Exploring Disparities in Pavement Burns: A Comparative Analysis of Housed and Unhoused Burn Patients

In some regions, extreme heat can result in pavement temperatures that are high enough to cause severe burn injuries within seconds of skin contact. This risk is elevated for unhoused individuals who may lack adequate clothing and shelter and have susceptibility to other risk factors, including substance use and in turn loss of consciousness. While prior studies have shown worse outcomes for unhoused individuals due to delays in care and higher susceptibility, there is a lack of data on the impact of pavement burns specifically within this population. This single-institution retrospective cohort study aims to explore burn severity and hospital outcomes in housed vs. unhoused patients with pavement burns. The data were analyzed using independent samples t-tests and logistic regression when appropriate, with p < 0.05 considered statistically significant. A total of 305 individuals met the inclusion/exclusion criteria and comprised the final study cohort, 17.7% of which were unhoused. There was no significant difference in TBSA, survival to discharge, or hospital length of stay between housed and unhoused patients. While unhoused individuals may still be at heightened risk for pavement burns due to exposure to extreme heat and a lack of protective measures, these results may additionally suggest consistent emergency care for patients regardless of housing status. Furthermore, these results highlight the importance of developing targeted outreach and prevention programs and equitable emergency care protocols for vulnerable populations.