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The loss of green spaces in urbanized areas has triggered a potential thermal risk in the urban environment. While the existing literature has investigated the direct relationship between urban temperatures and health risks, little is known about causal relationships among key components of urban sustainability and health risks, through a pathway involving urban temperature. This study examined the multiple connections between urbanized land use, urban greenery, urban temperatures and health risks in Harris County, Texas. The census tract-level health data from the 500 Cities Project (Centers for Disease Control and Prevention) is used for analysis. Structural equation model analyses showed that the urban temperature played a mediating role in associations between urbanized land use, urban greenery and health risk. Urban vegetation is associated with a decrease in health risks, while urban land use has associations with an increase in health risks. Findings suggest that proactive policies tailored to provide rich urban greenery in a neighborhood can alleviate urban land use effects on health risks.