The purpose of the study is to investigate whether higher prevalence of place-based structural determinants of health inequity is directly associated with frequent utilization of services in the emergency department. Chi-square and t-test analyses found that compared to non-frequent ED users, frequent ED users were older (mean age 43.18 vs. 35.23, p<0.001), more commonly Black or African American (65.13% vs. 52.36%, p<0.001), more commonly covered by public insurance [Medicaid (50.62% vs. 36.66%, p<0.001) or Medicare (15.45% vs. 11.41%, p<0.001)] and more commonly unemployed (41.04% vs. 33.09%, p<0.001). Multivariate logistic regression analysis demonstrated that several person-level factors, age of sixty years and older (OR: 3.57; CI [3.38-3.77]), female gender (OR: 1.40; CI [1.32-1.48]), and history of chronic pain (OR: 1.30; CI [1.13-1.50]) significantly increased the likelihood of being diagnosed in the ED with an ACSC (Table 9). Finally, multivariate logistic regression analysis also demonstrated that both person-level factors---homelessness (OR: 3.74; CI [2.35-5.95]), history of abuse (OR: 1.79; CI [1.54-2.09]), and history of substance use disorder (OR: 1.53; CI [1.37- 1.69])---and place-level factors with housing instability (1.36; CI [1.33-1.39]) were associated with frequent ED utilization. Using multilevel analysis, compared to within census tracts, the variance between census tracts was found to be greater (3.29 vs. 0.046). In conclusion, there is some evidence that residing in an area with greater prevalence of a social need domain, specifically housing instability, is associated with increased utilization of ED services.