Smart Meter-derived Air Conditioning Penetration Rate Modifies the Association Between Ambient Temperature and Emergency Department Visits.

Authors

Xiaping Zheng, McKenna Peplinski, Diego Ramos Aguilera, Kelly T Sanders, Stefanie Ebelt, Noah Scovronick, Peter Kalmus, Howard H Chang

Published in

Epidemiology (Cambridge, Mass.). Volume 37. Issue 5. Pages 719-723. Sep 01, 2026. Epub May 18, 2026.

Abstract

Air conditioning data are typically available only at coarse spatial resolutions. We examined modifications of heat-morbidity relationships using finer spatial resolution - specifically, ZIP code-level air conditioning penetration rates derived from household-level smart meter electricity records in southern California (2015-2019).
We first estimated ZIP code-specific relative risk (RR) between heat-related emergency department visits and 4-day lagged temperatures at the 95th to 50th temperature quantile. Meta-regression was used to estimate effect modification, as measured by the ratio of RR.
Air conditioning penetration rates ranged from 23% to 96% (median = 79%). Among non-coastal regions, a 10% increase in air conditioning penetration was associated with lower heat and emergency department visit risk: ratio of RR = 0.79 (95% confidence interval: 0.68, 0.91) for dry bulb temperature and 0.80 (95% confidence interval: 0.70, 0.92) for wet bulb temperature. Air conditioning penetration did not modify heat-morbidity associations in coastal regions.
Our results indicate that neighborhoods with higher air conditioning penetration rates were associated with lower heat-related health risks in noncoastal regions.

PMID:
42525476
Bibliographic data and abstract were imported from PubMed on 30 Jul 2026.

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