Closing the Climate Justice Gap: An Examination of Pregnancy Outcomes at the Intersection of Multiple Gradients of Social and Climate Vulnerability in San Francisco
Kimberly Lee, Mahal Bilaoen
School of the Environment
Faculty Supervisor: Nancy Carmona
Climate change has intensified the frequency and severity of extreme heat events, disproportionately burdening socially vulnerable populations, especially in urban environments. San Francisco’s historically temperate conditions due to cool coastal climates mask the growing risks of heat-related health inequities, as people and the built infrastructure are not adapted to heat. Pregnant individuals, particularly those from historically marginalized communities, face heightened exposure due to overlapping patterns of social vulnerability, limited access to health resources, and spatially constrained adaptive capacity, such as inadequate availability of cooling infrastructure. These factors align with temperature gradients across San Francisco. We investigate how climate change–induced extreme heat events intersect with urban social vulnerability and influence adverse pregnancy outcomes in San Francisco. Despite San Francisco’s active policy engagement with health equity, the health equity advocacy and policy community lacks place-based empirical data on the relationship between heat exposure and maternal health. Our study fills this critical data need producing spatially explicit analyses that inform equitable adaptation and public health planning in San Francisco. Study results will produce policy-relevant recommendations for the City’s health and planning agencies, and community based organizations on strengthening maternal health systems and services in heat-vulnerable communities and advance climate justice–oriented urban governance.