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Extreme Temperatures and Missed Pediatric Preventive Care Visits
Stephanie L Mayne1,2,3,4,5, Janani Ramachandran1,4,5, Priyani Sharma1,4,5
1Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
JAMA Network Open
|April 27, 2026
Summary
Extreme temperatures increase missed pediatric preventive care visits, especially in cold weather for commercially insured, younger, and higher socioeconomic status children. Adaptive strategies are needed to ensure consistent child healthcare access.
Area of Science:
- Pediatric Health
- Environmental Health
- Public Health
Background:
- Missed pediatric preventive care visits disrupt crucial child health services like immunizations and screenings.
- Climate variability and extreme temperatures pose challenges to maintaining consistent healthcare access for children.
Purpose of the Study:
- To examine the link between extreme temperatures and missed pediatric preventive care visits.
- To analyze how age, insurance status, and neighborhood socioeconomic status (SES) modify this association.
Main Methods:
- A cross-sectional time-series study analyzed electronic health records from over 4 million pediatric preventive care visits (2009-2023).
- Daily maximum temperatures were correlated with the daily rate of missed visits, analyzed separately for cold and warm months.
- Subgroup analyses assessed variations by patient age, insurance type, and neighborhood SES.
Main Results:
- Extreme cold (below 41.5°F) and heat (above 88.0°F) were associated with higher rates of missed visits.
- During cold months, missed visits were more prevalent among commercially insured, younger, and higher SES patients.
- Significant heterogeneity in missed visit rates was observed across demographic and socioeconomic strata during colder periods.
Conclusions:
- Extreme temperatures are linked to increased missed pediatric preventive care appointments.
- Disparities in missed visits exist, particularly during cold weather, affecting specific patient subgroups.
- Developing proactive scheduling and alternative care models is crucial for mitigating the impact of temperature extremes on pediatric care access.
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