs-based allocation of health and social protection resources. METHODS: We conducted an ecological geospatial analysis of 2,513 census tracts in Los Angeles County. Adult coronary heart disease (CHD) prevalence was obtained from CDC Population Level Analysis and Community Estimates (2021). Socioeconomic deprivation was measured using the Social Deprivation Index (SDI), and heatwave surface heat hazard was measured using land surface temperature (LST) retrieved from the ECOsystem Spaceborne Thermal Radiometer Experiment on Space Station. We identified hot spots and overlaps using Getis-Ord Gi(*) statistics. Associations between SDI, LST, and CHD were estimated using z-score-standardized OLS regression with tract-level sociodemographic controls; we assessed spatial dependence and applied geographically weighted regression (GWR) with adaptive bandwidths to characterize spatial heterogeneity. RESULTS: CHD hot spots overlapped with high-deprivation and high-heat areas, concentrated in the south and east of Los Angeles County. In standardized OLS models (z-scored outcome and predictors), a 1-SD increase in SDI was associated with a 0.163-SD higher CHD prevalence (p < 0.001), and a 1-SD increase in LST was associated with a 0.070-SD higher CHD prevalence (p < 0.001). GWR revealed substantial geographic variation: the SDI-CHD association was strongest in central and southern tracts, whereas the LST-CHD association was strongest in central and eastern tracts, suggesting that dominant risk drivers and intervention priorities differ by neighborhood. CONCLUSION: To address this, socioeconomic deprivation and urban heat indicators should be used to inform transparent resource allocation for chronic disease prevention and management. Neighborhoods with high deprivation and heat exposure should be prioritized for cooling infrastructure, home heat mitigation, and urban greening initiatives. Finally, public health, housing, and social services must work together to effectively address the structural drivers of cardiovascular disease disparities.