Nationwide, extreme heat kills more people than any other climate change hazard. Given that our weather will continue to get warmer, Get Healthy San Mateo County has been co-chairing the Climate Ready San Mateo County’s Extreme Heat Task Force that aims to find solutions to better adapt to this climate hazard. At the center of this effort is how can we ensure that climate change does not amplify the health inequities we see today. This recent national study links current patterns of vulnerable communities being inequitably more exposed to extreme heat to segregationist housing policies that emerged in the 1930s and continue to be exacerbated by current urban planning practices. As we move forward to find solutions to this complex issue, we need to keep in mind this historical perspective to ensure we are advancing adaptation policies that are equitable and can reverse this historical harm so all San Mateo County residents have the opportunity to live a long and healthy life.